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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
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FTC Continues to Target Noncompetes

September 11, 2025The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.Client Alert

Medicare Updates: Prior Authorizations and Physician Fee Schedule

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USCIS Policy Updates: Implications for Business Immigration

August 20, 2025In August 2025, USCIS issued three key policy updates enhancing vetting, good moral character (GMC) evaluations, and scrutiny of "anti-American" conduct in immigration adjudications. These policy memos will impact employers sponsoring foreign workers, including H-1B, L-1, EB visas, adjustments, and naturalization.Client Alert

Ohio Passes Antidiscrimination Provision for CRNA Reimbursement

August 14, 2025Ohio has passed House Bill 96, introducing a provider nondiscrimination provision that requires health plans to reimburse certified registered nurse anesthetists (CRNAs) at the same rate as physicians for the same services. The law aims to improve patient access to care by eliminating payment discrimination against CRNAs and will take effect on September 30, 2025.Client Alert

Ohio Board of Pharmacy | Administrative Code Rule Changes

July 16, 2025The Ohio Board of Pharmacy (“BOP”) recently posted notices of Ohio Administrative Code rule changes related to record keeping and the sale and distribution of certain ephedrine-containing products.
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