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Friday, March 29, 2024 | Back issues
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Medicaid Hearing Lags Land NY State in Court

MANHATTAN (CN) - New York State must face a class action against thousands Medicaid recipients forced to wait too long to fight the denials of their coverage, a federal judge ruled.

Marie Menking, 91, spent about a year as an inpatient at upper Manhattan's Fort Tryon Center, which she tried to get reimbursed through her Medicaid coverage.

New York State's Office of Temporary and Disability Assistance, or OTNA, denied that request on Aug. 23, 2007.

Menking says that she appealed her denial on time, but OTNA dragged its feet 106 days before sending her a Notice of Fair Hearing that initiates the process.

State law required them to hand her down a decision within 90 days.

After an adjournment at her request, Menking argued her case a little more than a year later, but she says the agency would not return a decision until she took them to court.

By April 27, 2009, the day she filed her complaint, the nonagenarian said that the department left her waiting 298 days.

On Friday, U.S. District Judge Loretta Preska ruled that Menking could pursue a class action against Dr. Richard Daines, Commissioner of the New York State Department of Health, and David Hansel, head of OTNA.

Her class includes "[a]ll current and future New York State applicants for or recipients of Federal Medicaid who have requested or will request fair hearings for whom Defendants fail to render a fair hearing decision within ninety days from the date of the request, excluding adjournments requested by the appellant."

According to Preska's order, U.S. Magistrate Judge Ronald Ellis authored a report and recommendation about the case finding that roughly 12,000 fair hearing decisions had been issued late between 2006 and 2010.

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