In an important decision protecting the due process rights of beneficiaries of public health programs, the U.S. Court of Appeals for the Second Circuit held last week in Bellin v. Zucker that a Medicaid beneficiary who was denied the right to appeal her initial allotment of personal care hours may proceed with her case. A lower court had ruled that Ms. Bellin, a New York resident who wanted to appeal for more personal care services, had no constitutionally protected interest in a particular number of care hours. It therefore dismissed her claim. The Second Circuit, however, found plausible allegations that official discretion regarding initial personal care hour determinations is “meaningfully channeled,” potentially creating an interest in those benefits that cannot be denied without an opportunity to appeal.
Citing a case brought by the Center, the court explained that “a protected property interest can arise in a number of ways and…it is important for district courts to consider the details of the administrative scheme—and the allegations regarding those details—before relying on general discretion-granting regulations to dismiss procedural due process claims.” Thus, while affirming the dismissal of Ms. Bellin’s statutory claims, it remanded her constitutional claim to the district court for further proceedings.
Like the Center’s pending Alexander v. Azar case, seeking the right to appeal for hospitalized Medicare beneficiaries placed on “observation status,” Bellin involves due process protections for people who rely on public health programs such as Medicare and Medicaid. The Center co-authored an amicus brief with the National Health Law Program and Justice in Aging in support of Ms. Bellin, explaining why she had stated a valid constitutional due process claim.
Also last week, the U.S. Court of Appeals for the Seventh Circuit ruled in Talevski v. Health and Hospital Corp. of Marion County, that residents of state-run nursing homes may enforce their rights in court under the Nursing Home Reform Act (NHRA). Joining the Third and Ninth Circuits, the Seventh Circuit held that the NHRA, which establishes minimum standards of care and includes a “Residents’ Bill of Rights,” provides a private right of action allowing individuals to sue their nursing homes for violations of the statute. The resident involved in the case brought claims involving the right to be free from chemical restraints and the right not to be transferred or discharged unless certain criteria are met. He may now pursue those claims.
Talevski marks a victory for nursing home residents, as the mere existence of rights in the law is not sufficient and regulatory oversight of nursing homes has proven to be inadequate. Residents must be able to go to court to hold nursing homes accountable. The Center joined AARP, the National Consumer Voice for Quality Long-Term Care, and other advocates in an amicus brief submitted in support of the resident who brought the case.
August 5, 2021 – A. Bers