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  • D.H. v. Snyder, District of Arizona

    Litigation Team

    Two transgender young people enrolled in Medicaid filed a class action lawsuit challenging an Arizona regulation that prohibits coverage of medically necessary gender-confirming surgery. The plaintiffs allege that the discriminatory coverage exclusion violates: (1) the EPSDT requirements in the Medicaid Act; (2) the comparability requirement in the Medicaid Act;…

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  • K.B. v. Michigan D.H.H.S., Eastern District of Michigan

    A class of Medicaid-eligible children with intensive mental health care needs who are at risk of avoidable psychiatric hospitalizations or commitment to the juvenile delinquency system sued the Michigan Department of Health and Human Services for failing to provide needed mental health services in the community as required by…

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  • Schwartz v. Cal DHCS, Superior Court of California

    Abbi Coursolle and

    An adult California Medicaid (Medi-Cal) beneficiary is challenging the California Department of Health Care Services and her county Mental Health Plan after she experienced a mental health crisis and was turned away from evaluation and subsequent treatment without appropriate notice. The Plaintiff alleges that she was denied medically necessary…

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  • A.J. vs Gee, Middle District of Louisiana

    Medicaid eligible children who require in-home nursing services challenged Louisiana’s failure to arrange for or provide those medically necessary services. The failure to provide in-home nursing services puts these children at serious risk of harm and institutionalization.

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  • Rose v. Azar, D.D.C.

    Litigation Team ,

    Indiana residents enrolled in Medicaid filed a lawsuit against the Trump administration challenging its extension of a Section 1115 project (HIP 2.0) allowing the State to condition Medicaid eligibility on compliance with work requirements. The approval also permits Indiana to charge enrollees premiums; terminate coverage and prohibit re-enrollment in…

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  • National Health Law Program Comments on HHS Safe Harbor Rule for Outpatient Prescription Drugs

    The U.S. Department of Health and Human Services (HHS) proposed new regulations that would remove safe harbor protections for prescription drug rebates. Currently, rebates paid by manufacturers to Medicare Part D plans and Medicaid managed care organizations (MCOs), including pharmacy benefit managers (PBMs) are shielded from federal anti-kickback laws.…

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