Foley & Lardner LLP attorneys Lori Rubin, Adam Hepworth, and Whitney Swart recently secured a significant pro bono victory in an Administrative Procedure Act (APA) challenge in federal court in California. This win helps ensure that senior citizens in California, and potentially in other states, can more easily obtain critical periodontal services.
The Foley team challenged the Secretary of the U.S. Department of Health and Human Services’ (HHS) approval of a California state plan amendment (SPA) that imposed severe Medicaid rate cuts and burdensome pre-authorization requirements for certain services provided by specialty dental hygienists. This SPA impacted seniors in a number of facilities and the hygienists who serve them by making it logistically or financially impossible – and in some cases both – to provide vital periodontal services.
Drawing on their acute knowledge of California’s Medicaid programs and depth of experience with administrative law, Rubin, Hepworth, and Swart challenged HHS’s approval of the SPA as arbitrary and capricious under the APA. After reviewing the summary judgment motion, the government backed down from its position and asked the court for a remand – while leaving the offending provisions in place – so that the HHS could reconsider and gather more support for its approval.
After extensive briefing and oral argument where the Foley team contended there should not be remand without vacatur, the court vacated and remanded the offending provisions. Together with partners at the AARP Foundation, The Foley team obtained an order from the U.S. District Court for the Central District of California to vacate the provisions of the SPA, which was the team’s ultimate goal.
In addition to Rubin, Hepworth, and Swart, the Foley team involved in this matter included Paralegal Wendy Delvalle and a former summer associate.
