Ron Landsman has been actively involved in initiating and litigating the issue of State Medicaid programs’ treatment of “pre-eligibility medical expenses.”
- Smith v. Colmers, Balt. City Cir. Ct., No. 24-C-05-007421, Memorandum, 1-18-2008 and Smith v. Colmers, Order, 3-12-2010 – Maryland agreed to pay $16 million in damages to class members and nursing homes for unpaid bills and consented to an injunction that requires full compliance with “PEME” rules. Co-counsel with Cy Smith and William Meyer of Zuckerman Spaeder. Obtained from the Federal agency, Center for Medicaid and State Operations, Gale P. Arden letter dated 9-13-2004, a determination that Medicaid beneficiary can use current income to pay old (pre-Medicaid eligibility) nursing home bills with Medicaid covering all of current cost of care.
- Janigan v. Pane, U.S. District Court for D.C., No. 1:07-cv-00508(PLF), Order, 4-21-2010 – D.C. consented to an injunction that requires full compliance with “PEME” rules. Co-counsel with Cy Smith and William Meyer of Zuckerman Spaeder.
- Timm v. Dept. of Public Health and Human Services, 343 Mont. 11, 184 P.3d 994 (2008), Of Counsel for National Academy of Elder Law Attorneys as Amicus curiae. The Montana Supreme Court held that its state Medicaid program was required to allow a “PEME” deduction, rejecting the state Medicaid department’s interpretation of Federal law.
- Maryland Department of Health and Mental Hygiene V. Centers for Medicare and Medicaid Services, 542 F.3d 424 (4th Cir. 2008), affirming, In re. Maryland State Plan Amendment 05-06 (CMS decision, March 30, 2007).Filed brief as counsel for the National Academy of Elder Law Attorneys as Amicus Curiae. The Fourth Circuit upheld the Center for Medicare and Medicaid Services (CMS) determination, against a challenge by the Maryland Medicaid program, that the Federal statute required “PEME” deductions for expenses incurred in no less than the three months prior to the month of initial eligibility.
Other significant cases and legal matters
- Walton v. Mariner Health of Maryland, Inc. 391 Md. 643 (2006). Co-counsel, with Benjamin Woolery, for appellant. The Court held that the standard agency-approved nursing home admission agreement did not permit a claim for non-payment against “responsible parties,” personally, who sign a relative in to a nursing home.
- D.C. v. Rasmussen, D.C. Superior Court, Admn. No. 1641-00 (Estate of Simmons). Successfully opposed D.C. Medicaid program claim against decedent’s estate for recovery of benefits paid for services provided individual under the “community medicaid” program because of D.C.’s failure to properly promulgate its estate recovery program in its Medicaid State Plan, a Federal law requirement. 2002-2006 In the next four years, successfully opposed D.C. Medicaid program claims against decedent’s estates for recovery of benefits paid for services for the same defect and because of D.C.’s failure to give Federally required notice respecting rights to hardship waiver and prohibition against estates with surviving spouses and disabled children. D.C. changes its policies and practices in 2006.
- McGhee et al. v. Secretary, Dept. of Health and Mental Hygiene, et al., Maryland Court of Special Appeals, September Term 1999, No. 02837, Order dated December 26, 2000. Settled claim with Maryland Medicaid agreement to come into compliance with Federal law and permit the use of court orders to increase the income and resources of the “community” spouses of married nursing home residents.
- Treatment of out-of-state former homes. In 1994, persuaded Maryland Medicaid program to change policy to come into compliance with Federal law and permit nursing home residents to treat out-of-state former homes as exempt former home without loss of residency status for Medicaid eligibility purposes. Results in treating former DC (and other state) residents in Maryland nursing homes to be treated same as Maryland residents with respect to former homes. See “Maryland Medicaid Agrees to Exclude Out-of-State Former Homes,” The ElderLaw Report, 12:2, P. 5 (September 1995).