Seittelman v. Sabol

OPINION OF THE COURT

Smith, J.

The primary issue presented by this appeal is whether defendants by regulation may limit Medicaid reimbursement for expenses incurred by eligible individuals during the three-month period preceding the application for Medicaid to only those services rendered by Medicaid-enrolled providers. We hold that such a State regulatory limitation is unsupported by the language or policy of the Federal statute. It is neither rational nor reasonable and is thus unenforceable. We also hold that the recipients may be reimbursed only at the Medicaid rate in existence at the time…