The Uncertainty Of Medicaid Entitlement Enforcement

Law360, New York (March 14, 2012, 1:56 PM EDT) -- The Medicaid statute begins with seven words: “A state plan for medical assistance must,” and the statute then proceeds to list 83 requirements that a state Medicaid plan is required to meet.[1] Absent from the statute, however, is any remedy for Medicaid beneficiaries or providers who are harmed by a state’s failure to satisfy any one of those requirements.

An aggrieved party can always petition the U.S. Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the program, for relief when a state...
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