Federal court certifies class action for seniors applying to Medicaid

On March 29, 2018, the Federal District Court in Chicago in Koss v. Norwood, certified a class of members who applied for nursing home coverage and have not received a final eligibility determination or a notice of an opportunity for a hearing within 45 days of the date of application in non-disability cases or 90 days in disability cases. Then the court ordered the State to:

• Determine, on or before June 28, 2018, the eligibility of Class Members for the long-term care Medicaid benefits for which they have applied;
• Implement policies and processes to ensure that the defendants prospectively comply with the Medicaid Act’s deadlines for eligibility determination found in 42 U.S.C. § 1396a(a)(8) and 42 C.F.R. 435.912;
  
• Beginning June 28, 2018, pay the long-term care and other Medicaid benefits to (or for the benefit of) Class Members while their applications remain pending beyond the Medicaid Act’s deadlines for eligibility determination.

• Medicare, the health coverage for seniors, offers only limited coverage for extended care or nursing homes. Senior must use private, separately purchase long-term care insurance, or spend down their asets. Medicaid will cover this care only when the senior has impoverished his or her assets. The application for medicaid is complicated, but an experienced attorney can preserve some of your loved-one's assets and thus improve the quality of life while under care. Prior to the Koss case, the State was taking too long to approve Meidcaid applications.