Medicaid Recipients' Class Action Against Washington State on 'Shared Living' Rule Cannot Proceed

A U.S. district court finds that Washington State is entitled to summary judgment in a lawsuit by a group of disabled Medicaid recipients and Medicaid providers challenging the state's rule automatically reducing benefits to recipients with live-in caregivers. Pfaff v. Washington (U.S. Dist. Ct., W.D. Washington, Nos. C07-5280RJB, C07-5306RJB, Dec. 8, 2008).

A Washington State regulation reduced in-home personal care services given to disabled Medicaid recipients by 15 percent if the recipients lived with their paid caregivers. The Washington Supreme Court found the "shared living" rule invalid in Jenkins v. Dep't of Social & Health Services (Wa., Nos. 78652-6 & 78931-2, May 3, 2007). The rule was later repealed.

A group of disabled individuals and Medicaid providers filed a class action lawsuit in federal court claiming the rule violated discrimination law, Medicaid comparability requirements, Medicaid's choice of provider rule, and equal protection and due process laws, among other things. The class asked for damages for violations of Medicaid law under 42 U.S.C. § 1983, but the district court dismissed those claims, holding that the state was entitled to qualified immunity. Both parties asked for summary judgment on the remaining claims.

The U.S. District Court for the Western District of Washington grants summary judgment to the state. The court finds that the rule did not violate discrimination law because it denied benefits based on the provider's residence, not based on disability. The court holds that there is no private right of action under the Medicaid comparability statute or choice of provider rules. The court also rules that the state is entitled to qualified immunity on the due process and equal protection claims.

For the full text of this decision, go to: https://attorney.elderlawanswers.com/pfaff-v-washington-us-dist-ct-wd-washington-nos-c07-5280rjb-c07-5306rjb-dec-8-2008-7350

Did you know that the ElderLawAnswers database now contains summaries of more than 1,500 fully searchable elder law decisions dating back to 1993? To search the database, click here.