Federal Medicaid officials are reviewing complaints that Maryland's Developmental Disabilities Administration (DDA) has let disability-service appeals run past the 90-day limit in federal fair-hearing rules. The limit is set by 42 CFR 431.244. The review came to light in CMS emails to a family's lawyer, which Spotlight on Maryland reported on Oct. 21, 2026.
The numbers so far
| Item | Figure | Source |
|---|---|---|
| DDA appeals pending since June 2025 | 247 | Maryland Public Information Act response, reported Sept. 16, 2026 |
| Pending appeals already past the 90-day deadline | 219 | Same response |
| DDA budget | About $3.3 billion, roughly half of it federal | Spotlight on Maryland, Oct. 21, 2026 |
| DDA budget cut this year | $126 million | Spotlight on Maryland, Sept. 16, 2026 |
The appeal counts come from records released to Spotlight in September. No newer count has been published as of Oct. 22.
What the federal rule says
Under 42 CFR 431.244(f), a state Medicaid agency must ordinarily take final action on a fair hearing within 90 days of receiving the request. Urgent cases that qualify for an expedited hearing have much shorter limits. A state may go past the deadline only in unusual circumstances: when the person appealing asks for a delay or doesn't take a required step, or when an administrative or other emergency beyond the agency's control gets in the way. The agency must write down the reason for any delay in the person's record.
According to the family's lawyer, Jonathan Martinis, DDA has given no reason for the delay in his client's case.
What Maryland has said
The backlog is not a surprise to the state. A March 4, 2026 DDA presentation on Community Pathways waiver financial eligibility said appeals had risen sharply and that people could wait several months for a hearing and a final decision. In September, a Maryland Department of Health spokesperson told Spotlight that the state Office of Administrative Hearings, not the department, schedules hearings. The department declined to discuss individual cases or pending litigation.
Where the complaints stand
- Sept. 8: A CMS staff member wrote to Martinis that CMS "is not an investigative agency" but would review the allegations. If CMS finds the state out of compliance, it can require a corrective action plan with set steps and a timeline. CMS also sent the complaint to the state so it could act right away.
- Oct. 5: CMS said it had received the public-records data but couldn't share the status of its review.
- Oct. 7: Maryland's Office of the Inspector General for Health said the matter falls within its jurisdiction but did not say whether it would investigate.
- As of Oct. 21: The appeal filed in April on behalf of Martinis's client, Connor Feron, still had no hearing date more than 180 days later.
Both families who spoke to Spotlight are appealing over costs for the support staff their sons rely on. One appeal is about $10,000 in unreimbursed health care costs for a staff member. The other is about unpaid benefits for a worker. One mother said the dispute makes it hard to hire new staff, because she can't promise that DDA will cover their benefits.
These delays come while DDA's other changes remain on hold. Provider rates and new self-directed wage limits are frozen at June 30, 2026 levels while CMS reviews the state's Community Pathways waiver amendment.
What this means for providers and DSPs
- Appeals are how cuts get checked. When a service is reduced or denied, the fair hearing is the person's main way to challenge it. A stalled appeal leaves people, families and agencies planning around an answer that hasn't come.
- Staffing decisions get harder. Agencies supporting someone with a pending appeal may not know what hours or staffing will be authorized. Keep records of how the current authorization affects the person's supports. Those records are useful at a hearing.
- Self-directed staff are directly affected. In self-directed services, families hire their own direct support professionals. Disputes over staff pay or benefits can cost a family its workers while the appeal waits.
- Track the clock. The 90-day limit runs from the date the agency receives the hearing request. Supports coordinators and families should keep proof of that date and can ask the agency to put in writing the reason for any delay, as the rule requires.
- Watch for a corrective plan. If CMS finds Maryland out of compliance, a corrective action plan would set public steps and deadlines for clearing the backlog.