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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 ExplainerRead moreThis 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…
- August 29, 2023
Guide to Accessing Medi-Cal Mental Health Services for Current and Former Foster Youth
Read moreCurrent and former foster youth in California have access to a broad array of mental health services. Working with the National Center for Youth Law, the National Health Law Program developed a guide to help foster youth better understand the mental health services available to them through Medi-Cal, as well…
- August 1, 2023
Institutions for Mental Diseases (IMD) Exclusion and Substance Use Disorders: Lay of the Land
Read moreThe Medicaid Act prohibits the use of federal funding for services provided in Institutions for Mental Diseases (IMDs). In response to the overdose epidemic, two competing pathways have been implemented that allow states to circumvent the IMD exclusion: the SUPPORT Act's state plan amendment (SPA) option and the use…
- July 14, 2023
Comments on Proposed Medicaid Managed Care Access Rule
Read moreCMS 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…
- July 13, 2023
Comments on Proposed Medicaid Access Rule
Jennifer Lav, Wayne Turner, David Machledt, Abigail Coursolle, Dania Douglas, Charly Gilfoil, Jasmine Young, and Madeline Morcelle CommentsRead moreCMS proposed changes and additions to regulations enforcing the "equal access" provision of Medicaid. These changes would strengthen opportunities for enrollees' input and oversight of state Medciaid programs, would help promote access to Medicaid services, would improve quality of care, and promoting transparency and adequate payment for fee-for-service Medicaid.…
- May 17, 2023
Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights
Read moreMedi-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…
