Legal Aid Society


LAS Files Amended Medicaid Dental Suit, Demands Dentures for Cancer Survivor

The Legal Aid Society and Willkie Farr & Gallagher LLP filed an amended class-action lawsuit to challenge New York State’s Medicaid rules on reimbursing certain dental services that advocates deem medically necessary, according to POLITICO.

Medicaid recipients cannot receive crowns and root canals under state rules that became effective Nov. 12, 2018. They also cannot receive replacement dentures within 8 years or dental implants unless they have letters of support from a physician and a dentist, according to the complaint. The amended lawsuit includes additional plaintiffs and alleges that the 2018 Medicaid rules are causing harm to individuals who need care and were denied services.

LAS petitioned the court to grant a preliminary injunction on behalf of one of the new plaintiffs, Yvonne Hawkins, in order to expedite her replacement dentures, which the state previously denied. The plaintiff is a head and neck cancer survivor with severe physical impairments due to her illness, and is in need of replacement lower dentures. Her cancer care, which included extensive chemotherapy, radiation and surgery that removed two-thirds of her jaw bone, required her to have a prosthetic jaw and lower dentures to chew, swallow and speak, according to the complaint.

“For Ms. Hawkins, we hope to resolve the preliminary injunction. We hope we can settle that. We hope to move forward and fight these rules,” said Belkys Garcia, Staff Attorney in our Civil Practices’ Law Reform Unit.