Opinion
Civil Action No.: 5:92-0731
October 28, 1994
Michael Miskoviec, West Virginia Legal Services Plan, Charleston, West Virginia, John S. Whitelaw, APPALRED, Beckley, West Virginia, Counsel for Plaintiffs.
Thomas M. Woodward, Deputy Attorney General, State Capitol Complex, Charleston, West Virginia, Counsel for Defendant.
ORDER
Came the parties, by counsel, and informed the Court that they had reached an agreement regarding the Notice to the class members of this action, said Notice being required by this Court in its Memorandum Opinion and Order entered on September 23, 1994. The Court, having reviewed the parties' agreement as to Notice, does accept said agreement and accordingly Orders as follows:
1. All class members who have an active AFDC-related Medicaid case) including those individuals previously identified by the Defendant as affected by this action, will be evaluated at their scheduled six (6) month review pursuant to the methodology set forth in this Court's Order of October 20, 1994. Each class members' case will be reviewed from May 1, 1990, forward.
2. The Defendant will identify all inactive AFDC-related Medicaid cases filed within three years of the entry of this Order. The Defendant will mail a Notice to each applicant household identified by this search. The Notice to be mailed to these class members is attached hereto as Annex A.
3. Each person notified by mail will have 63 days from the date of the mailing of the Notice to either return the bottom portion of the Notice that requests a reevaluation or to call their local DHHR office and request a reevaluation. Any class member who does not receive their Notice in time to have a 60 day period to respond may contact their local DHHR office with proof of the date that they received the Notice and they will be allowed 60 days from receipt to make their request.
4. The Notice will go out in three separate mailings 30 days apart.
5. In the Notice, a name and telephone number of the county Richardson point of contact will be provided. In some large counties this may be more than one person. In small counties that have combined offices, one point of contact may handle two counties. Each class member who receives a Notice will also receive a list of legal aid offices and their telephone numbers.
6. The Department will conduct training for each person serving as aRichardson point of contact. These persons will be required to maintain a log of everyone requesting a reevaluation.
7. In addition to individual Notices, the Defendant will post a copy of the Notice attached hereto as Annex B at each county office as well as publish said Notice as a legal advertisement in the local paper of the ten largest cities in the State.
The Defendant is further Ordered to process for payment through its Medicaid program all medical bills of affected class members that would now be appropriate for payment under the methodology set forth in this Court's order of October 20, 1994, even if such medical bills are more than 12 months old.
IMPORTANT NOTICE
According to our records, you applied for Medicaid benefits in the past while you were living with minor children. If any of the children in your household had income such as child support, Social Security or Black Lung survivor's benefits, your Medicaid eligibility may have been decided incorrectly. You may have been told that you or members of your family had to meet a higher spenddown or deductible than federal law allows. If you or someone in your family is currently receiving Medicaid, Medicaid will not be terminated as a result of this change.
A federal court has ruled in a case called Richardson v. Lewis that the West Virginia Department of Health and Human Resources must change the way it calculates Medicaid eligibility for households with children who have income. If you lived with children who had income when you applied for Medicaid, you may be eligible to have Medicaid pay unpaid previous medical expenses or reimburse you or your family for medical expenses you paid. You may also be eligible for Medicaid now.
To have your previous Medicaid application reviewed to see if you qualify, you must return the enclosed form to your local Department of Health and Human Resources office or contact your local welfare office. If you choose to contact your local office, please make sure you tell them you are inquiring about the Richardson notice. Enclosed with this notice is a list of Richardson contact persons and free legal assistance agencies.
To be eligible for a reevaluation you must respond within sixty days of receipt of this notice. We will assume you receive this notice three days after the date on the notice unless you provide us with evidence such as a post marked envelope that shows you received the notice later.
Name: _____________________________ SSN:_______________
Address: _______________________________
Telephone No.: ____________________________
NOTICE
If you applied for Medicaid benefits after May 1, 1990, because you had dependant children and you were required to meet a spenddown, you may be eligible to be reimbursed for medical expenses you paid or to have unpaid medical bills processed for payment through the State's Medicaid programs. Because of a lawsuit named Richardson v. Lewis, the Department of Health and Human Resources cannot count the income of children in determining Medicaid eligibility of parents and siblings. If you wish to have your case evaluated, you must contact your local Department of Health and Human Resources Office on or before ___________________ ____. When contacting the Department, please be sure to mention that you are aRichardson class member.