Florida Medicaid beneficiaries sue state to receive home-based care

Sep 24 2008

Nearly 8,500 Florida Medicaid beneficiaries living in nursing homes have filed a federal class-action lawsuit claiming they are being forced to obtain care in nursing homes rather than in the community, the AP/Miami Herald reports.

Advocates say that nursing homes have sought to increase business by pressuring lawmakers to increase requirements for people seeking coverage of home-based care, according to the AP/Herald. The suit alleges that plaintiffs have been illegally forced to move into nursing homes when they should be able to live where they choose and receive community care.

According to the AP/Herald, Medicaid beneficiaries who are sick or disabled have little trouble getting admitted to nursing homes, but obtaining Medicaid services at home is "substantially harder and often involves a long waiting list," even though the latter may cost the government less. Advocates for the elderly point to a 1999 U.S. Supreme Court case known as the Olmstead case, in which the court ruled that the unjustified placement of individuals in institutions such as nursing homes amounted to discrimination. The decision stated that states must provide community care if it can be accommodated and would be appropriate.

The defendants named in the suit -- the Florida Agency for Health Care Administration, the Florida Department of Elder Affairs and Gov. Charlie Crist's (R) Office -- say the plaintiffs have not been able to prove that health care providers deemed community care appropriate for each patient. They wrote, "Plaintiffs are not alleging that Florida's Medicaid program has failed to cover their medically necessary services. Instead, plaintiffs want this court to second-guess the manner by which Florida's elected officials and policymakers have chosen to make those services available in light of the state's available resources" (Sedensky, AP/Miami Herald, 9/21).