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May 30, 2023
Trends in State Medicaid Continuous Coverage Unwinding Plans
Cassandra LaRose Fact Sheet
As part of the Medicaid continuous coverage unwinding, states were required to create plans to describe how they will redetermine the eligibility of all Medicaid enrollees. This paper identifies some of the major trends affecting beneficiaries in available unwinding plans including choices that may affect coverage loss and ease…
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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 15, 2023
Principles for Fairer, More Responsive Automated Decision-Making Systems
Elizabeth Edwards and David Machledt Issue Brief, Manual/Report, Fact Sheet, Guide, Case Explainer
Many government agencies use automated decision-making systems (ADS) for public benefits coverage and enrollment decisions, including Medicaid. By ADS we mean, broadly, systems that use standardized logic or algorithms to assess eligibility for and access to public benefits. This includes not only sophisticated “big data” systems, such as programs…
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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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April 20, 2023
AMICUS: J.R. v. Horizon NJ Health, New Jersey Superior Court, Appellate Division
Litigation Team Cases
J.R. is a young child who requires nursing services and appealed a significant reduction in her Medicaid nursing services that was based on the results of a secret scoring tool and care guidelines. The notice provided to J.R. reducing their services only provided the end result of the tool…
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April 17, 2023
What Makes Medicaid, Medicaid? — Consumer Protections and Due Process
Kimberly Lewis, Wayne Turner, and Skyler Rosellini Issue Brief
To ensure that Medicaid beneficiaries have complete access to quality health care, Medicaid provides important consumer protections and due process rights, many of which are enforceable through legal action. In this paper for our "What Makes Medicaid, Medicaid," series, NHeLP attorneys detail the consumer protections and rights of Medicaid…
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Trends in State Medicaid Continuous Coverage Unwinding Plans

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

Principles for Fairer, More Responsive Automated Decision-Making Systems

NHeLP Summary of Proposed Access and Managed Care Rules

AMICUS: J.R. v. Horizon NJ Health, New Jersey Superior Court, Appellate Division

What Makes Medicaid, Medicaid? — Consumer Protections and Due Process