Medicaid and the role of the courts
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Report (Commonwealth Fund)
- Author(s):
- Rosenbaum, Sara, author
- Contributor(s):
- Commonwealth Fund, issuing body.
- Publication:
- [New York, N.Y.] : Commonwealth Fund, June 2018
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Judicial Role Medicaid -- legislation & jurisprudence Eligibility Determination -- legislation & jurisprudence Federal Government Health Services Accessibility -- legislation & jurisprudence Insurance Benefits -- legislation & jurisprudence Insurance Coverage -- legislation & jurisprudence Medicaid -- standards State Government Humans United States
- Genre(s):
- Technical Report
- Abstract:
- ISSUE. By interpreting and enforcing law, courts historically have played a vital role in shaping Medicaid policy. Among the thousands of cases interpreting Medicaid's meaning, numerous decisions have led to further statutory and regulatory reforms. GOAL. To review judicial decisions that have been instrumental in shaping Medicaid policy regarding eligibility, benefits, and provider participation and payment; to review the scope and limits of state and federal powers, including powers granted under Section 1115 to approve Medicaid demonstrations; and to review the critical question of whether courts can intervene, prior to federal agency review, to prevent states from implementing potentially unlawful and harmful policies. METHODS. Review of leading Medicaid cases. FINDINGS AND CONCLUSIONS. The courts have shaped virtually all aspects of Medicaid policy, including eligibility, benefits and coverage, access to care, provider participation and payment, and the scope of federal agency demonstration powers under Section 1115. Furthermore, underlying the cases that focus on what federal law requires of participating states is a key threshold question of importance to lawsuits brought against states by beneficiaries and providers: whether, in advance of federal agency review, federal courts can intervene to prevent potentially unlawful state policies from taking effect before they cause immediate and irreparable injury. This question has commanded the attention of a more conservative judiciary, whose rulings increasingly are narrowing access to the courts.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (10 pages)).
- NLM Unique ID:
- 101729291 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101729291