ALJ Review Abuse of Discretion.

• Author: Hawkins, Derek
• Position: J.T. v. Wisconsin Department of Health Services

Byline: Derek Hawkins

WI Court of Appeals District IV

Case Name: J.T. v. Wisconsin Department of Health Services

Case No.: 2020AP2085

Officials: Blanchard, P.J., Kloppenburg, and Graham, JJ.

Focus: ALJ Review Abuse of Discretion

Before September 2019, J.T. received behavioral health services from a therapy provider for J.T.'s disorder on the autism spectrum. Through his guardian, J.T. appeals a circuit court order that affirmed a decision of the Wisconsin Department of Health Services (the Department) following a contested case hearing. The challenged agency decision is the Department's denial of a request by the therapy provider for an extension of Medicaid funding to cover therapy beyond August 31, 2019. The Department based its denial on the determination that the provider had not produced sufficient information in response to demands by the Department regarding specific types of progress that J.T. has made as a result of therapy by the provider and skills-instruction by his parents. We affirm for the following reasons.

First, J.T. contends that the circuit court should have reversed the challenged Department decision based on WIS. STAT. 227.57(8) ("The court shall reverse if it finds that the agency's exercise of discretion is inconsistent with an officially stated agency policy , if deviation therefrom is not explained to the satisfaction of the court by the agency."). J.T...