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  • Fact Sheet: Private Enforcement of the Medicaid Act

    Medicaid recipients and applicants may encounter problems when state Medicaid programs do not comply with mandatory requirements of the federal Medicaid Act, 42U.S.C. §§ 1396-1396v. These individuals may consider a court action to obtain injunctive relief.This Fact Sheet will provide background and discuss trends affecting private enforcement of the…

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  • Q & A: Defining Medical Necessity

    Question: Our office has been contacted by Ms. G., a 32-year-old Medicaid recipient. She tells us that the state Medicaid agency is seeking to implement a definition of ?medical necessity? that, when applied to her condition, will cause her physical therapy services to be terminated. What is the…

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