State Has Immunity in Lawsuit Alleging It Did Not Make Timely Medicaid Eligibility Determinations

A U.S. district court rules that in a lawsuit filed by a nursing home on behalf of residents, alleging that the state did not make timely Medicaid eligibility determinations, the state is immune from lawsuit because the nursing home was seeking retroactive relief. Wicomico Nursing Home v. Padilla (U.S. Dist. Ct., D. Md., No. RDB-16-1078, Aug. 7, 2017)

Wicomico Nursing Home filed a class action lawsuit on behalf of its residents against the secretary of the Maryland Department of Human Services and the secretary of the Maryland Department of Health, claiming that the state violated federal law by failing to issue timely Medicaid eligibility determinations. The nursing home also claimed that the state violated the residents' due process rights by permitting the delays to continue.

The state filed a motion to dismiss, arguing that it is entitled to sovereign immunity under the Eleventh Amendment because the nursing home was seeking retroactive relief. All of the residents whom the nursing home alleged were harmed are currently receiving Medicaid benefits or are deceased.

The U.S. District Court, District of Maryland, grants the motion to dismiss, holding that the state is immune because the nursing home residents are currently receiving Medicaid or are deceased. According to the court, even though the nursing home claimed "that they are seeking prospective relief, they are unable to demonstrate how the relief sought in this suit on behalf of these residents can be characterized as 'prospective.'" [emphasis in original] The court also rules that the nursing home has not proven that the state violated the residents' due process rights because the residents had access to an administrative procedure.

For the full text of this decision, go to: http://www2.mdd.uscourts.gov/Opinions/Opinions/Wicomico%20MEMO%20AND%20ORDER.pdf

Did you know that the ElderLawAnswers database now contains summaries of more than 2,000 fully searchable elder law decisions dating back to 1993? To search the database, click here.