Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

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

Supreme Court Upholds Coverage under the Affordable Care Act

July 10, 2025The U.S. Supreme Court has upheld the authority of the U.S. Preventive Services Task Force under the ACA, ensuring continued no-cost coverage for over 100 preventive health services. The decision impacts millions of Americans and preserves provider reimbursement through insurance.Client Alert

Health Care Providers Take Note: Federal Budget Brings Medicaid and Staffing Rule Changes

July 7, 2025The 2025 federal budget introduces significant changes for health care providers and Medicaid recipients, including new cost-sharing requirements, work eligibility mandates, rural health grants, and a pause on minimum staffing rules.Client Alert

Key Healthcare Provisions in Ohio’s 2026–2027 Budget

July 2, 2025Ohio’s newly enacted biennial budget (HB 96) for FY 2026–2027 brings sweeping changes for healthcare providers across the state. The law includes new Medicaid eligibility requirements, reporting mandates, funding directives, and social policy provisions. Several vetoes by Governor DeWine also affect healthcare-related initiatives.Client Alert

Providers Beware: Court Sides with Insurers in No Surprises Act Arbitration

July 2, 2025On June 12, 2025, the Fifth Circuit ruled in favor of Aetna and Kaiser in two lawsuits brought by air ambulance providers challenging how insurers calculated payments under the No Surprises Act’s Independent Dispute Resolution process. The court held that unless there is clear evidence of fraud or serious misconduct, IDR decisions will stand, reinforcing the finality of the arbitration process.Client Alert

Introducing HB 281: Enforcement of Federal Immigration Laws in Ohio Hospitals

July 1, 2025House Bill 281, introduced on May 20, 2025, would require Ohio hospitals to allow law enforcement, including federal immigration agents, to enter facilities and enforce immigration laws. The bill mandates that hospitals comply with information requests and adopt formal policies, raising significant concerns about patient privacy and access to care for immigrant communities.
Older posts