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- December 19, 2019
Opportunities for Public Comment on HCBS Assessment Tools
Read moreMedicaid home and community-based services (HCBS) are critical to ensuring people with disabilities and older adults are supported in their communities. State Medicaid agencies and their contractors often rely on assessment tools to make eligibility decisions, allocate services, and inform person-centered planning processes. However, these tools can be difficult to…
- March 1, 2019
Hawkins v. Cohen, Eastern District of North Carolina
Read moreHawkins Summary Hawkins v. Cohen (5:17-CV-581 E.D.N.C.) is a federal lawsuit filed in 2017 by Charlotte Center for Legal Advocacy and the National Health Law Program to stop illegal terminations of Medicaid benefits in North Carolina. The Court hearing the case has certified it as a class action. This…
- June 13, 2017
Evaluating Functional Assessments for Older Adults
Read moreState Medicaid agencies and their contractors rely on functional assessment tools to make coverage and eligibility decisions for long-term services and supports (LTSS). Many states use tools developed and licensed by private entities, while others have developed and implemented their own tools. The variety of tools is staggering. One…
- July 22, 2016
Darjee v. Betlach, District of Arizona
Litigation Team CasesRead moreLow-income immigrant residents of Arizona who were eligible for full Medicaid benefits, but whose benefits were reduced to emergency-only benefits, filed suit against the state Medicaid agency for preventing them from accessing the full scope of necessary medical care. Plaintiffs alleged that these benefit reductions violated the obligation to…
- June 9, 2016
Q&A: Using Assessment Tools to Decide Medicaid Coverage
Read moreThis Q&A provides case developments in efforts to ensure that state Medicaid coverage assessment tools are used in compliance with federal law and constitutional due process.
- September 10, 2015
Ensuring that Assessment Tools are Available to Enrollees
Read moreThe amount of Medicaid services for enrollees, particularly home and community based services, is increasingly being determined through prior authorization processes that use assessment tools and clinical coverage criteria. These assessment documents may not be made available to the enrollee. However, Medicaid law and due process call for disclosure…