Last week, the US Court of Appeals for the Fourth Circuit issued a decision holding that state health care plans in North Carolina and West Virginia must cover gender-affirming surgeries. A copy of the decision, Kadel v....more
Walgreens Medicaid Fraud Case Kicked Back to Trial Court - On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more
On June 6, 2022, the U.S. Supreme Court issued its ruling in Gallardo vs. Marstiller. In an opinion drafted by Justice Clarence Thomas, the Court held that the federal Medicaid Act, specifically §1396k(a)(1)(A), permits a...more
The Supreme Court delivered a huge blow to tort victims in a recent decision that will effectively eliminate the tort victim’s settlement/award by expanding the ability of states to recoup health care costs from accident...more
The Supreme Court has announced that it will consider a case next term that has the potential to upend several decades of jurisprudence involving the Medicaid program. It involves a complicated area of the law, and in writing...more
The U.S. Supreme Court interpreted the Medicaid Act on June 6, 2022, to permit state Medicaid programs to recover costs for future medical care that has not yet been provided and may never be provided from Medicaid...more
On June 6, 2022, the U.S. Supreme Court decided Gallardo v. Marstiller, No. 20-1263, holding that the federal Medicaid Act does not preempt Florida’s policies dictating how the State can obtain Medicaid reimbursements from...more
Proskauer, in conjunction with attorneys from Children’s Rights, Disability Rights New York, and the National Health Law Program, have filed a class action lawsuit against New York officials in response to the mental health...more
We begin the year with a case, Riverside County Public Guardian v. Snukst (2022) ___ Cal.App.5th ___, involving an elder with dementia who received Medi-Cal benefits. The case, a blast from the past, illustrates how the...more
On April 22, 2021, thirteen Medicaid beneficiaries, represented by the National Health Law Program, the Tennessee Justice Center, and King & Spalding, filed a complaint in the U.S. District Court for the District of Columbia...more
On March 17, 2021, HHS notified Arkansas and New Hampshire officials that it was withdrawing its approval of demonstration projects which had permitted those states to impose work requirements as a condition for eligibility...more
On Thursday, March 11, 2021, the U.S. Supreme Court announced that it will no longer hear oral arguments that were set to occur on March 2, 2021, over D.C. Circuit Court of Appeals rulings striking down Medicaid work...more
Efforts by the federal government and some states to require certain Medicaid beneficiaries to work in order to maintain eligibility for benefits has run into a series of obstacles, both in the courts and in state...more
Medicaid - Florida's Medicaid Third-Party Liability Act Pre-empted by Federal Law - By Eddie Williams - In Gallardo v. Dudek, Sec. of Florida Agency for Health Care Administration, No. 4:16cv116-MW/CAS, 2017 WL...more
On March 31, 2015, the U.S. Supreme Court issued its decision in Armstrong v. Exceptional Child Center, Inc., holding that Medicaid providers cannot sue to enforce reimbursement standards set forth in federal Medicaid law....more
On March 31, 2015, the Supreme Court issued the first of several expected decisions that will impact the healthcare industry this year, ruling that Medicaid providers have no constitutional or statutory right to challenge a...more
The Supreme Court ruled, on March 31, in a 5-4 decision, that hospitals and all other providers cannot sue to force a state to pay higher Medicaid rates. The name of the case is Armstrong v. Exception Child Center. In...more
Yesterday, the United States Supreme Court issued an opinion that denies providers the right to challenge low Medicaid reimbursement rates by suing state agencies in federal court. In Armstrong v. Exceptional Child...more
The Idaho Medicaid program scored a victory in the United States Supreme Court today, and did it by persuading normally liberal Justice Breyer to enter the conservative tent reliably inhabited by Justices Scalia, Thomas,...more
On Tuesday, January 20, 2015, the U.S. Supreme Court will hear oral argument in a significant Medicaid-preemption case from the Ninth Circuit, Exceptional Child Center, Inc. v. Armstrong. In that case, Medicaid-participating...more