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Fight Over Arizona Medicaid Payment Denials Revived on Appeal

Sept. 2, 2022, 5:45 PM

The Ninth Circuit Friday revived a challenge by federally qualified health centers in Arizona to the state’s refusal to reimburse them for dental, optometric, podiatric, and chiropractic services.

The state’s categorical exclusion of reimbursement for chiropractic services violated the “unambiguous text” of the Medicaid Act, the US Court of Appeals for the Ninth Circuit said.

The court reversed in part and vacated in part a lower court’s dismissal of the lawsuit filed by the Arizona Alliance for Community Health Centers and 11 other centers. It remanded the case for further proceedings.

Federally qualified health centers treat medically underserved areas and are permitted under the Medicaid Act to obtain reimbursement from state Medicaid plans for providing services to program beneficiaries.

The court also ordered the lower court to allow the parties to further develop the record as to whether the state’s limitations on reimbursement for adult dental, podiatric, and optometric services were entitled to deference.

The case is Arizona Alliance for Cmty. Health Ctrs. v. Arizona Health Care Cost Containment Sys., 9th Cir., No. 21-16262, opinion 9/2/22.

To contact the reporter on this story: Christopher Brown in St. Louis at ChrisBrown@bloomberglaw.com

To contact the editor responsible for this story: Alexis Kramer at akramer@bloomberglaw.com