Florida held 4% of hearings requested by people who lost their Medicaid benefits • Florida Phoenix

JACKSONVILLE — State agencies received more than 11,000 requests for hearings from people challenging the loss of Medicaid benefits between April of last year and May of this year, but held only 484 hearings, according to evidence filed in federal court Thursday.

The office that oversees hearings reversed the Florida Department of Children and Families’ decision to revoke people’s Medicaid benefits in just 52 appeals. At the time, DCF was reviewing the Medicaid eligibility of millions of people after the end of the COVID-19 public health emergency, making mistakes that led to children and postpartum women losing benefits.

About 70% of hearings were canceled after people who filed appeals withdrew them. Most of those people said DCF altered their records after they filed formal complaints, according to the data. But Brandy Jones, a supervisor in charge of hearing requests who testified Thursday, could not say whether people who withdrew their appeals did so because they had gotten their benefits back.

“I believe there is a part on the form to explain the withdrawal, but it is not required,” Jones said in court about a form people can fill out to withdraw their hearing request.

In short, the Office of the Inspector General, which acts as an arbiter between Floridians and DCF, doesn’t keep track of what happens to appeals that people drop or abandon. Thirty-three people work in that office, Jones said.

Jones is one of several state employees who have taken the stand in the federal class-action lawsuit filed by Medicaid patients who allege Florida violated their constitutional right to due process by removing their health care coverage without proper notice. Her testimony has provided insight into Florida’s management of the subsidized health care program through its notices and call center.

DCF blocked more than 700,000 calls in April from people who wanted to speak to a real person

How long does the appeal process take?

People who disagree with DCF’s decision to revoke their benefits can request a hearing, and the agency must provide them with a packet of information about their cases seven days before the hearing. But hearings can take time.

The state took two months to schedule a hearing for an Orlando woman who was wrongfully kicked off Medicaid by DCF when she was seven months pregnant, according to notices she received. The agency reinstated her benefits in August.

If someone has an urgent medical need, they can request an expedited hearing. The frequency of requests for expedited hearings has increased from one or two per month to 10 per week since the post-COVID eligibility review began, Jones said.

He suggested that the system works to the extent that customers know their rights.

“The number of appeals we receive shows that this is a well-known fact,” he said.

Writing the notices

But the agency has changed the wording describing the right to a fair hearing in the notices it sends to people. DCF must provide continued Medicaid coverage to people who appeal. Previous notices indicated that people would have to reimburse the state for coverage provided during that time if they did not win the appeal.

In October, the statement was amended to say that benefits may have to be repaid, but that sentence was changed only in the footer of the notice. It took until April for the agency to make that change to the entire notice.

The trial is set to end Friday, but the presiding judge, U.S. District Judge Marcia Morales Howard, indicated Thursday that the dispute will not be resolved anytime soon.

“I just want to make sure that when this gets to the Court of Appeals, we have an appeal record,” he told the attorneys, referring to the labeling of the evidence. Attorneys from the Florida Health Justice Project and the National Health Law Program are representing the plaintiffs.

If the plaintiffs are successful, everyone the state kicked off of Medicaid without proper notice could get their coverage back. About 1.9 million people have lost Medicaid benefits in Florida, according to KFF’s status tracker.