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SCOTUS to Weigh In on Medicaid Beneficiaries’ Right to Choose their Provider

Client Alert
January 2, 2025

The Supreme Court of the United States (SCOTUS) recently granted a petition filed by the state of South Carolina to determine whether Medicaid recipients have the right to choose their provider without state interference. Section 1902(a)(23) of the Social Security Act generally requires state Medicaid programs to permit Medicaid beneficiaries to seek care from any institution, agency, community pharmacy, or provider that is qualified and willing to deliver care to beneficiaries.

South Carolina filed its petition in response to a Fourth Circuit ruling that prevented South Carolina’s Medicaid program from terminating its provider agreement with Planned Parenthood. In the Fourth Circuit case, Planned Parenthood South Atlantic argued that Section 1902(a)(23) of the Social Security Act gives Medicaid beneficiaries the right to seek care from any qualified and willing provider and that it was not Congress’ intent for states to intrude on a Medicaid patients’ personal decisions about medical care. Arguments will take place this spring; SCOTUS will consider the merits of the case and issue a decision by the end of the summer.

If you have questions about the Supreme Court’s decision to determine whether a Medicaid beneficiary has an enforceable right to challenge a state’s determination that a provider is unqualified, please contact Member Daphne Kackloudis at dlkackloudis@bmdllc.com, Attorney Jordan Burdick at jaburdick@bmdllc.com, or Attorney Kate Crawford at khcrawford@bmdllc.com.

MedicaidHealth LawHealthcareDaphne KackloudisKatherine CrawfordJordan Burdick
Client Alert

Corporate Transparency Act Overhauled: U.S. Entities No Longer Required to Report

March 24, 2025The Department of Treasury has issued an interim final rule significantly altering the Corporate Transparency Act (CTA). As of March 21, 2025, all U.S.-created entities and their beneficial owners are exempt from reporting requirements. Only non-U.S. entities registered to do business in the U.S. must still report, but they are not required to disclose U.S. citizen owners. Business owners should stay informed on these changes and consult legal counsel for compliance guidance.Client Alert

ODM to Implement Medicaid Work Requirements: What Providers and Medicaid Expansion Recipients Need to Know

March 21, 2025The Ohio Department of Medicaid (ODM) has submitted a waiver to impose work requirements for Medicaid expansion recipients. If approved, the new eligibility criteria will take effect on January 1, 2026. A federal public comment period is open until April 7, 2025.Client Alert

Ohio Appellate Court Rules in Favor of Gender-Affirming Care

March 19, 2025On March 18, 2025, the 10th District Court of Appeals in Franklin County ruled that Ohio’s House Bill (HB) 68, which restricts puberty blockers and hormone therapy for minors seeking gender-affirming care, violates the Health Care Freedom Amendment and is therefore unenforceable. The court found that the law unlawfully interferes with parental rights and medical decision-making. The case, Moe v. Yost, has been remanded, and Ohio Attorney General Dave Yost intends to appeal.Client Alert

HHS Revokes Public Comment Requirement on Certain Policy Changes

March 5, 2025The U.S. Department of Health and Human Services (HHS) has revoked the Richardson Waiver, eliminating the requirement for public notice and comment on certain policy changes. This decision allows HHS to implement new policies more quickly, potentially affecting healthcare funding rules like Medicaid work requirements. While it speeds up policymaking, it also reduces opportunities for stakeholder input, raising concerns over transparency and unintended consequences for healthcare providers, states, and patients.Client Alert

Don't Get Caught Dazed and Confused: Another Florida Court Weighs in on Employer Obligations to Accommodate Medical Marijuana Use

March 3, 2025A Florida trial court ruled in Giambrone v. Hillsborough County that employers may need to accommodate off-duty medical marijuana use under the Florida Civil Rights Act (FCRA). This contrasts with prior rulings and raises new compliance challenges for employers. With the case on appeal, now is the time to review workplace drug policies.
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