Friday, December 2, 2022
HomeHealth & FitnessSupreme Court to hear Indiana nursing home case involving Medicaid benefits

Supreme Court to hear Indiana nursing home case involving Medicaid benefits

When Susie Talevski sued the agency that cared for her elderly father before his death, she wanted justice for her family. She did not expect that the case would develop into a national bellwether. A ruling against her could strip millions of vulnerable Americans of the power to hold states accountable when they do not receive benefits that are legally allowed.

Talevski, a resident of Valparaiso, Indiana, said: He lived to care for his dementia.

“He went from being able to walk and talk … to being immobile,” Talevski said. “[The nursing home] treated my father like garbage, like dogs. In fact, dogs were treated better than that.”

In court documents, the Talevski family alleges that Gorgi Talevski Overdosing on medication to keep him asleep, his dementia not being properly controlled, and his involuntary transfers to different facilities hours away from home accelerated his decline. Her father died a year ago in October.

Talevski sued the Marion County Health and Hospitals Corporation, the Indiana public health agency that owns the nursing facility. The agency, known as HHC, declined to comment on the case but denied any wrongdoing. In court documents, it argues that Gorgi Talevski was violent and sexually aggressive, which affected his care. It sought to dismiss the case, saying Talevski had no standing to sue. But the federal court said the lawsuit could move forward.

So the public health agency made an unexpected move. It takes the case to the nation’s highest court and asks a sweeping question: whether people who rely on programs partially funded by the federal government — such as Medicaid and programs that provide nutrition, housing and disability services — should be allowed to sue states when they When they believe their rights have been violated?

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A ruling in favor of HHC could mean that millions of Americans who depend on federal aid programs lose that right. The Supreme Court is scheduled to hear oral arguments on Nov. 8. “Without a real enforcement mechanism, these programs really come to the fore.”

Marion County’s HHC owns and operates 78 in Indiana in a public-private partnership with American Senior The answer to the question of whether people who rely on federal aid programs can sue for rights violations has been settled for decades, said Perkins, who has litigated numerous civil rights cases. Litigated Medicaid beneficiaries.

So she was shocked to learn that the Supreme Court had chosen to hear the case. The Supreme Court is asked to review nearly 7,000 cases a year, and they typically agree to hear only 1%-2% of them.

Perkins said she sees parallels in the case to a recent Supreme Court ruling that struck down the constitutional right to abortion.

“The question of whether the court will take this case and accept that you can enforce these laws is worrying,” Perkins said. “Recent court decisions — Dobbs in abortion case to mind — show that courts are willing to set aside precedent.”

Now that the Supreme Court has agreed to hear the case, at least 25 entities have filed Friends statement, which provides court information from people not directly involved in the case. Most are on Talevskis’ side — including members of Congress including House Speaker Nancy Pelosi (D-Calif.) and Majority Whip James Clyburn (DS.C.), AARP, American Cancer Network, American Public Health Association and Children’s Medical Health care providers and advocates. Marion County HHC will be represented by Lawrence Robbins, who argued 19 cases before the Supreme Court and was confirmed by Judge Brett Kavanagh Representing Christine Blasey Ford at the hearing. Talevski will be represented by Andrew Tutt of Arnold & Porter. Most recently, Tutt argued and won a Supreme Court case upholding the reemployment rights of thousands of veterans and active-duty military personnel.

Programs that rely on federal funds flowing from Congress to the states, such as Medicaid, typically come with a set of rules or requirements that states follow when receiving and using funds. Civil rights litigation is one of the primary enforcement mechanisms by which beneficiaries of these programs must hold state agencies accountable if they violate their rights or fail to provide due services.

There are other forms of oversight, which supporters of the Indiana agency petition have touted as viable alternatives to litigation. One is federal oversight by the Department of Health and Human Services. The agency can investigate and threaten to withhold funding for state programs that do not comply with federal regulations. But this often involves a lengthy legal process that can backfire, delaying the benefit of individual patients rather than helping them.

“If [HHS] tried to shut down funding, the state could take them immediately,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. The court and obtained an injunction, “concluding that withholding federal funding would cause irreparable harm. “People [would be] not getting their benefits at all, or providers not getting paid for them at all.

Former top HHS officials say federal oversight is not enough and civil rights litigation remains an important enforcement mechanism. Private enforcement through lawsuits is not an option for nursing home residents, they say Indispensable, especially in a place like Indiana with the largest number of nursing homes in the state.

Supporting HHC may increase the risk of waste, fraud, and misuse of Medicaid funds, leading to widespread poor enforcement, And make “millions of individuals, providers, and other beneficiaries more vulnerable to violations of their statutory rights. “

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Nearly 83 million Americans, a quarter of the U.S. population, are enrolled in Medicaid. That means HHS oversees more than $500 billion in spending across all states and U.S. territories—a federal agency that, according to former officials, Lacks the logistical and practical capacity to “meaningfully remediate individual violations in many cases.”

Indiana Attorney General Todd Rokita is one of the allies who have spoken out in favor of the state’s views Rokita said in a court briefing with 21 other Republican attorneys general that the civil rights lawsuits that burden states and cripple them with legal fees are meant to add to lawyers’ pockets, not enroll in Medicaid

“In the past three years alone, 1,200 civil rights lawsuits have been filed in the state,” Rokita said in a written statement.

Legal experts told Side Effects that the numbers Rokita cites are extremely misleading because it lumps together all civil rights lawsuits, not just those related to the federal rights program that is at the heart of the case.

If the Supreme Court rules in favor of HHC, a lawsuit like the one that won Medicaid recipients’ right to expensive hepatitis C drugs in 2015 may not be possible in the future, says Emily Munson, She is an attorney for Indiana Disability Advocates.

Civil rights lawsuits help patients access things like family support as states try to limit benefits for people with disabilities in Indiana and nationwide A day-to-day task called nursing.

Munson has filed a similar case. She has a disability herself and the prospect of the Supreme Court ruling in favor of Marion County terrifies her.

“I depend on Medicaid for care and wheelchair repairs,” Monson said, “and losing the ability to go to federal court if needed is pretty scary. “

The landmark case was not on the agenda at the most recent HHC board meeting in mid-October. But when the meeting was open for comment, state representatives, patients and Advocates seized the opportunity to voice their concerns.

They have one demand on the agency: withdraw its Supreme Court petition.

State Rep. Robin Shackleford, D-Ind., and others in the Legislature voiced their concerns. Shackleford said many of her constituents are enrolled in Medicaid and SNAP, the Department of Agriculture’s supplemental nutrition program.” Shackleford Coleford said.

This story is part of a partnership that includes Side Effects Public Media — a public health journalism initiative based on WFYI, NPR, and KHN.

Kaiser Health News is a national health policy news service. It is an independent editorial project of the Henry J. Kaiser Family Foundation and is not affiliated with Kaiser Permanente.

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