Academic journal article Missouri Law Review

Implementing Online Dispute Resolution in MO HealthNet Appeals: Increasing Access to Remedies While Decreasing State Spending

Academic journal article Missouri Law Review

Implementing Online Dispute Resolution in MO HealthNet Appeals: Increasing Access to Remedies While Decreasing State Spending

Article excerpt

I. INTRODUCTION

The distress associated with filing a civil lawsuit can leave an individual with a range of emotions, including despondency, humiliation, frustration, loss of self-confidence, and anxiety. (1) Generally, an individual will only file suit if they (2) suffer a serious harm. Subsequently, the individual must relive the injury at each step of the litigation. Repeatedly revisiting the injury disrupts the individual's life and often leaves them feeling isolated and helpless. (3) Now, picture an individual having to go through the entire process without the guidance of a lawyer, which is called pro se representation. (4) This only adds to the individual's stress levels. Representing one's self in a traditional court system is similar to playing chess without ever learning the rules. Both games are governed by precise, complex procedures that make it very difficult for any novice to win against an expert. Consequently, pro se individuals often fail to obtain the relief they seek, rendering all of their stress and physical suffering moot. (5)

Indigent individuals may be able to utilize legal aid services instead of resorting to pro se representation. However, accessibility to these services is declining. (6) Budget cuts at the state and federal levels are reducing funding to these services. (7) This restricts access to civil remedies for many potential litigants, including recipients of Missouri's Medicaid system, MO HealthNet ("MOHN"). MOHN recipients must not only overcome procedural hurdles, but they often face accessibility hurdles--such as transportation--to recover remedies. (8)

A possible way to offset the negative impacts of these cuts and hurdles is to implement an online dispute resolution ("ODR") system in a sub-department of the Missouri Department of Social Services' ("DSS") appeals process, such as the MO Healthnet Division's ("MHD") MOHN appeals. ODR utilizes technology to create flexible systems that can be tailored to facilitate a wide variety of resolution methods. (9) Because ODR is highly customizable, it could be optimized to inexpensively improve system efficiency while reducing pressure on charitable legal aid services. Should these benefits materialize, legal aid services in Missouri would be able to allocate their resources to other clients. ODR could also relieve financial stress on MOHN, which currently faces pressure to reduce expenditures. Adopting ODR could directly increase access to remedies for MOHN recipients by creating a wider variety of ways for individuals to recover remedies while simultaneously decreasing the emotional toll associated with litigation.

This Note proceeds in four parts. Part II discusses the background of MOHN as well as the additional hardships individuals with disabilities encounter during the current appeals process and concludes with an analysis of ODR and its recent developments. Part III examines ODR systems currently in use in comparable public-sector applications. Finally, Part IV suggests that both the procedural and additional hurdles individuals with disabilities face in the traditional appeals system can be mitigated by implementing an ODR system while simultaneously decreasing state spending.

II. LEGAL BACKGROUND

MOHN recipients must be impoverished to qualify for benefits. (10) Correspondingly, indigent individuals are more likely to represent themselves pro se than individuals within other economic brackets. (11) Thus, MOHN recipients are more likely to represent themselves pro se if they have an issue with coverage. Unfortunately, the current DSS appeals process requires a level of evidentiary sophistication that many pro se individuals do not possess. (12)

Many MOHN recipients must overcome procedural hurdles to access legal remedies. In addition, multiple subsets of MOHN patients, including individuals with disabilities, must conquer other hurdles unique to their situations. Section A examines MOHN's origins, eligibility requirements, and current appeals process. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.