Recently, three organizations filed a lawsuit in the U.S. District Court for the District of Columbia, which challenges CMS's approval of Kentucky's Medicaid waiver and CMS's recent guidance on community engagement. In taking these actions, the lawsuit claims that CMS acted beyond its scope of authority under Section 1115 and bypassed the legislative process to transform Medicaid. It also claims that certain waiver provisions are not likely to promote the objectives of the Medicaid Act.
The lawsuit specifically challenges the following waiver components:
- Work and community engagement requirements;
- Premium requirements;
- Cost sharing for non-emergency use of the emergency room;
- Lockout penalties for beneficiaries;
- Waiver of retroactive eligibility; and
- Waiver of non-emergency medical transportation.
Legal experts have noted that the lawsuit, were it to succeed, may not directly impact other states' waivers. However, it could impact CMS's willingness to approve similar waivers.
The text of the legal challenge is available here.
[ via National Association of Medicaid Directors Update, Feb. 6, 2018 ]