Supreme Court affirms Medicaid recipients' right to free choice of provider

June 19, 2014Choice!

The NH Supreme Court has ruled in the case of Gary Dube & a v. NH Department of Health and Human Services & a., a case concerning individuals' right under Medicaid to choose among all qualified and willing providers. Harbor Homes in Nashua, a Medicaid mental health provider, had its ability to receive Medicaid payments cut off by the state in 2011 and its clients were forced to receive services from a different provider. In its decision, the Court affirmed the right to choice of provider, and said that Harbor Homes should not be excluded from the Medicaid program for reasons unrelated to its fitness to provide services.

The issue was whether the State violated the Medicaid Act’s free choice of provider provision by denying Harbor Homes the ability to provide mental health services to individuals because they did not have an Interagency Agreement (IAA) with the local community mental health center. The NH Supreme Court ruled that because the State’s regulation requiring Harbor Homes to have an IAA was unrelated to a providers actual qualifications to provide the services, the regulation violates the Medicaid Act. The lower court’s decision was reversed and the Supreme Court remanded the case for further proceedings.*

DRC attorneys Amy Messer, Adrienne Mallinson and Rebecca Whitley brought the suit on behalf of individuals with mental illness who were forced out of services from Harbor Homes. Attorneys Tom Quarles and Lee Smith of Devine Millimet represented Harbor Homes.

* Note: Applicability of freedom of choice under Medicaid managed care is a complex area of law not directly addressed by this decision.

Read the NH Supreme Court opinion in re: Gary Dube &a v. NH Department of Health and Human Services &a.

Read about it in the news:

June 18, 2014, Union Leader: NH Top Court sides with individual choice, private Medicaid provider
June 19, 2014, Nashua Telegraph: Harbor Homes wins 3-year-old court case over Medicaid funding
June 19, 2014, Concord Monitor: Court: New Hampshire erred in Harbor Homes case

updated September 8, 2015