In a recent decision, the United States Court of Appeals for the Fifth Circuit in Legacy Community Health Services v. Smith held that state Medicaid programs may refuse to pay community health centers for the non-emergency, out-of-network care they furnish to Medicaid managed care enrollees. The Legacy (TX) decision carries important implications for the financial stability of community health centers in states that rely extensively on managed care. A new issue brief discusses the national implications of this ruling and estimates the economic impact on community health centers, their staff, and their patients nationally if the decision stands.
The brief was authored by Leighton Ku, Peter Shin, Jessica Sharac, and Sara Rosenbaum.