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Case Name A.M.T. v. Gargano PB-IN-0003
Docket / Court No. 1:10-cv-0358-JMS-TAB ( S.D. Ind. )
State/Territory Indiana
Case Type(s) Disability Rights-Pub. Accom.
Public Benefits / Government Services
Attorney Organization ACLU Chapters (any)
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 Director of the Office of Medicaid Policy and Planning of FSSA. The named ... read more >
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 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 continuing access to these therapies, citing 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 brought 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.

Plaintiffs sought preliminary and permanent injunctive relief, enjoining 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. 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 Court (Judge Magnus-Stinson) certified the plaintiff class. 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."

Alex Colbert-Taylor - 08/07/2013


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Issues and Causes of Action
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Issues
Benefit Source
Medicaid
Defendant-type
Hospital/Health Department
Jurisdiction-wide
Disability
disability, unspecified
Mental impairment
Mobility impairment
Discrimination-basis
Disability (inc. reasonable accommodations)
General
Habilitation (training/treatment)
Payment for care
Public benefits (includes, e.g., in-state tuition, govt. jobs)
Reassessment and care planning
Medical/Mental Health
Medical care, general
Medical care, unspecified
Mental health care, general
Mental health care, unspecified
Mental Disability
Cerebral palsy
Developmental disability without intellectual disability
Intellectual/developmental disability, unspecified
Plaintiff Type
Private Plaintiff
Type of Facility
Government-run
Causes of Action 42 U.S.C. § 1983
Title XIX of the Social Security (Medicaid) Act, 42 U.S.C §1396
Defendant(s) Indiana
Indiana
Plaintiff Description Class of minors with serious disabilities who were Indiana Medicaid recipients and who were denied physician-prescribed therapies necessary to ensure their conditions would not deteriorate .
Indexed Lawyer Organizations ACLU Chapters (any)
Class action status sought Yes
Class action status granted Yes
Prevailing Party Plaintiff
Public Int. Lawyer Yes
Nature of Relief Attorneys fees
Declaratory Judgment
Injunction / Injunctive-like Settlement
Source of Relief Litigation
Settlement
Form of Settlement Private Settlement Agreement
Voluntary Dismissal
Order Duration 2011 - n/a
Case Closing Year 2011
Case Ongoing Yes
Docket(s)
1:10−cv−00358 (S.D. Ind.) 06/10/2011
PB-IN-0003-9000.pdf | Detail
PACER [Public Access to Court Electronic Records]
General Documents
Class Action Complaint for Declaratory and Injunctive Relief 03/25/2010
PB-IN-0003-0001.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Motion for Preliminary Injunction 03/25/2010
PB-IN-0003-0002.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Memorandum of Law in Support of Plaintiffs' Motion for Preliminary Injunction 04/16/2010
PB-IN-0003-0003.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Stipulation 05/21/2010
PB-IN-0003-0004.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Second Stipulation 09/20/2010
PB-IN-0003-0005.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Order 09/28/2010 (S.D. Ind.)
PB-IN-0003-0006.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
More Definite Statement Concerning Legal Claims 10/01/2010
PB-IN-0003-0007.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
First Amended Class Action Complaint for Declaratory and Injunctive Relief 10/11/2010
PB-IN-0003-0013.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Order on Defendants' Motion to Stay 11/12/2010 (S.D. Ind.)
PB-IN-0003-0008.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Order Certifying Class Action 11/22/2010 (2010 WL 4860119) (S.D. Ind.)
PB-IN-0003-0009.pdf | WESTLAW | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Decision on Pending Motion 02/10/2011 (781 F.Supp.2d 798) (S.D. Ind.)
PB-IN-0003-0010.pdf | WESTLAW| LEXIS | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Permanent Injunction and Final Judgment 02/10/2011 (S.D. Ind.)
PB-IN-0003-0011.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Unopposed Motion to Withdraw (A) Motion to Amend Judgment 06/09/2011
PB-IN-0003-0012.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Order [Withdrawing Motion for Attorneys' Fees and Motion to Amend Judgment] 06/10/2011 (S.D. Ind.)
PB-IN-0003-0014.pdf | Detail
Document Source: PACER [Public Access to Court Electronic Records]
Judges Baker, Tim A. (S.D. Ind.) [Magistrate]
PB-IN-0003-0014 | PB-IN-0003-9000
Magnus-Stinson, Jane Elizabeth (S.D. Ind.) [Magistrate]
PB-IN-0003-0006 | PB-IN-0003-0008 | PB-IN-0003-0009 | PB-IN-0003-0010 | PB-IN-0003-0011 | PB-IN-0003-9000
Monitors/Masters None on record
Plaintiff's Lawyers Falk, Kenneth J. (Indiana)
PB-IN-0003-0007 | PB-IN-0003-0012 | PB-IN-0003-0013 | PB-IN-0003-9000
Rose, Gavin Minor (Indiana)
PB-IN-0003-0001 | PB-IN-0003-0002 | PB-IN-0003-0003 | PB-IN-0003-0004 | PB-IN-0003-0005 | PB-IN-0003-0007 | PB-IN-0003-0012 | PB-IN-0003-0013 | PB-IN-0003-9000
Defendant's Lawyers Isenberg, Betsy M (Indiana)
PB-IN-0003-0004 | PB-IN-0003-0005 | PB-IN-0003-9000
Sullivan, Erica Sue (Indiana)
PB-IN-0003-9000
Other Lawyers None on record

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