Lawsuit: Idaho Medicaid changes violate due process rights

Twelve people with disabilities filed a class action lawsuit against the state of Idaho last month, arguing that the state violated federal law by cutting Medicaid benefits without providing a fair process for allowing them to appeal the changes.

Tan paper cut in shape of Idaho
News from Idaho

For some of the plaintiffs, who are represented by an Idaho Legal Aid attorney, the cuts were by as much as 42 percent.

The state is refusing to disclose its budget-setting methodology for individual recipients, calling it a “trade secret,” according to an Idaho Statesman article. Therefore, the individuals have little grounds to “discover or confront the evidence against them.”

A variety of other procedural safeguards were also removed at the beginning of January, according to the lawsuit. If the individual’s plans exceed their initial budget, the state is no longer required to do a clinical review of the recipient, only a review of services in cases of “medical necessity.”

“The methodology itself is a black box to these participants and their attorneys and advocates—no different than a hat from which (the Idaho Department of Health and Welfare) magically pulls dollar figures,” according to the lawsuit.

The Medicaid Act “requires that individual budgets be subject to modification for other reasons beyond just medical reasons,” such as changes in functional status and living situations. Many of the individuals require 24-hour supervision, and without the Medicaid benefits are at risk of having to leave their homes and transfer to institutional settings.

The U.S. District Court for the District of Idaho has ordered the state to temporarily restore the recipients’ benefits, pending a hearing, according to an Associated Press article.