M.N., c/o P.N. v. Agency for Persons with Disabilities
The Fifth DCA reversed an administrative order denying a Medicaid iBudget waiver applicant's request for services. The court held the hearing officer violated Article V, Section 21 of the Florida Constitution by deferring to APD's internal policy interpretation of Rule 65G-4.0215(7)(a), and that under the rule's plain language a client disenrolled solely for moving out of state need not re-establish medical eligibility on returning. The court further held that a change of location and passage of time alone are not a significant change in circumstances defeating administrative finality.
Key facts
- M.N., a Medicaid iBudget waiver applicant, was disenrolled from the program after moving out of state; upon returning to Florida within 365 days, M.N. sought re-enrollment without re-establishing medical eligibility.
- The Agency for Persons with Disabilities denied M.N.'s request for re-enrollment, relying on its internal policy interpretation of the governing administrative rule.
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Why it matters
The opinion is a useful vehicle for arguing that post-Amendment article V, section 21 forbids ALJs and hearing officers — not just courts — from deferring to agency interpretations, including agency 'internal policies'… — full analysis with a trial
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