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O'Malley administration settles suit over Medicaid backlog

The O'Malley administration has settled a class action lawsuit brought by critics who accused the state of failing low-income and disabled Marylanders by regularly taking nearly a year to approve medical assistance applications as part of a severe backlog.

The settlement means the Maryland Department of Human Resources will process claims faster and work to eliminate a backlog of more than 9,000 delayed cases, according to the Public Justice Center, the Homeless Persons Representation Project and the National Center for Law and Economic Justice, the organizations that filed suit.


"Imagine being sick and getting sicker, and not being able to go see a doctor because you can't pay," Camilla Roberson, staff attorney at the Public Justice Center, said in a statement. "Now, timely processing will at least eliminate one of the barriers to healthcare that low-income, vulnerable individuals have been facing for years."

The lawsuit, which the advocacy groups filed in January in Baltimore Circuit Court on behalf of nearly 10,000 disabled adults, sought to force the Department of Human Resources to approve the Medicaid applications within 60 days, as required by state law. The advocates alleged that nearly 46 percent of applications in 2012 were illegally delayed.


Ted Dallas, the state's secretary of human resources and member of Gov. Martin O'Malley's Cabinet, said the administration agreed to the settlement because his agency was already working to reduce the backlog.

Under the settlement agreement, the department agrees to eliminate the backlog of pending applications by Jan. 15, Dallas said in a statement. Already this year, the agency has reduced the backlog to 5,245 cases, a decrease of 66 percent, he added.

"These cases are, by their very nature, complex determinations of eligibility that involve medical determinations by doctors and significant documentation from the applicant, which can be difficult to collect," Dallas said.

Dallas added that portions of federal health care reform that become effective in January 2014 will simplify the application process with changes to the documentation requirements.

The Morning Sun


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The advocacy groups said they will monitor the agency's progress closely.

"This is an important first step," Mary Lou Magee-Kern, a 47-year-old Reisterstown woman who was the lead plaintiff and lost health insurance when her husband was laid off, said in a statement. "Now people won't be waiting months or years and getting sicker and sicker like me, just to find out if they have Medicaid."

When the suit was filed, Magee-Kern had been waiting more than 230 days for the state to approve her application, according to the suit. Magee-Kern first filed her application for medical assistance May 29. She received two letters from the state, dated June 28 and July 30, that indicated "an agency delay has occurred."

As a result, Magee-Kern hadn't been able to get treatment by specialists — except when hospitalized — for kidney failure, diabetes and hypertension, among other ailments. Within two days of the case being filed, Magee-Kern's application was processed and she was found eligible for Medicaid, according to the advocacy groups.


Baltimore Sun reporter Yvonne Wenger contributed to this article.