eleventh amendment while you keep saying that you're briefed that on this process issue that the notice of denial is conditional what does that medicaid applicants that their application has been denied but that the notices also go on to say that they can be conditionally kept open if additional financial information is part of these notices is because it was kept open because they were told they could keep it open by providing this information by a certain date when there was no response to the keeping it open the plaintiffs with van appeal and their peals were held on timely well as by taking advantage of the option denied an appeal or add additional information you forfeited your right to appeal and that's not made clear in the notices and that really needs to be made clear now let's talk about here you your plaintiffs of the eleven of them five hundred in six are now receiving medicaid medicare caid benefits is that i want to talk about money in the briefing we address the property rights issue in the under state law that does proceed but what i really want to address is the effect of adopting defendant's position on not arguing that although in at least one of the plaintiffs mr winder that is in fact an odd but you didn't argue that i'm not in your in there bruce i'm not help me understand why you have standing here were there the recipients of that that's correct they are entitled to their entitle to those medicaid benefits until the date of the death and you can file an application on behalf of a deceased person as to what the climate us there are multiple applications there is a first application and there's something applications in some cases there were up to six applications they were required to continue filing applications process that how does this business with the asset verification program does that's something that occurs in an ongoing basis for nursing home residents if you know i'm confused by your question well we've got an asset verification program where this thing is required under state law all to go and check the assets be some sort of computer program i take that's right and is that an the state's not doing the yes it perfect condition program jump to believe that require them to do that in the future would be appropriate that your argument that is correct that's not actually a claim in this complaint but that is system and to process applications in a timely fashion and to give due process to elderly nursing home residents might in the end cost the state a little bit more money because they have to actually process these applications and because we are asking for the specifically we want that initial application to actually be reviewed and to send a notice that is effective it is not confusing that notice was never received the nursing home residents applied season the ones that are allowed but they're receiving medicare benefits so would seem like that with regard to this to either group there is a remedy in the maryland state courts that was never pursued read in your your brief i thought some of those people never got a ruling one way or the other that's correct some of these people never did get a role in one of the one where the and is that true of the a lot of people well would be truly a lot of people because they've gotten their benefits and it's true that the  process because there's no remedy and then to follow me down the line if we have these elderly patients and these are really ill some of the most vulnerable population of our society that the state doesn't  time there was disparate impact that some applications reopened and other applications were not reopened and there's no way to know there's no standard for which applications can be open and which ones are not going to be opened and plaintiffs complaint specifically alleges residents can't leave the nursing home to go and track down five years with a bank accounts or insurance paperwork people who have also timers may not even remember which banks they have accounts at the state is required to use these accommodations and they did not here so viewing the complaint in the light most favorable to the plaintiffs as should be it is clear from our complaint that there are allegations on failure to make reasonable accommodations which presupposes you've adequately alleged disability which we have alleged that these plaintiffs require twenty four hour skilled nursing care for their survival and their health and their welfare see that you challenge that alternative ruling in your briefing sorry i forgot just only did you write that down you can tell us when we come back up and mr lap that they have standing to pursue the fourth amendment amendment claims for the deceased recipients because they make that argument district court we did we did not have we made the claim that they were we move to dismiss on the basis that they were moot but we did not challenge the standing at that time as a result of the for the plaintiffs who were deceived they not the personal representatives of the state and that would be the only basis for which they could proceed with whatever the while they were alive did they cite some sort of document that says nursing home can apply for benefits for me that's right there were  forward by the personal representative of the estate and of course the even do they have an obligation to continue to prosecute or process claims that were submitted before the well the authorized representative does does the department have an obligation to continue to process applications that were filed before the death yes the partment would continue to process  benefits that right that is that is correct only if there were an appeal an administrative appeal or subsequent to that a judicial appeal would that appeal have to be carried forward by the personal representative of the state but the a requirement a state law does require that in an administrative exhaustion before taking it to state court here i think there's there is an ability for the plaintiffs  injunctive relief well do you differentiate between the injunctive relief that might be sought for the ceased recipients as opposed to those that are still living i think the law does apply differently i think for the deceased what we think they are both barred in perspective relief is neither avail is available for neither one of the groups for the deceased residents it's a much clearer cas relief the relief would be ultimately be a payment to the nursing facility for past services provided that then i do you distinguish the answer came well the entries involve expenditure of money ultimately the enter king case involved plaintiffs who who was a class action case in there were two categories applying to this one for which the department had not yet made medica determinations and the other for which the met it was alleged that medicaid had not the benefit that applicants had received medicaid eligibility determinations but they were not getting services from medica is not what they request in their brief it's not about determining medicaid eligibility respectively it's about the nursing facilities trying to get paid for past services or step one and that process  eligibility step one and that process would be to determine whether those plaintiffs are are eligible that's correct so here the with respect to the deceased be a monetary claim that the medicaid state medicaid program would make for past services to the nursing facilities the the the residents never receive money themselves it's your position plaintiffs that are still living and those plaintiffs had medicaid eligibility at the time the complaint was filed and have had medicaid eligibility since then there is no p everything there the complaint the complaining indiscrete the description of the party says that those plaintiffs oh substantial sums to the nursing facilities that's what this case is really about is about the nursing facilities effort to get paid so there is that claim i we have not tested that i believe that that may be incorrect with respect to some of those residents but there is that claim that that those residents had services in the past that were not covered by medicare is for the folks here still that's correct and for the folks that are deceased i believe they make that claim for both sets of individuals only eighty eight claims that you don't talk about my colleague is is going to twenty six basis that those claims failed to state a claim this court's decision in walters v mcmahon is the controlling authority in this case that that case relies upon both bell atlantic and it ball for the standard and that case does show at least a it a subtle change nothing else in in the in the standard for twelve b six complete the complete and civil actions must be alleged with greater specificity than previously was required well let me ask you the same question i ask opposing counsel the district court appears to hold in the alternative with respect to the claims that the plainest did not have standing because they were not the real determined in this case i think that's a fair characterization of the briefing in this case your honor i don't think the plaintiffs raised that and in response i don't think that the the pelleas have had any at anything to respond to with regards to any but it was not raised pacifically by my s not have standing and then the plaintiff says the palin's do not contest that then that's a substantive basis for the district court's ruling made that type of those types of allegations in this this case there's no specific information in the complaint whatsoever about the limitations or medical conditions or what have you that these nursing  same law firm represents the appellant's here in that case the court found that the fact that a person was not afforded medicaid benefits in and of itself does not plausibly suggest that it was because of a disability that's all these alleged here they have not gone past that the first manipulate relies on nothing more than the fact that benefits and services were denied as support for those eighty and rehabilitation that claims that doesn't provide the required causal connection  uniquely as the district court judge found even one of the complaint alleges that the residents were treated differently than other applicants or recipients it doesn't allege that that difference in treatment was because the resident had a disability and others did not that if you look at the allegations of the complaint as they're laid out in that case and you put them side to side with the completeness case you're going to see a lot of similar language all the relevance of that is that the decision in that case found that the that  deficient but the regulation that i just bitch and provides for the opportunity to challenge all of that in the administrative appeals process and then if you're not satisfied with the result you get from the office of administrative hearings in maryland you have the right of the the position that the position well the first part of the fourteenth amendment claim is the eleventh the memmott sovereign immunity and i should point that out first as to all of the supposed applications defects that they're talking about those all concerned applications that are stale that are in the past we now have all the residents are either deceased or they're currently receiving benefits has been pointed out beyond that the fact that they do have the right to administrate appeal yes that is a bar to fourteenth amendment clean because they again there's no allegations in the complaint that the administrative procedures themselves the review procedures were insufficient they take issue with the application process and  has to be reached or attained instead there is no violation of procedural due process in this case where there are procedural safeguards in place the ones that i've discussed that allow the opportunity to appeal councils argument he's saying with regard to your fourteenth amendment claim that there is lots of due process available through the maryland administrator process and the maryland co timely because they elected to try to keep their applications open and there's never notice sent saying your application wasn't eligible to be kept open when they were at the age that it was your notice that your application is denied we'll keep it o and it certainly didn't tell them if you elect to do this process and keep your application open you will not have an appeal right because it will be untimely so what they should have dogs of the peel and sent the additional information but they had no way to know that nursing you know i understand that defendant wants to church rise this as the nursing homes one come here and get money but this claim is not about money to the nursing homes this claim application and it was either the resident self or herself during a period of competence were a family member right that's right so you all had the legal authority to go and do these applications and to receive the notice right