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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 the 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 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, 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. 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.

Alex Colbert-Taylor - 08/07/2013
Eva Richardson - 11/21/2018


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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
Filed Pro Se No
Prevailing Party Plaintiff
Public Int. Lawyer Yes
Nature of Relief Declaratory Judgment
Injunction / Injunctive-like Settlement
Source of Relief Litigation
Settlement
Form of Settlement Private Settlement Agreement
Voluntary Dismissal
Order Duration 2011 - n/a
Filing Year 2010
Case Ongoing Yes
Additional Resources
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Docket(s)
1:10−cv−00358 (S.D. Ind.)
PB-IN-0003-9000.pdf | Detail
Date: 06/10/2011
Source: PACER [Public Access to Court Electronic Records]
General Documents
Class Action Complaint for Declaratory and Injunctive Relief [ECF# 1]
PB-IN-0003-0001.pdf | Detail
Date: 03/25/2010
Source: PACER [Public Access to Court Electronic Records]
Motion for Preliminary Injunction [ECF# 12]
PB-IN-0003-0002.pdf | Detail
Date: 03/25/2010
Source: PACER [Public Access to Court Electronic Records]
Memorandum of Law in Support of Plaintiffs' Motion for Preliminary Injunction [ECF# 23]
PB-IN-0003-0003.pdf | Detail
Date: 04/16/2010
Source: PACER [Public Access to Court Electronic Records]
Stipulation [ECF# 36]
PB-IN-0003-0004.pdf | Detail
Date: 05/21/2010
Source: PACER [Public Access to Court Electronic Records]
Second Stipulation [ECF# 55]
PB-IN-0003-0005.pdf | Detail
Date: 09/20/2010
Source: PACER [Public Access to Court Electronic Records]
Order [ECF# 57] (S.D. Ind.)
PB-IN-0003-0006.pdf | Detail
Date: 09/28/2010
Source: PACER [Public Access to Court Electronic Records]
More Definite Statement Concerning Legal Claims [ECF# 58]
PB-IN-0003-0007.pdf | Detail
Date: 10/01/2010
Source: PACER [Public Access to Court Electronic Records]
First Amended Class Action Complaint for Declaratory and Injunctive Relief [ECF# 60]
PB-IN-0003-0013.pdf | Detail
Date: 10/11/2010
Source: PACER [Public Access to Court Electronic Records]
Order on Defendants' Motion to Stay [ECF# 84] (S.D. Ind.)
PB-IN-0003-0008.pdf | Detail
Date: 11/12/2010
Source: PACER [Public Access to Court Electronic Records]
Order Certifying Class Action [ECF# 87] (2010 WL 4860119) (S.D. Ind.)
PB-IN-0003-0009.pdf | WESTLAW | Detail
Date: 11/22/2010
Source: PACER [Public Access to Court Electronic Records]
Decision on Pending Motion [ECF# 99] (781 F.Supp.2d 798) (S.D. Ind.)
PB-IN-0003-0010.pdf | WESTLAW| LEXIS | Detail
Date: 02/10/2011
Source: PACER [Public Access to Court Electronic Records]
Permanent Injunction and Final Judgment [ECF# 100] (S.D. Ind.)
PB-IN-0003-0011.pdf | Detail
Date: 02/10/2011
Source: PACER [Public Access to Court Electronic Records]
Unopposed Motion to Withdraw (A) Motion to Amend Judgment [ECF# 114]
PB-IN-0003-0012.pdf | Detail
Date: 06/09/2011
Source: PACER [Public Access to Court Electronic Records]
Order [Withdrawing Motion for Attorneys' Fees and Motion to Amend Judgment] [ECF# 115] (S.D. Ind.)
PB-IN-0003-0014.pdf | Detail
Date: 06/10/2011
Source: PACER [Public Access to Court Electronic Records]
show all people docs
Judges Baker, Tim A. (S.D. Ind.) [Magistrate] show/hide docs
PB-IN-0003-0014 | PB-IN-0003-9000
Magnus-Stinson, Jane Elizabeth (S.D. Ind.) show/hide docs
PB-IN-0003-0006 | PB-IN-0003-0008 | PB-IN-0003-0009 | PB-IN-0003-0010 | PB-IN-0003-0011 | PB-IN-0003-9000
Plaintiff's Lawyers Falk, Kenneth J. (Indiana) show/hide docs
PB-IN-0003-0007 | PB-IN-0003-0012 | PB-IN-0003-0013 | PB-IN-0003-9000
Rose, Gavin Minor (Indiana) show/hide docs
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) show/hide docs
PB-IN-0003-0004 | PB-IN-0003-0005 | PB-IN-0003-9000
Sullivan, Erica Sue (Indiana) show/hide docs
PB-IN-0003-9000

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