What objective criteria supported recommendations that Waiver I participants move to Waiver II?

Watch with captions

Video file · VTT captions · SRT captions · Transcript file

Full transcript

Question 52. What objective criteria supported recommendations that Waiver I participants move to Waiver II? The 2023 report raises a concern, not a finding. People served: A covered service decision may require informed choice, conflict safeguards, accessible notice, and a fair hearing. David Medeiros: Questioning authority or transitions may be protected advocacy, but government action and causation remain essential. ABI Resources: ABI may enforce actual contracts or process rights; it has no presumed property right in referrals or waiver placement. Constitutional claims need state action; beneficiary choice does not guarantee ABI referrals or a contract. Classify the issue before choosing a remedy. Preserve waiver terms, amendments, authorizations, assessments, consultation notes, billing codes, notices, and appeals. Apply Constitution, statute, regulation, contract, then record.

Three separate rights lenses

Limits and records needed

Constitutional claims require conduct fairly attributable to government; private-provider status is not automatic state action.

Provider choice chiefly protects beneficiaries and does not guarantee ABI referrals, volume, renewal, contracting, or payment.

Records identified for review: waiver terms, amendments, authorizations, assessments, consultation notes, billing codes, notices, and appeals

Educational issue spotting, not legal advice. A filing is not a finding; a question does not prove its premise or answer.

Source and authorities

• Public report page
• Public PDF
• U.S. Constitution — state-action doctrine
• U.S. Const. amend. XIV — procedural due process
• 42 C.F.R. § 431.51
• 42 C.F.R. Part 431, Subpart E
• 42 C.F.R. § 441.301(c)
• 42 U.S.C. § 1983; Talevski; Gonzaga; Armstrong

How to cite a source · Understand evidence limits