State plans for medical assistance under federal Medicaid law must comply with certain requirements located in Title 42 U.S.C. § 1396a.4, but do not always do so. In 2018, the United States District Court for the District of Alaska in the case of Disability Law Center of Alaska v. Davidson denied a motion for summary judgment on three claims alleging that Davidson who in her position as the commissioner of the Alaska Department of Health and Social Services had violated federal Medicaid law.
The violations of which the Center was accused were: failure to provide adequate notice on how to apply for and access applied behavioral therapy, not reimbursing for ABA under the program, and not providing ABA services under the program with reasonable promptness. In arriving at its decision, the court noted that the Disability Law Center had the burden under federal law of establishing that Davidson had deprived them of the following rights: the right to notice of availability of ABA services, the right to be reimbursed for ABA therapy, and the right to have ABA therapy provided.
The court’s subsequent decision subsequently supported the position that any state that has elected to participate in federal Medicaid programs must be prepared to provide services identified under the federal statute as mandatory. This case underscores the right that many individuals in the United States have to Medicaid benefits.
Medicaid is a Federal Based Program
In accordance with federal regulations, each of the 50 states administer Medicaid program and have the ability to determine who is covered, how service is provided, and the method for reimbursing medical professionals and medical facilities.
Additionally, states can also obtain Section 115 waivers to test and determine the best ways to implement Medicaid funds. This means there is great disparity over how each state decides to execute its Medicaid program.
Despite these differences, it is important to understand Medicaid entitlement. First, all American citizens who qualify for Medicaid are guaranteed coverage. Second states are guaranteed federal matching dollars without a cap for qualified services to qualified applicant.
The Value of Medicaid for New York Residents
Medicaid is an important program for many individuals in the United States, particularly senior citizens. Unfortunately, however, Medicaid can leave individuals facing a number of complications including the decision of whether to spend down assets or pay for the services themselves.
Currently, the limit to receive Medicaid services is only a few hundred dollars for an individual and a little over $1,000 for married individuals, which leaves applicants with little money to pay for a number of monthly living costs. To determine if Medicaid planning could serve an invaluable role in your estate plan, it is often a wise idea to contact an experienced lawyer.
Speak with a Skilled Estate Planning Attorney
While federal Medicaid programs have their advantages, it can be difficult to navigate a number of challenges that can involve with medicaid. If you need the assistance of an experienced attorney, do not hesitate to contact Ettinger Estate Planning today.