Due process enforcement is a common element in our policy advocacy because too often Medicaid enrollees’ coverage and services are threatened without the required processes that protect their access to critical services.
NHeLP’s due process policy advocacy has helped ensure Medicaid enrollee rights are not impacted by the use of managed care and that Medicaid coverage is not denied or ended without appropriate notice and access to a hearing. This is particularly important because managed care uses a more complicated appeal process that can be even more challenging for enrollees to navigate. Chronically low appeal rates for decisions on prior authorizations and other service denials from managed care plans demonstrate some of those challenges.
Our Delivery System policy team coordinates closely with our Litigation & Enforcement team. You can find out more about all of our cases on the Litigation & Enforcement page.
