Are Healthcare Provider Challenges to Medicaid Cuts Dead?

By Stephen D. Rose
Health Care Attorney and Owner
Garvey Schubert Barer

With the demise of the Boren Amendment, healthcare providers and Medicaid recipients have searched for an effective avenue to challenge state proposed Medicaid rate reductions that threaten access to healthcare services by Medicaid beneficiaries. With the implementation of the Affordable Care Act and significant expansion of Medicaid beneficiaries expected in the very near future, whether healthcare providers and Medicaid recipients can challenge Medicaid rate reductions takes on added importance. On May 24, 2013, the Ninth Circuit drastically reduced the legal avenues that can be taken to challenge Medicaid rate reductions. Managed Pharmacy Care v. Sebelius, ___ F.3d ___ (9th Cir. 2013) (Managed Pharmacy Care), significantly weakened the ability of healthcare providers and Medicaid recipients to challenge Medicaid rate reductions. Read article

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