News & Analysis as of

Medicaid Constitutional Challenges State and Local Government

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
King & Spalding

Supreme Court Holds Medicaid Participants Lack Standing to Enforce “Any-Qualified-Provider” Clause

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On June 26, 2025, the Supreme Court ruled that Medicaid providers and beneficiaries lack the ability to enforce the Medicaid Act’s “any‑qualified‑provider” clause in federal court. In Medina v. Planned Parenthood, the Court...more

Goodwin

Health Headlines: June 2025

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Welcome to the seventh issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice. Iowa Governor Kim Reynolds signed Senate File 383 into law, placing new restrictions on pharmacy benefit...more

Troutman Pepper Locke

U.S. Supreme Court Holds Medicaid’s Any-Qualified-Provider Provision Does Not Confer Enforceable Rights

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The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more

Goodwin

Prescription Drug Affordability Review Boards - 2025 Update

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Prescription Drug Affordability Boards (PDABs) are becoming a larger part of the state drug price regulatory landscape. The boards are regulatory bodies that review the affordability and cost of specific prescription drugs. ...more

Sheppard Mullin Richter & Hampton LLP

Recent Legal and Regulatory Developments Involving Gender-Affirming Care

On January 28, 2025, President Trump signed Executive Order 14187 (the “EO”), which directed the federal government to take steps to ensure that the federal government does not “sponsor, promote, assist, or support” the...more

Littler

DOJ Files a Statement of Interest in a Federal Lawsuit Against the NY Department of Health and Court Issues a Preliminary...

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As previously discussed, in Engesser v. McDonald, a class of Medicaid beneficiaries who receive personal care and home care services through New York’s CDPA Program (Consumers), and two independent living centers...more

Littler

NY Federal Court Issues TRO Against the NY Department of Health

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As previously reported, in April 2024, New York’s Social Services Law was amended to include a substantial change to the state’s Consumer Directed Personal Assistance Program (CDPA Program), a Medicaid-funded program allowing...more

Littler

New York Court Issues Decision and Order Declaring the DOH’s August 2024 Reimbursement Rate Adjustment for Fiscal Intermediaries...

Littler on

On March 20, 2025, a New York Supreme Court Justice in Albany County issued a decision and order declaring the New York State Department of Health (NY DOH)’s August 2024 implementation of an administrative rate reimbursement...more

Falcon Rappaport & Berkman LLP

Disruptions to the Medicaid System, Alongside Trump Administration’s Freeze of Federal Funding to Agencies, Results in Lawsuit by...

On the evening of January 27, 2025, the Trump Administration’s Office of Management and Budget (OMB) issued a “Memorandum for Heads of Executive Departments and Agencies” titled, “Temporary Pause of Agency Grant, Loan, and...more

Polsinelli

Polsinelli Obtains Favorable Decision in Challenge to Colorado’s Medicaid Funding Program

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Medicaid is a shared federal and state program. Federal and state dollars are combined so states can furnish Medicaid health coverage to poor and disabled Coloradans including many who need nursing facility care. ...more

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