Case: A.M.T. v. Gargano

1:10-cv-00358 | U.S. District Court for the Southern District of Indiana

Filed Date: March 25, 2010

Case Ongoing

Clearinghouse coding complete

Case Summary

On March 25, 2010, this class-action lawsuit was filed in the United States District Court for the Southern District of Indiana against the Secretary of the Indiana Family and Social Services Administration (FSSA) and the Director of the Office of Medicaid Policy and Planning of FSSA. The named plaintiffs were minor Medicaid recipients with serious disabilities who had been receiving medically-necessary therapies, paid for by the State's Medicaid program and administered by the FSAA. The FSSA h…

On March 25, 2010, this class-action lawsuit was filed in the United States District Court for the Southern District of Indiana against the Secretary of the Indiana Family and Social Services Administration (FSSA) and the Director of the Office of Medicaid Policy and Planning of FSSA. The named plaintiffs were minor Medicaid recipients with serious disabilities who had been receiving medically-necessary therapies, paid for by the State's Medicaid program and administered by the FSAA. The FSSA had denied the named plaintiffs and others similarly situated individuals continued access to these therapies. It cited two provisions of the Indiana Administrative Code, one of which limited the provisions of these therapies to two years unless patients demonstrated significant progress to a "higher functional state," and the other which generally prohibited all "maintenance therapies," i.e. therapies designed to prevent deterioration rather than improve a patient's condition. The plaintiffs filed suit pursuant to 42 U.S.C. § 1983 and argued that the FSSA's refusal to provide the therapies unlawfully violated Title XIX of the Social Security Act, 42 U.S.C. § 1396, et seq. (the "Medicaid Act" or the "Act"), which require states that participate in Medicaid to provide early screening, physical therapy and related services, and preventative services, respectively.

The plaintiffs sought preliminary and permanent injunctive relief to enjoin the defendants from refusing or limiting Medicaid coverage for therapies recommended or prescribed by a Medicaid recipient's physician, and preventing the enforcement of both of the contested provisions of the Indiana Administrative Code. The plaintiffs also sought legal costs and attorneys' fees.

On September 20, 2010, the parties filed a joint stipulation, wherein the defendants agreed to provide the named plaintiffs with funding for their therapies while the case awaited its final outcome. This was in lieu of a preliminary injunction.

On October 1, 2010, the plaintiffs, upon order from the court, filed a document clarifying their claim that the FSSA had violated federal Medicaid law. The following day the plaintiffs filed an amended complaint integrating these changes.

On November 22, 2010, the Judge Jane Magnus-Stinson certified the plaintiff class. The class was defined as: "Any and all persons in Indiana who are or will be enrolled in the Medicaid program and who are or will be under the age of twenty-one (21) who have been or will be denied coverage for physical therapy, occupational therapy, respiratory therapy, and/or speech pathology (“therapies”), or who have had or will have coverage for these therapies otherwise limited, which denial or limitation is based upon 405 IAC 5-22-6(b)(6) and/or 405 IAC 5-22-6(b)(7), notwithstanding the fact that a physician acting within the scope of his or her practice under Indiana law has or will recommend and/or prescribe these therapies for the Medicaid recipient." A.M.T. v. Gargano, 2010 WL 4860119 (S.D. Ind. 2010).

On February 10, 2011, the Court granted summary judgment in favor of the plaintiffs, issuing a permanent injunction preventing the defendants and their successors from limiting or denying coverage for prescribed physical, occupational, or respiratory therapy, and/or speech pathology, for any person under 21 enrolled in the State's Medicaid program when such denial or limitation was based upon the two disputed provisions of the Indiana Administrative Code (405 I.A.C. 5-22-6(b)(6) and (b)(7).) The Court denied the plaintiffs' request for attorneys' fees and costs. A.M.T. v. Gargano, 781 F. Supp. 2d 798 (S.D. Ind. 2011)

On February 23, 2011, the plaintiffs filed a motion to amend the final judgment and for attorneys' fees and costs. On June 9, 2011, they withdrew this motion, "the parties having resolved the matters without the necessity of Court intervention." The docket reflects no further litigation activity after June 10, 2011, and the case is now closed.

Summary Authors

Alex Colbert-Taylor (8/7/2013)

Eva Richardson (6/8/2020)

People

For PACER's information on parties and their attrorneys, see: https://www.courtlistener.com/docket/4867621/parties/amt-v-murphy/


Judge(s)

Baker, Tim A. (Indiana)

Magnus-Stinson, Jane Elizabeth (Indiana)

Attorneys(s) for Plaintiff

Falk, Kenneth J. (Indiana)

Rose, Gavin Minor (Indiana)

Attorneys(s) for Defendant

Beaver, Eric James (Indiana)

Isenberg, Betsy M (Indiana)

Sullivan, Erica Sue (Indiana)

Judge(s)

Baker, Tim A. (Indiana)

Magnus-Stinson, Jane Elizabeth (Indiana)

Attorneys(s) for Plaintiff

Falk, Kenneth J. (Indiana)

Rose, Gavin Minor (Indiana)

Attorneys(s) for Defendant

Beaver, Eric James (Indiana)

Isenberg, Betsy M (Indiana)

Sullivan, Erica Sue (Indiana)

Documents in the Clearinghouse

Document

1:10-cv-00358

Docket [PACER]

A.M.T. v. Murphy

June 10, 2011

June 10, 2011

Docket
1

1:10-cv-00358

Class Action Complaint for Declaratory and Injunctive Relief

A.M.T. v. Murphy

March 25, 2010

March 25, 2010

Complaint
12

1:10-cv-00358

Motion for Preliminary Injunction

A.M.T. v. Murphy

March 25, 2010

March 25, 2010

Pleading / Motion / Brief
23

1:10-cv-00358

Memorandum of Law in Support of Plaintiffs' Motion for Preliminary Injunction

A.M.T. v. Murphy

April 16, 2010

April 16, 2010

Pleading / Motion / Brief
36

1:10-cv-00358

Stipulation

A.M.T. v. Murphy

May 21, 2010

May 21, 2010

Pleading / Motion / Brief
55

1:10-cv-00358

Second Stipulation

A.M.T. v. Murphy

Sept. 20, 2010

Sept. 20, 2010

Pleading / Motion / Brief
57

1:10-cv-00358

Order

A.M.T. v. Murphy

Sept. 28, 2010

Sept. 28, 2010

Order/Opinion
58

1:10-cv-00358

More Definite Statement Concerning Legal Claims

A.M.T. v. Murphy

Oct. 1, 2010

Oct. 1, 2010

Pleading / Motion / Brief
60

1:10-cv-00358

First Amended Class Action Complaint for Declaratory and Injunctive Relief

Oct. 11, 2010

Oct. 11, 2010

Complaint
84

1:10-cv-00358

Order on Defendants' Motion to Stay

A.M.T. v. Murphy

Nov. 12, 2010

Nov. 12, 2010

Order/Opinion

Resources

Docket

See docket on RECAP: https://www.courtlistener.com/docket/4867621/amt-v-murphy/

Last updated July 18, 2022, 3:05 a.m.

ECF Number Description Date Link Date / Link
87

ORDER CERTIFYING CLASS ACTION. For the reasons discussed herein, the Court GRANTS Plaintiffs' Motion to Certify Class. Class is certified as described in this Order. The Court hereby DESIGNATES A.M.T., J.J.M, and J.M.G. as the representative pl aintiffs for the certified class and, pursuant to Federal Rule of Civil Procedure 23(g), DESIGNATES Mr. Kenneth Falk and Mr. Gavin Rose as lead class counsel. The Court now ORDERS the parties to meet and confer with one another and, by December 3, 20 10, submit a joint report in this matter setting forth a proposed plan (or alternative plans) as to what notice, if any, should be provided to the class. Additionally, pursuant to docket entry 84, FSSA has until December 1, 2010 to file a response to Plaintiffs' Motion for Summary Judgment. See Order. Signed by Judge Jane Magnus-Stinson on 11/22/2010. (LBK)

Nov. 22, 2010

Nov. 22, 2010

Clearinghouse
99

ORDER granting in part and denying in part 64 Motion for Summary Judgment; denying 78 Motion for Judgment on the Pleadings; denying 91 alternative Motion. The Court denies pltfs request for attny fees. The Court grants pltfs request for permanent injunctive relief. Signed by Judge Jane Magnus-Stinson on 2/10/2011. (CBU)

Feb. 10, 2011

Feb. 10, 2011

RECAP
100

PERMANENT INJUNCTION and FINAL JUDGMENT -The Court enters Final Judgment in favor of pltfs and the class and against defts to the extent that pltfs sought relief in their Amended Complt. The Court Grants pltfs request for permanent injunction. Signed by Judge Jane Magnus-Stinson on 2/10/2011.(CBU)

Feb. 10, 2011

Feb. 10, 2011

RECAP

Case Details

State / Territory: Indiana

Case Type(s):

Public Benefits/Government Services

Special Collection(s):

Multi-LexSum (in sample)

Key Dates

Filing Date: March 25, 2010

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

All persons under the age of 21 in Indiana who are or will be enrolled in the Medicaid program and have been or will be denied coverage for physical therapy, occupational therapy, respiratory therapy, and/or speech pathology (“therapies”), or who have had or will have coverage for these therapies otherwise limited, notwithstanding the fact that a physician acting within the scope of their practice under Indiana law has or will recommend these therapies for the Medicaid recipient.

Plaintiff Type(s):

Private Plaintiff

Attorney Organizations:

ACLU Affiliates (any)

Public Interest Lawyer: Yes

Filed Pro Se: No

Class Action Sought: Yes

Class Action Outcome: Granted

Defendants

Indiana, State

Indiana, State

Defendant Type(s):

Hospital/Health Department

Jurisdiction-wide

Case Details

Causes of Action:

42 U.S.C. § 1983

Medicaid, 42 U.S.C §1396 (Title XIX of the Social Security Act)

Availably Documents:

Trial Court Docket

Complaint (any)

Injunctive (or Injunctive-like) Relief

Non-settlement Outcome

Any published opinion

Outcome

Prevailing Party: Plaintiff

Nature of Relief:

Injunction / Injunctive-like Settlement

Declaratory Judgment

Source of Relief:

Settlement

Litigation

Form of Settlement:

Private Settlement Agreement

Voluntary Dismissal

Amount Defendant Pays: Unknown

Content of Injunction:

Preliminary relief request withdrawn/mooted

Issues

General:

Habilitation (training/treatment)

Payment for care

Public benefits (includes, e.g., in-state tuition, govt. jobs)

Reassessment and care planning

Discrimination-basis:

Disability (inc. reasonable accommodations)

Disability:

disability, unspecified

Mental impairment

Mobility impairment

Mental Disability:

Cerebral palsy

Developmental disability without intellectual disability

Intellectual/developmental disability, unspecified

Medical/Mental Health:

Medical care, general

Medical care, unspecified

Mental health care, general

Mental health care, unspecified

Type of Facility:

Government-run

Benefit Source:

Medicaid