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September 18, 2023
EPSDT’s Legal Landscape & Implementation History
Amanda Avery and Jane Perkins Court Document, Health Advocate, Regulations and Laws, Fact Sheet, Case Explainer
This Fact Sheet provides essential information to help advocates become EPSDT experts. After giving an overview to EPSDT, we focus on: (1) legislative milestones; (2) notable federal agency guidance; and (3) precedent-setting cases from the judiciary. Next, we provide a snapshot of states’ performance implementing EPSDT, using government reports…
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July 14, 2023
Comments on Proposed Medicaid Managed Care Access Rule
Sarah Somers Comments
CMS proposed a major administrative rule that would increase transparency in managed care; improve monitoring and assure adequacy of payments in managed care; increase accountability, transparency, and participant input into external quality review; and help states to make information about quality measures widely available. NHeLP filed comments in support…
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June 28, 2023
California Abortion Coverage in Medi-Cal and Private Insurance
Jasmine Young, Amy Chen, and Fabiola De Liban Fact Sheet, Guide
*Co-written with Xochitl Lopez-Ayala (Policy Advocacy Coordinator at ACCESS REPRODUCTIVE JUSTICE) Access to comprehensive health care, which includes abortion care, is critical to every person’s health and well-being. Abortions are legal in California. Both Medi-Cal and private health insurance plans in California are required to cover all abortions. This…
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May 17, 2023
Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights
Abigail Coursolle and Nancy Lam Issue Brief
Medi-Cal covers Specialty Mental Health Services (SMHS) for beneficiaries who need them. In California, County Mental Health Plans (MHPs) are responsible for providing SMHS to Medi-Cal beneficiaries of all ages. This issue brief analyzes the legal requirements that require MHPs to ensure Medi-Cal beneficiaries’ access to SMHS and maintain…
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May 10, 2023
How Funding and Eligibility Cuts to Medicaid Harm Response Efforts to Public Health Crises (Updated May 2023)
Michelle Yiu Issue Brief, Fact Sheet
Congressional Republican leadership is considering funding and eligibility cuts to Medicaid, such as work requirements, block grants, and per capita caps. Such proposals would impose new budgetary pressures on states and make it more difficult for individuals to access necessary health care programs and services. Because Medicaid is uniquely…
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May 3, 2023
NHeLP Summary of Proposed Access and Managed Care Rules
Sarah Somers Fact Sheet
Last week, the Centers for Medicare and Medicaid Services (CMS) released two proposed rules intended to improve access to care, quality and health outcomes, and address health equity issues. The first, Medicaid Program: Ensuring Access to Services (Access Rule), addresses in Medicaid fee-for-service, managed care, and HCBS program. The…
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EPSDT’s Legal Landscape & Implementation History

Comments on Proposed Medicaid Managed Care Access Rule

California Abortion Coverage in Medi-Cal and Private Insurance

Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights

How Funding and Eligibility Cuts to Medicaid Harm Response Efforts to Public Health Crises (Updated May 2023)

NHeLP Summary of Proposed Access and Managed Care Rules