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