The Arkansas Department of Human Services failed to follow a state law when it began using a new method to determine Medicaid recipients' eligibility for home-based services for the elderly and disabled, a lawsuit filed Thursday contends.
Filed by Jonesboro-based Legal Aid of Arkansas on behalf of seven Medicaid recipients, the suit in Pulaski County Circuit Court targets the state's use of an electronic assessment tool, known as the ArPath, to determine how many hours of home-based care the state will pay for.
Previously, nurses used the tool and their own professional judgment to set the number of hours, according to the lawsuit.
Starting in 2016, however, the department began assigning the hours based solely on a formula that uses information from the assessment tool, the suit says.
As of May 19, the system had resulted in reductions in hours for 47 percent of recipients who were assessed, increased hours for 43 percent and no change for the remaining 10 percent, according to the suit.
Although it says the use of the tool was authorized by rules that were adopted in 2015, the change in how the service-hour amounts are allocated isn't described in the rules, the lawsuit says.
The suit contends that the change violates the state's Administrative Procedures Act, which requires rules to be submitted for public comment and review by the state Legislature.
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The formula "was decided on in secret by unelected DHS leaders who don't understand the system well enough to explain how it works," Kevin De Liban, an attorney with Legal Aid of Arkansas, said in a news release announcing the lawsuit.
Department spokesman Amy Webb defended the use of the assessment tool.
"The system we used previously was subjective, which meant that a person with a disability in Texarkana may not get the same level of services as a person with the same disability and needs in Jonesboro," Webb said in an email.
"We wanted to take the subjectivity out of the system so that decisions about level of care were objective, consistent, based on science and based on real data from real Arkansans."
The lawsuit is the second one Legal Aid of Arkansas has filed over the use of the ArPath.
In a federal suit filed in May on behalf of two recipients, the organization contended that the use of the tool had resulted in arbitrary reductions in benefits.
One plaintiff in that case was dropped from the suit after he won an administrative appeal. U.S. District Judge D. Price Marshall Jr. later issued an order preventing the department from reducing benefits to the other plaintiff until it issued an adequate notice explaining the reason for the reduction.
That plaintiff, a 90-year-old woman with Alzheimer's disease, died a week after the judge's ruling, De Liban said.
Metro on 01/27/2017