Woman with rare genetic disorder loses Medicaid, after officials admit mistake

The lingering question: Would she get her Medicaid back?

HYATTSVILLE, MD (WUSA9) - Andraea LaVant's morning routine starts with someone else. She needs help every day to get in and out of bed, because she lives with a form of Muscular Dystrophy called Spinal Muscular Atrophy. The effect is muscle weakness.

"I don't get out of bed without those services," said LaVant who needs five hours of in-home nursing each day. 

According to a bill she showed the WUSA9 Special Assignment Unit, the in-home nurse can cost about $2,250 per month.


From 2007 until June 2017, Medicaid paid the bill.

When the Maryland Department of Health sent her a notice in early June ending her benefits unexpectedly, LaVant called the SAU.

RELATED: Woman fights for Medicaid after government error

After WUSA9 started digging, officials agreed to allow LaVant to appeal on August 3.  

During the hearing, Steven Simone, a representative for the Prince George's County Department of Social Services, admitted the agency made a mistake.

He pointed out that in July 2015, LaVant submitted an application for her yearly Medicaid redetermination. She told officials her bi-weekly income from her full-time job.

Officials said LaVant couldn't make more than $1,366 per month to qualify for Medicaid. LaVant's income exceeded that level.

RELATED: MEDICAID IN MD | MEDICAID IN DC | MEDICAID IN VA

So how was she approved?

"So the medical assistance was based on zero income," said Simone. "And I'm saying that was a department error."

In the hearing, Simone admitted to Judge Michael Osborn officials coded LaVant as a food stamp recipient and approved her for Medicaid.

More than a month later Osborn issued his ruling.

In a copy of his decision obtained by the SAU, Osborn noted officials' failures, such as consistent misspellings of her name and citing a non-existent code as a reason to end her Medicaid.

Osborn also wrote the agency "presented no evidence as to how it discovered that it had for over two years" approved her for Medicaid.

However, Osborn decided confusion plus mistakes doesn't change the math. He ended her Medicaid benefits because she is ineligible.

"I was very sad," LaVant said during an interview after Osborn's decision.

"I think [the] reaction is, you know, that I'm trying to get a handout," she said. "It's actually quite the contrary. I'm trying to be a responsible person, responsible citizen."

She's hoping for a change in the system and better training for the people who approved her for care in the first place.

For now, she's relying on donations and savings from her retirement.

"Everything that I know is here. I'm going to fight to keep that because I've worked really hard for it," she said. "I deserve just as much as the next person to be able to live my life."

LaVant faces the possibility of having to pay the Medicaid benefits back, a possible sum in the tens, if not hundreds of thousands of dollars.  

She's researching other insurance programs, but worries if she works with the same agencies, she'll end up on the wrong end of yet another mistake.

WUSA


JOIN THE CONVERSATION

To find out more about Facebook commenting please read the
Conversation Guidelines and FAQs

Leave a Comment