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- June 11, 2021
L.S. by and through Ron S. v. Delia, Eastern District of North Carolina and Fourth Circuit Court of Appeals
Litigation Team CasesRead moreThis class action was filed on behalf of a class of North Carolinians with intellectual and developmental disabilities who received letters from their regional managed care organization, Piedmont Behavioral Health (known as PBH and later Cardinal Innovations Healthcare), informing them that, based on their Supports Intensity Scale (SIS) assessment,…
- June 11, 2021
Cyrus ex rel. McSweeney v. Nusbaum, Southern District of West Virginia
Litigation Team CasesRead moreIn 2004, a class of recipients of West Virginia’s Medicaid HCBS waiver program for older adults and people with disabilities was granted a preliminary injunction that restored HCBS benefits that had been terminated the year before and required the state to provide adequate notice that explained the reasons for…
- June 11, 2021
Salazar v. District of Columbia, D.C. District Court, D.C. Circuit
Litigation Team CasesRead moreThis class action was originally brought in 1996 on behalf of children and adults who had applied for Medicaid, with claims including that the Medicaid agency failed to: issue decisions and provide coverage within 45 days of a submitted application, provide advance notice of termination of benefits; provide or…
- June 11, 2021
Demanding Ascertainable Standards: Medicaid as a Case Study
Read moreState Medicaid agencies and their contractors are increasingly relying on preset guidelines or assessment tools or both to make coverage decisions. Problems arise when the use of these tools results in program enrollees and advocates being refused access to the standards and procedures that govern the operation of the…
- June 10, 2021
NHeLP AHRQ Comments
Read moreIn these comments, NHeLP responds to a request for information from AHRQ regarding the use of clinical algorithms that have the potential to introduce racial/ethnic bias into healthcare delivery. Using our long history of litigation and advocacy on issues that involve the use of automated decision-making systems, including algorithms,…
- May 26, 2020
A.M.C. v. Smith, Middle District of Tennessee
Read moreThirty-five children and adults from across Tennessee brought a class action challenging the State for wrongfully terminating people’s health insurance under Tennessee’s Medicaid program, known as TennCare. The Plaintiffs allege that TennCare’s system for reevaluating eligibility is defective and fails to provide the notice and opportunity for hearing required…
