Medicaid Appeals and Younger Abstention Doctrine

A Missouri ElderLawAnswers member attorney is pursuing an important Medicaid case, currently before the 8th Circuit, that will decide Medicaid applicants' right to appeal certain cases to federal district court. The case, Hudson v. Campbell, involves a nursing home resident in Missouri, Greta Hudson, who applied for Medicaid, but was rejected due to transfers made during the look-back period. Ms. Hudson appealed, and on the day before the hearing the state notified her that it was withdrawing the original denial notice and substituting a new one, albeit apparently based on a new reason. Because of the new denial decision, the hearing officer cancelled the pending hearing and advised Ms. Hudson that she needed to request a new hearing to appeal the new grounds for denial. Ms. Hudson sued in federal court, but the U.S. District Court for the Western District of Missouri dismissed her claims. The court relied on the U.S. Supreme Court's decision in Younger v. Harris, 401 U.S. 37 (1971), holding that because Ms. Hudson had not exhausted her state remedies, the federal court must abstain. Ms. Hudson appealed this ruling to the 8th Circuit. The case could have big implications for Medicaid applicants. Ms. Hudson's estate (she died while the appeal to the 8th Circuit was pending) is represented by Columbia, Missouri, ElderLawAnswers member attorney Nathan Forck (photo). According to Forck, "If the 8th Circuit rules against us, it would essentially foreclose Medicaid applicants'/beneficiaries' right to appeal procedural due process violations that occur within the context of a state fair hearing to a federal district court." Forck also noted that a negative decision in this case "would put the 8th Circuit directly at odds with the 10th Circuit's 2010 ruling in Brown ex. rel Brown v. Day on facts almost identical to the ones here. There would be a split in the circuits that would necessitate an appeal to the Supreme Court to resolve the issue at that point." Forck added that because the district court substantially modified its original order in almost every respect except for the issue of abstention, "if this case makes it back to the district court, my client should be in very good shape with respect to the court's view on her right to a remedy." For a copy of the appellant's brief to the 8th Circuit, click here. For the appellant's reply brief, click here.