If You’re Excluding Planned Parenthood From Medicaid, You’re Violating the Law
After close to a year of unrelenting attacks on family planning providers at the federal and state levels, there is some very good news to report. Yesterday, the Centers for Medicare & Medicaid Services (CMS) made it absolutely clear that states attempting to exclude Planned Parenthood and other family planning providers from Medicaid are violating federal law. CMS provided guidance to state Medicaid directors on the legal requirement that people enrolled in Medicaid have a right to obtain care from any health care provider who is willing to provide that care (often referred to a “free choice of provider.”) CMS made clear that while states have a role setting standards for health care providers that participate in state Medicaid programs, those standards cannot interfere with enrollees’ free choice of provider. Any standards set by the state must be related to whether a health care provider is able to provide covered medical services or bill for those services appropriately. Moreover, the reasons to exclude a health care provider from Medicaid cannot be “a desire to target a provider or set of providers for reasons unrelated to their fitness to perform covered services or the adequacy of their billing practices.”
That last part might sound familiar. It is exactly what many states, and some members of Congress, have been trying to do: exclude Planned Parenthood and other family planning providers from Medicaid, Title X, and other programs. These legislators do not have real concerns about whether these providers are able to perform services Medicaid covers, like well-woman visits, screenings for sexually transmitted diseases, or birth control. They don’t have real concerns if these providers can bill Medicaid properly. These attacks are politically-motivated and intended to shut down clinics and make it more difficult for women to get these services.
Yesterday, CMS said, no more. These legislators need to hear this message loud and clear.