Federal Appeals Court Rules That New York Must Ensure FQHCs Are Fully Reimbursed For Services Provided To Medicaid MCO Members

On October 7, 2014, the U.S. Second Circuit Court of Appeals said that New York Medicaid must ensure that federally qualified health centers (FQHCs) are fully reimbursed for services provided to Medicaid managed care organization (MCO) enrollees. The statement was in a decision issued in Community Health Care Association of New York State, et al., v. Shah. The plaintiffs said Medicaid reimbursement rates were inadequate, and alleged that the state failed to ensure that FQHCs were fully paid for services provided to Medicaid beneficiaries enrolled in managed care plans. The plaintiffs said that when an MCO failed . . .