Medicaid

Medicaid: General Principles Explained by the Courts

Harris v. McRae, 448 U.S. 297 (1980).
The Medicaid program created by Title XIX is a cooperative endeavor in which the Federal Government provides financial assistance to participating States to aid them in furnishing health care to needy persons. Under this system of “cooperative federalism,” King v. Smith, 392 U.S. 309, 316, if a State agrees to establish a Medicaid plan that satisfies the requirements of Title XIX, which include several mandatory categories of health services, the Federal Government agrees to pay a specified percentage of “the total amount expended . . . as medical assistance under the State plan. . . . ” 42 U. S. C. § 1396b (a)(1). The cornerstone of Medicaid is financial contribution by both the Federal Government and the participating State.

Md. Dep’t of Health & Mental Hygiene v. Ctrs. For Medicare & Medicaid Srvs, 542 F.3d 424 (4th Cir. 2008). “Designed to provide medical assistance to persons whose income and resources are insufficient to meet the costs of necessary medical care, the Medicaid program functions as a partnership between the federal government and the states. 42 U.S.C. § 1396a(a)(10). After a state elects to participate in the program, the federal government shares the costs of providing medical assistance in a ratio that varies from state to state. 42 U.S.C. § 1396a(a)(2). In return, the state agrees to comply with the Medicaid statute and any administrative regulations properly promulgated by CMS. 42 U.S.C. 1396a(a)(1).”

In re Estate of Bruce, 260 S.W.3d 398 (Mo. Ct. App. 2008). “Medicaid is a cooperative federal–state program designed to assist the states in providing health care to people who cannot afford it. McNeil-Terry v. Roling, 142 S.W.3d 828, 833 (Mo. App. 2004). If a state opts to participate in the program, it must comply with all federal statutory and regulatory requirements. Id. Because Medicaid is a cooperative program, it is not susceptible to express or implied field preemption. It is susceptible only to conflict preemption.”

Wojchowski v. Daines, 498 F.3d 99 (2nd Cir. 2007). “Medicaid, which is jointly funded by the federal and state governments, is a medical assistance program authorized to pay for necessary medical care for those eligible individuals whose income and resources do not allow them to meet the costs of their medical needs.”

Published by
David McGuffey

Recent Posts

Medicaid Post Eligibility Treatment of Income and Incurred Medical Expenses

After Medicaid eligibility is established, 42 C.F.R. § 435.725 addresses how income is treated. For…

7 days ago

Medicaid’s Refusal to Provide 24/7 Care in the Community Might be Discrimination

In Harrison v. Young (5th Cir. June 6, 2024), the Fifth Circuit considered Ms. Barbara…

3 weeks ago

Updates to Nursing Home Quality of Care Regulations

From time to time federal regulations covering nursing home quality of care are updated. Thus…

3 weeks ago

Federal Nursing Home Quality of Care Regulations

Nursing homes that accept Medicare or Medicaid are required to comply with quality of care…

3 weeks ago

New Article Discussing Medicaid Enrollment and Wealth Transfers

On June 11, 2024, the Gerontologist published an article on Medicaid enrollment and Intergenerational transfers…

4 weeks ago

Virtual Dementia Tour

Dementia affects more than 50 million people worldwide. The Virtual Dementia Tour is designed to…

4 weeks ago