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Private Rights Enforcement

Learn about legal theories that private litigants use to enforce their rights under the Medicaid program.


Under Medicaid’s federal-state split, each state creates its own Medicaid plan, and the federal government is responsible for overseeing that plan’s compliance with federal law. If a state plan isn’t compliant, then the federal government, through HHS, has the authority to terminate the plan’s federal funding completely. However, the federal government has yet to exercise this authority. Rather, federal control tends to come in the form of denying state requests to change plans or denying...