No. 14-801 (D.Conn.), filed June 4, 2014
Issue: Whether the Secretary of Health & Human Services’ denial rate of about 98% at the lowest two levels of appeal in Medicare’s system of administrative review (redetermination and reconsideration) violates the Medicare statute and the Due Process Clause.
Relief sought: Declaratory and injunctive relief for a Connecticut class of Medicare beneficiaries who have received or will receive adverse redetermination and reconsideration decisions on their claims for coverage of home health care services.
Updated: November 12, 2014
Status: The complaint (here) and a motion for class certification with a supporting memorandum were filed on June 4, 2014. The Secretary filed a motion to dismiss instead of an answer, claiming that plaintiffs lacked standing and had failed to exhaust administrative remedies. That motion was argued on October 31, 2014. Plaintiffs’ motion for class certification, which is now fully briefed, has not yet been scheduled for argument. Plaintiffs served written discovery, which must be responded to in December.