Padron v. Feaver

180 F.R.D. 448, 1998 U.S. Dist. LEXIS 8557, 1998 WL 303958
CourtDistrict Court, S.D. Florida
DecidedMay 20, 1998
DocketNo. 97-2883 CIV
StatusPublished
Cited by3 cases

This text of 180 F.R.D. 448 (Padron v. Feaver) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Padron v. Feaver, 180 F.R.D. 448, 1998 U.S. Dist. LEXIS 8557, 1998 WL 303958 (S.D. Fla. 1998).

Opinion

ORDER RE PENDING MOTIONS

BROWN, United States Magistrate Judge.

The following matters are pending1 before this Court: Defendants’ Motion to Dismiss Plaintiffs’ Complaint for mootness and failure to state a cause-of action, pursuant to Fed. R.Civ.P., 12(b)(6); Plaintiffs’ Motion to Certify the Class, pursuant to Fed.R.Civ.P., 23(b)(2); and Defendants’ Ore Tenus Motion to Abate. This Court having reviewed these Motions, Plaintiffs’ and Defendants’ respective Oppositions to these Motions, and all the pertinent portions of the record, and having heard argument of counsel at a hearing held on February 26, 1998, FINDS AS FOLLOWS:

FACTS

Plaintiffs Antonia C. Padrón (“Padrón”) and Enrique Reyna (“Reyna”) are indigent, disabled individuals whose applications with the U.S. Social Security Administration (SSA) for federal Supplementary Security Income (SSI) benefits, pursuant to 42 U.S.C. § 1381, et seq.; 20 C.F.R. Part 416 were respectively denied on June 20, 1997 and, or [450]*450about December 30, 1996, due to their U.S. immigration status as parolees. However, under Florida law disabled indigents who are ineligible for federal SSI benefits, but who meet certain income/asset criteria may still be eligible for joint federal/state Medicaid benefits under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. FlaStat. § 409.904(1). Under the current federal/state regulatory framework, an application for SSI may also serve as an application for federal/state Medicaid benefits. Thus, when an applicant applies for Medicaid by means of an application for SSI, the SSA determines whether the applicant is disabled, or otherwise eligible and pursuant to an agreement 2 between the State of Florida, acting through the Department of Children and Family Services (DCFS) and the SSA. If that applicant is found eligible for SSI, the SSA will also make the determination of Medicaid eligibility. 20 C.F.R. § 416.2101 et seq.

However, if the applicant is found by the SSA to be ineligible for SSI, under the present regulatory arrangement the SSA does not provide the applicant with any notice regarding his/her pending federal/state Medicaid application. Instead the SSA, via its data exchange system (SDX/BENDEX), refers the Medicaid application directly to DCFS in order for it to determine eligibility. The SSA also provides DCFS with all information relevant to the Medicaid application including the reason for SSI denial 20 C.F.R. §§ 416.2116, 416.2145; 1634 Agreement.

The practice at issue involves the fact that following the SSA’s referral of the Medicaid application, DCFS takes absolutely no action; 1. e., it does not notify applicants of the referral and/or their federal appeal rights, or request any additional information requisite to the processing of these applications, nor does it make eligibility decisions on these referrals on a timely basis. Pursuant to current statutory requirements, once an application for Medicaid is filed, federal law mandates the state to render assistance with reasonable promptness and in a manner consistent with the best interests of the recipients. 42 U.S.C. § 1396a(a)(8), (a)(19).

Regarding disabled applicants, reasonable promptness is defined as a ninety day maximum response time, and this time standard can only be exceeded in “unusual circumstances.” 42 C.F.R. §§ 435.911(c), (d). Moreover, upon making an eligibility decision, an agency “must send each applicant a written notice of the agency’s decision ... and, if eligibility is denied, the reasons for the action, the specific regulations supporting the action and an explanation of his/her right to request a hearing.” 42 C.F.R. § 435.912. Furthermore, applicants must be provided with an opportunity for a fair hearing if their application is not acted on with reasonable promptness. 42 U.S.C. § 1396a(a)(3).

Recently, DCFS commenced preliminary efforts to implement a new remedial rule in an effort to rectify these discrepancies. Nevertheless, the new rule, even if adopted, still fails to meet Defendants’ prescribed statutory/regulatory duties and at present there is no definite date as to when the new rule would be implemented. Moreover, the proposed rule contains no guarantees that Plaintiffs, who have already waited far beyond the statutory time limit for their Medicaid applications to be processed, will receive any priority, or expedited processing. Furthermore, despite Plaintiffs’ requests Defendants have refused to adopt any rule on a priority, or emergency basis. Plaintiffs also assert that the State of Florida Agency for Health Care Administration (AHCA), the state agency responsible for the administration of Title XIX of the Social Security Act, was aware of, and approved of, the aforementioned practice and took no action to halt, or eliminate this practice. Fla.Stat. § 409.901(2), (14).

Accordingly, on September 9, 1997 Plaintiffs sought declaratory and injunctive relief3 on behalf of themselves and all others similarly situated as a class action pursuant to Fed.R.Civ.P., 23(b)(2). Plaintiffs sought to present a class consisting of all persons in the State of Florida who applied for and who [451]*451have been denied SSI benefits on, or after August 22,1996 and who have been negatively impacted by the Defendants’ failure to process their applications for Medicaid in accordance with the requirements of federal law and the Fourteenth Amendment of the U.S. Constitution.

On September 23, 1997, the parties filed a joint stipulation re: Withdrawal of Plaintiffs’ Motion for Preliminary Injunction which was followed on October 31, 1997 by a Joint Motion for Order of Abatement of Action and Stipulation which abated this action until December 16, 1997.4 Under the terms of the joint stipulation, the Defendants agreed to notify, on, or before October 1, 1997,5 “all persons in the State of Florida who were denied SSI benefits on August 22, 1996, or later, and who have not thereafter had their eligibility for Medicaid benefits determined by the Defendants,”6 that they had pending Medicaid applications.

It was further stipulated that Defendants would either “(a) process those persons’ applications and within thirty days provide them with a notice of eligibility for benefits, or denial, or (b) request any additional information and then, within thirty days after being provided with said information, process those applications according to the information provided, and provide [the applicants] with a notice of eligibility for Medicaid benefits, or a denial.”

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Hernandez v. Medows
209 F.R.D. 665 (S.D. Florida, 2002)

Cite This Page — Counsel Stack

Bluebook (online)
180 F.R.D. 448, 1998 U.S. Dist. LEXIS 8557, 1998 WL 303958, Counsel Stack Legal Research, https://law.counselstack.com/opinion/padron-v-feaver-flsd-1998.