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Archives
- June 16, 2021
Primer: State Plan Amendments v. Section 1115 Waivers
Read moreTension and confusion can arise over how HHS allows states to change their Medicaid programs, whether through a state plan amendment (SPA) or a Section 1115 project. To help guard against the improper use of Section 1115 waivers, advocates must know the distinctions between Section 1115 waivers and SPAs.…
- June 15, 2021
State Approaches to Improving Reproductive and Sexual Health
Read moreNHeLP conducted a 50-state review of state Medicaid websites of COVID-19 related policies related to reproductive and sexual health care. This issue brief describes some of the temporary Medicaid and other health care policies and practices states put in place during the pandemic to facilitate the coverage and delivery…
- June 11, 2021
L.S. by and through Ron S. v. Delia, Eastern District of North Carolina and Fourth Circuit Court of Appeals
Litigation Team CasesRead moreThis class action was filed on behalf of a class of North Carolinians with intellectual and developmental disabilities who received letters from their regional managed care organization, Piedmont Behavioral Health (known as PBH and later Cardinal Innovations Healthcare), informing them that, based on their Supports Intensity Scale (SIS) assessment,…
- June 11, 2021
Cyrus ex rel. McSweeney v. Nusbaum Southern District of West Virginia
Litigation Team CasesRead moreIn 2004, a class of recipients of West Virginia’s Medicaid HCBS waiver program for older adults and people with disabilities was granted a preliminary injunction that restored HCBS benefits that had been terminated the year before and required the state to provide adequate notice that explained the reasons for…
- June 11, 2021
Salazar v. District of Columbia, D.C. District Court, D.C. Circuit
Litigation Team CasesRead moreThis class action was originally brought in 1996 on behalf of children and adults who had applied for Medicaid, with claims including that the Medicaid agency failed to: issue decisions and provide coverage within 45 days of a submitted application, provide advance notice of termination of benefits; provide or…
- June 11, 2021
Demanding Ascertainable Standards: Medicaid as a Case Study
Read moreState Medicaid agencies and their contractors are increasingly relying on preset guidelines or assessment tools or both to make coverage decisions. Problems arise when the use of these tools results in program enrollees and advocates being refused access to the standards and procedures that govern the operation of the…
