February 7, 2024 by Natalie Cochran
Lone Star Legal Aid Fights for Client with Multiple Disabilities Who Lost Medicaid Benefits Despite Submitting Recertification Packet
Mark is a minor facing various disabilities and health challenges. His mom, Laura, found out about the Medicaid denial when she tried to take him to the doctor. Laura turned to Lone Star Legal Aid (LSLA) to appeal the denial and address the mistakes made by Texas Health and Human Services (HHSC) in her son’s case. She shared that because of this incorrect denial, she could not get the necessary medicine for Mark, and his urgent health needs were left unmet.
Throughout the pandemic, Mark received children’s Medicaid benefits due to the continuous coverage initiated in 2020. During this period, recipients did not need to renew their Medicaid benefits and continued to receive them even if not technically eligible. After the pandemic ended, HHSC said they were stopping Continuous Coverage. This meant the state could now say no to benefits if people did not send in their renewal forms or sent them in but were told they were no longer eligible.
Mark’s mom went through a complete renewal, providing income verification that confirmed Mark’s eligibility for benefits. However, HHSC failed to process the application within the required 45 days. Despite Mark calling HHSC multiple times, they did not process the renewal application and, without sending a denial letter, terminated his benefits.
LSLA Staff Attorney, Elizabeth Green filed an appeal for the failure of HHSC to process Mark’s renewal application timely, and the erroneous termination of Mark’s benefits. LSLA represented Mark in an Administrative Appeal and went to a Fair Hearing. The HHSC Hearings Officer issued a favorable decision for Mark. Now his mom could take Mark to get the medical care he needed.
*Names have been changed to protect the identity of the client(s).
Lone Star Legal Aid is making a significant impact by spearheading efforts to assist Medicaid recipients who have been unjustly cut off from their coverage. Recognizing the critical importance of healthcare access, we are diligently working to navigate the complexities of the system, advocating for those who are eligible to regain their Medicaid benefits.
Lone Star Legal Aid (LSLA) is a 501(c)(3) nonprofit law firm focused on advocacy for low-income and underserved populations by providing free legal education, advice, and representation. LSLA serves millions of people at 125% of federal poverty guidelines, who live in 72 counties in the eastern and Gulf Coast regions of Texas, and 4 counties in Southwest Arkansas. LSLA focuses its resources on maintaining, enhancing, and protecting income and economic stability; preserving housing; improving outcomes for children; establishing and sustaining family safety, stability, health, and wellbeing; and assisting populations with special vulnerabilities, like those with disabilities, the aging, survivors of crime and disasters, the unemployed and underemployed, the unhoused, those with limited English language skills, and the LGBTQIA+ community. To learn more about Lone Star Legal Aid, visit our website at www.LoneStarLegal.org.
Media contact: media@lonestarlegal.org
