Tuesday, April 3, 2018

Update on Illinois Medicaid Pending Litigation

Rae Anne Davis

An important court decision was recently issued in Illinois.  Koss v. Norwood, was filed in April 2017 as an effort to create a class action lawsuit on behalf of Medicaid applicants for long term care benefits that are pending in Illinois. Last week a judge ruled that any Illinois resident who filed an application for Medicaid benefits after February 1st, 2015 and has not yet received a determination are now certified as part of the class action. This is an important procedural hurdle that allows the case to proceed.

The judge also issued the following three-part ruling on behalf of all class members:

  1. The state must determine eligibility for class members before June 28, 2018.
  2. The state has to draft new policies to ensure ongoing compliance with the existing 45- and 90-day deadlines already in place for Medicaid applicants for long term care.
  3. Starting June 28th, 2018, any Medicaid applicants for long term care whose application is pending beyond the 45- and 90- day deadlines, will now have presumptive eligibility, including for payment.

The state must provide an update on their efforts to comply with the ruling by the end of April.

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