Imagine receiving medically necessary services that are required to prevent you from being institutionalized. Now imagine having those services cut in half and not being given an opportunity to explain why you disagree. That is what happened to one of LSGMI’s clients who, at only 29 years old, required nearly $67,000 in medically necessary services to avoid being institutionalized for his cerebral palsy, profound mental retardation, autism and cerebral hypotonia.

When the Agency for Persons with Disabilities (APD) placed a $35,000 cap on the medically necessary services which would be covered for our client by Medicaid’s Developmental Disabilities Waiver, LSGMI attorney Mandy Mills appealed to the Third District Court of Appeal with the pro bono help of Nancy Ciampa, Carlton Fields. The appeal sought a hearing and an opportunity for our client to present evidence and arguments supporting his disagreement with APD’s severe reduction in services. While the appeal was pending, APD requested that the appellate court relinquish jurisdiction so that it could grant our client a hearing. Before the hearing, APD reconsidered its original decision and restored our client’s medical services with no monetary cap, granting all the relief that we would have asked for during the hearing. Our client can now rest assured that he will receive all medically necessary services he needs to allow him to remain living at home with his family.