Judge OKs settlement in medicaid class action

TALLAHASSEE , Fla. — A federal magistrate judge Tuesday approved a class-action lawsuit settlement requiring Florida’s Medicaid program to provide incontinence supplies to adults with disabilities.

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U.S. Magistrate Judge Patricia Barksdale issued a six-page order approving the settlement reached by lawyers for the state Agency for Health Care Administration and two women with disabilities and the advocacy group Disability Rights Florida.

The settlement had been in the works for more than a year, including the Agency for Health Care Administration going through a rule-making process to provide “medically necessary” incontinence supplies to adults, according to court documents.

“Through the proposed settlement, the plaintiffs will receive the relief they sued to obtain,” Barksdale wrote in Tuesday’s order. “Absent settlement, litigation would resume with its attendant cost, delay and risk. The proposed method of delivering relief to the class is effective; specifically, the ordinary process for obtaining Medicaid benefits and the provision of provider and plan alerts about the policy change.”

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A Jan. 17 joint motion that sought a preliminary review of the proposed settlement said the Agency for Health Care Administration adopted a final rule on providing incontinence supplies in December.

“In short, AHCA (the agency) intends to amend all AHCA policies, fee schedules, and administrative rules necessary … for the coverage of incontinence supplies,” the joint motion said. “If the rulemaking process and AHCA’s amendment of all policies, fee schedules, and administrative rules results in coverage of incontinence supplies, the parties agree that they will file a joint motion for voluntary dismissal of this litigation ‚,, and, upon order of the court, AHCA will pay plaintiffs $50,000 in full satisfaction of attorneys’ fees and costs.”

Barksdale’s order Tuesday directed the agency to pay $50,000 in attorney fees to the plaintiffs by Oct. 3 and said the parties must file a joint motion to dismiss the case by Sept. 10.

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The lawsuit, filed in July 2022, alleged the Medicaid program violated federal laws by denying coverage of incontinence supplies to adults with disabilities. The lawsuit was filed on behalf of Duval County resident Blanca Meza and St. Johns County resident Destiny Belanger, who are incontinent and unable to care for themselves, with Disability Rights Florida also a plaintiff.

U.S. District Judge Marcia Morales Howard in March 2023 certified the case as a class action. Morales Howard’s decision cited one estimate that at least 480 Medicaid beneficiaries a year turn 21 and lose coverage for incontinence supplies that they received as children. The state has provided the supplies, such as briefs, diapers and underpads, for Medicaid beneficiaries under age 21 and for certain adults, including people in nursing homes.

The lawsuit alleged that the state’s policy of not providing incontinence supplies to other adults violated federal Medicaid law and laws including the Americans with Disabilities Act. It said the state stopped providing the supplies to Meza and Belanger after they turned 21, though they were incontinent and unable to care for themselves.

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As an example of their disabilities, the lawsuit said Meza “is diagnosed with spastic quadriplegic cerebral palsy, muscle spasticity, neuromuscular scoliosis and partial epilepsy.”

“Plaintiffs are medically fragile adults each with bladder and bowel incontinence,” the lawsuit said. “As low-income Florida residents with significant disabilities, they receive their health services through Florida’s Medicaid program. Plaintiffs’ physicians have prescribed certain incontinence supplies, including briefs and underpads, as medically necessary to treat plaintiffs’ incontinence, keep their skin dry and clean, prevent skin breakdowns and infections and maintain their ability to live in the community.”

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