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Medicaid Recipient Cannot Bring Claim to Require State to Deduct Guardianship Fees

NEW YORK: The U.S. Court of Appeals for the Second Circuit holds that a Medicaid recipient who is under guardianship cannot bring a § 1983 claim to require the state to deduct guardianship fees from her available income. Backer v. Shah (U.S. Ct. App., 2nd Cir., No. 14-1367-cv, June 3, 2015).

Ms. Backer sued under 42 U.S.C. § 1983, alleging that the state violated 42 U.S.C. § 1396a(a)(19), which requires the state to ensure eligibility is determined in the best interest of the recipient, and 42 U.S.C. § 1396a(q)(1)(A), which requires the state to deduct a personal needs allowance. The district court dismissed the claim for lack of standing because Ms. Backer’s injury was solely attributable to her own action in paying her guardian instead of the nursing home, and Ms. Backer appealed.

The U.S. Court of Appeals, Second Circuit, affirms, holding that while Ms. Backer had standing to bring the claim, she did not allege a violation of a federal right that could be enforced through § 1983. The court rules that the provision requiring the state to ensure eligibility is determined in the best interest of the recipient could not be enforced through § 1983 because it does not provide a “workable standard for judicial decision making.” In addition, according to the court, the personal needs allowance section does not require the state to allow the deduction of guardianship fees.

For the full text of this decision, go to: http://cases.justia.com/federal/appellate-courts/ca2/14-1367/14-1367-2015-06-03.pdf?ts=1433341806

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