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December 22, 2025
Federal AI Policy Threatens Prior Authorization Reform
Brit Vanneman Uncategorized
Automated systems play increasingly important roles in shaping access to health care services. Frequently, insurers use algorithms and artificial intelligence (AI) to route requests and make coverage decisions, fill records and forms, and even make recommendations about medical necessity. While automation can improve speed, relying too heavily on AI…
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December 22, 2025
An Advocate’s Guide to Medi-Cal Services
Fabiola De Liban, Amy Chen, Abigail Coursolle, Alicia Emanuel, Héctor Hernández-Delgado, T. Nancy Lam, Kimberly Lewis, Carly Myers, Alexis Robles-Fradet, Skyler Rosellini, Jasmine Young, and Elizabeth Zirker Guide
NHeLP’s Medi-Cal Services Guide provides an in-depth description of some of the most important services covered in the Medi-Cal program, including prescription drug services, mental health and substance use disorder services, reproductive and sexual health services, gender-affirming services, among others. The guide seeks to help legal aid attorneys, health…
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December 11, 2025
Prior Authorization in Medicaid Series
Brit Vanneman Issue Brief
This issue brief series explores how prior authorization policies shape access to care in public health coverage programs, particularly Medicaid. The first brief introduces the fundamentals of prior authorization, how it operates for Medicaid beneficiaries, and the growing movement for reform. Future installments will explore the legal and policy…
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September 24, 2025
New Medicaid Work Requirements: How Managed Care Plans Can Help
Abigail Coursolle Uncategorized
Beginning January 1, 2027, OBBBA requires adults covered under the Medicaid expansion population to participate in mandatory work activities or show they are exempt. These work requirements will force Medicaid beneficiaries to show that they participate in one or more required work-related activities for 80 hours per month. Activities…
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July 29, 2025
Revisiting Managed Care Sanctions
Daniel Young Issue Brief
This issue brief is part of the National Health Law Program’s ongoing work on accountability in Medicaid managed care. It updates our research on Medicaid managed care sanctions by revisiting the states we profiled in 2022. We summarize recent sanctions content from the managed care websites of those states…
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July 28, 2025
Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised July, 2025)
Abigail Coursolle Issue Brief
Federal and state law and the state and federal Constitutions require that enrollees in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not…
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Federal AI Policy Threatens Prior Authorization Reform

An Advocate’s Guide to Medi-Cal Services

Prior Authorization in Medicaid Series

New Medicaid Work Requirements: How Managed Care Plans Can Help

Revisiting Managed Care Sanctions

Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised July, 2025)