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Case Name DeSario v. Thomas PB-CT-0006
Docket / Court 3:96-cv-00646-JBA ( D. Conn. )
State/Territory Connecticut
Case Type(s) Disability Rights-Pub. Accom.
Public Benefits / Government Services
Special Collection Olmstead Cases
Case Summary
On April 11, 1996, a group of Connecticut Medicaid recipients filed a lawsuit in the U.S. District Court for the District of Connecticut against the Connecticut Department of Social Services (DSS). The plaintiffs filed the lawsuit under the Medicaid Act, Title XIX of the Social Security Act (42 U.S. ... read more >
On April 11, 1996, a group of Connecticut Medicaid recipients filed a lawsuit in the U.S. District Court for the District of Connecticut against the Connecticut Department of Social Services (DSS). The plaintiffs filed the lawsuit under the Medicaid Act, Title XIX of the Social Security Act (42 U.S.C § 1396), as well as 42 U.S.C. § 1983 and the Due Process Clause of the Fourteenth Amendment. The plaintiffs alleged that the DSS had improperly administered Connecticut's Medicaid program with respect to the process by which payments of durable medical equipment (DME) are authorized. Specifically, the plaintiffs challenged two of defendant's regulations: one in which the defendant was permitted to deny coverage to plaintiffs for DME not included on the defendant's fee schedule; and one in which the defendant identified specific equipment as being categorically excluded from coverage, including, inter alia, air conditioners and room humidifiers. Plaintiffs sought an injunction, barring the DSS from applying the exclusive fee schedule to their requests for approval of DME and requiring the DSS to provide the medically necessary DME for which plaintiffs contend they are eligible.

On January 7, 1997, the District Court (Judge Janet Bond Arterton) granted plaintiffs' Motion for Class Certification. The class consisted of two subclasses: (1) Connecticut Medicaid recipients who have been or who will be denied coverage for equipment on the basis that such equipment is not included on the DSS's fee schedule list for such equipment, and (2) Connecticut Medicaid recipients who have been or who will be denied coverage for equipment on the basis that such equipment is not included on the DSS's fee schedule list for such equipment due to the DSS's having identified the equipment as being specifically excluded from coverage. DeSario v. Thomas, 963 F. Supp. 120, 141 (D. Conn. 1997).

On February 13, 1997, the District Court granted the plaintiffs' Motion for Preliminary Injunction. DeSario v. Thomas, 963 F. Supp. 120, 124 (D. Conn. 1997). However, the DSS appealed to the U.S. Court of Appeals for the Second Circuit, and on February 24, 1998, the Second Circuit (Judge Guido Calabresi, Judge Dennis Jacobs, and District judge Charles Brieant, Jr.) held that DSS's definition of DME was permissible under the Medicaid program as well as DSS's use of fee schedule to determine Medicaid coverage for DME. DeSario v. Thomas, 139 F.3d 80, 98 (2nd Cir. 1998).

On January 19, 1999, the U.S. Supreme Court granted the plaintiffs' petition for writ of certiorari, vacated the judgment, and remanded the case to the Second Circuit "for further consideration in light of the interpretive guidance issued by the Health Care Financing Administration on September 4, 1998." Slekis v. Thomas, 525 U.S. 1098 (1999).

After the case was remanded, the parties reached a settlement agreement, which was approved by the District Court on June 23, 1999. Under the settlement, the state agreed to (1) have a process for annually updating its DME list, (2) allow a recipient to obtain an item not on the list if she can demonstrate that there is not a less costly Medicaid service or an item that could meet her needs as effectively, and (3) adopt regulations clarifying that a request for an item which is not on the DME list will not be denied solely because it is not on the DME list. The case is now closed.

Jordan Rossen - 03/16/2013


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Issues and Causes of Action
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Issues
Benefit Source
Medicaid
Plaintiff Type
Private Plaintiff
Causes of Action Title XIX of the Social Security (Medicaid) Act, 42 U.S.C §1396
42 U.S.C. § 1983
Defendant(s) Connecticut Department of Social Services
Plaintiff Description A class of Connecticut Medicaid recipients who were denied coverage for items of equipment that met the State’s general ‘durable medical equipment’ definition but that were not on the State’s list of covered items
Indexed Lawyer Organizations None on record
Class action status sought Yes
Class action status granted Yes
Prevailing Party Plaintiff
Public Int. Lawyer Yes
Nature of Relief Injunction / Injunctive-like Settlement
Source of Relief Settlement
Form of Settlement Court Approved Settlement or Consent Decree
Order Duration 1999 - n/a
Case Closing Year 2002
Case Ongoing No
Docket(s)
3:96-cv-00646-JBA (D. Conn.) 01/07/2002
PB-CT-0006-9000.pdf | Detail
PACER [Public Access to Court Electronic Records]
3:96-cv-00646-JBA (U.S. Court of Appeals) 01/11/2002
PB-CT-0006-9001.pdf | Detail
Westlaw
General Documents
Order (Granting petition for writ of certiorari, vacating judgment, and remanding case for further consideration in light of the interpretive guidance issued by the Health Care Financing Administration) 01/19/1991 (525 U.S. 1098)
PB-CT-0006-0007.pdf | WESTLAW| LEXIS | Detail
Document Source: Westlaw
Order Reconsidering Class Certification and Clarifying Injunction 02/13/1997 (963 F.Supp. 120) (D. Conn.)
PB-CT-0006-0005.pdf | WESTLAW| LEXIS | Detail
Document Source: Google Scholar
Brief of Defendant-Third-Party Plaintiff-Appellant 04/10/1997 (1997 WL 33544218)
PB-CT-0006-0001.pdf | WESTLAW | Detail
Document Source: Westlaw
Brief of the Plaintiffs-Appellees and the Intervenor-Plaintiffs-Appellees 05/13/1997 (1997 WL 33544217)
PB-CT-0006-0002.pdf | WESTLAW | Detail
Document Source: Westlaw
Opinion Vacating District Court's Injunction and Remanding Case for Further Proceedings 02/24/1998 (139 F.3d 80)
PB-CT-0006-0006.pdf | WESTLAW| LEXIS | Detail
Document Source: Google Scholar
Brief for the United States as Amicus Curiae 12/01/1998
PB-CT-0006-0003.pdf | Detail
Connecticut Department of Social Services Press Release 09/15/1999
PB-CT-0006-0004.pdf | Detail
Judges Arterton, Janet Bond (D. Conn.)
PB-CT-0006-0005 | PB-CT-0006-9000
Brieant, Charles L. Jr. (S.D.N.Y.)
PB-CT-0006-0006
Calabresi, Guido (Second Circuit)
PB-CT-0006-0006
Jacobs, Dennis G. (Second Circuit)
PB-CT-0006-0006
Monitors/Masters None on record
Plaintiff's Lawyers Garten, Susan (Connecticut)
PB-CT-0006-0002 | PB-CT-0006-9001
Toubman, Sheldon V. (Connecticut)
PB-CT-0006-0002 | PB-CT-0006-9000 | PB-CT-0006-9001
White, Shelley (Connecticut)
PB-CT-0006-0002 | PB-CT-0006-9000 | PB-CT-0006-9001
Defendant's Lawyers Barber, Hugh (Connecticut)
PB-CT-0006-9000
Blumenthal, Richard (Connecticut)
PB-CT-0006-0001
Lynch, Richard J. (Connecticut)
PB-CT-0006-0001 | PB-CT-0006-9000
Merrill, Judith A. (Connecticut)
PB-CT-0006-0001 | PB-CT-0006-9000 | PB-CT-0006-9001
Mollin, Alfred (District of Columbia)
PB-CT-0006-9001
Nash, Lauren M. (Connecticut)
PB-CT-0006-9000
Other Lawyers Choe, Kenneth Y. (District of Columbia)
PB-CT-0006-0003
DuMont, Edward C. (District of Columbia)
PB-CT-0006-0003
Golinker, Lewis (New York)
PB-CT-0006-9001
Hunger, Frank W. (District of Columbia)
PB-CT-0006-0003
Kneedler, Edwin S. (District of Columbia)
PB-CT-0006-0003
Rabb, Harriet (New York)
PB-CT-0006-0003
Solet, Irene M. (District of Columbia)
PB-CT-0006-0003
Steinmeyer, Anthony J. (District of Columbia)
PB-CT-0006-0003
Waxman, Seth (District of Columbia)
PB-CT-0006-0003
Wilder, Marcy (District of Columbia)
PB-CT-0006-0003

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