Tag Archives: Doe v. Gillespie

The Availability of a Private Right of Action in Medicaid

A few years ago, we told you about the “ongoing saga” surrounding the ability of a Medicaid beneficiary or a provider of health care services to a Medicaid beneficiary to challenge a state Medicaid agency’s putative violation of a requirement of the Medicaid program.  For example, section 1902(a)(8) of the Social Security Act says that a state Medicaid agency must provide Medicaid benefits “with reasonable promptness to all eligible individuals.”  Well,… More

Enforcing the Entitlement to Medicaid: The Ongoing Saga

We have written in the past about enforcing the entitlement to Medicaid through the federal court system.  In light of a recent opinion by the United States Court of Appeals for the 8th Circuit, it seems that this judicial saga continues.

The federal Medicaid statute imposes roughly 80 requirements on a state Medicaid plan.  For example, a state Medicaid plan must make medical assistance available “with reasonable promptness.”  Social Security Act § 1902(a)(8). … More