Maryland fails to process hundreds of disability appeals, violating federal rules

MARYLAND (WBFF) — Hundreds of Marylanders have filed appeals amid budget cuts and denials of disability services over the past two years.

In more than 200 cases, the state has failed to process those appeals, violating federal rules.

“Not one — not one — has been heard yet,” said Tracie Feron, whose son is one of the many waiting on appeals.

Connor Feron, a 30-year-old man with autism and other medical conditions, receives state funds to pay for caregiving staff and to be trained in spelling communication.

Maryland’s Developmental Disabilities Administration cut some of Feron’s services back in April, and he filed an appeal.

Under federal regulations, he should receive a decision within 90 days. It’s been 150 days, and the state hasn’t even given him a hearing, according to Feron’s lawyer, Jonathan Martinis.

“We filed a letter with DDA and with the Office of Administrative Hearings saying, ‘Why haven’t we had our hearing yet?’ And we essentially got no answer,” Martinis said.

Martinis shared an August email with Spotlight on Maryland from an OAH representative who said the Maryland Department of Health hadn’t yet sent Feron’s appeal to OAH. When he asked why, the OAH representative replied, “I do not know MDH’s protocol for processing appeals or why it takes as long as it does.”

“It just shows how systemically broken the system is here, that this department can’t even send a file over for a fair hearing to be heard,” Tracie said.

According to a Maryland Public Information Act response shared with Spotlight, 247 appeals have been pending since June of last year, 219 of which have missed the 90-day deadline.

Tracie said her son is appealing $10,000 in non-reimbursement of healthcare services for one of his staff.

“These services — they depend on them for their health, their safety, their independence, to access community, to stay and remain safe in their homes,” Tracie said. “If Connor cannot have his voice heard in a courtroom, how broken is our system here in Maryland? And who is going to hold this department accountable?”

Appeals have been pouring in amid DDA budget cuts over the past two years, including a $126 million cut this year. Last year, lawmakers also proposed DDA cuts that were partially restored, but a number of participants said they still faced service denials that year.

A spokesperson for MDH noted that the OAH is responsible for scheduling hearings, not MDH. But they did not explain why Feron’s file hadn’t been sent to OAH by the 90-day deadline.

MDH added that it can’t discuss a participant’s record without a release from that participant, and that it declines to comment on matters involving pending litigation.

Back in March, the DDA acknowledged in online materials a “significant backlog in appeals,” saying the appeals had “skyrocketed recently” and that “constituents may wait several months for an appeals hearing and final decision.”

Martinis filed a complaint on Feron’s behalf with the federal Centers for Medicare and Medicaid Services and with Maryland’s Office of Inspector General for Health.

“If DDA says, ‘We don’t have the personnel to do what we promised the federal government would do’ – that they’ve taken over the last 20 years, more than $20 billion to do — if they say we can’t keep our promise for $20 billion, to me, that’s a DDA problem, not a problem for Connor Feron,” Martinis said.

Under federal regulations, a state can face consequences from the Centers for Medicare and Medicaid Services if they don’t abide by the 90-day timeline. The DDA can take longer than 90 days only if the appellant asks for a delay or if there’s an “administrative or other emergency beyond the agency’s control.”

The DDA is supposed to provide a reason for any such delay, and Martinis said the agency has not provided one for Feron’s case.

CMS did not reply to questions about whether they’ve been in communication with the DDA about the appeals or if the state will face any consequences.

Have a news tip? Contact Brooke Conrad at bjconrad@sbgtv.com or 443-578-2126, or contact the Spotlight team at SpotlightOnMaryland@sbgtv.com or 410-467-4670. Spotlight on Maryland is a joint venture by The Baltimore Sun, FOX45 News and WJLA in Washington, D.C.