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Medeiros's report asks whether
care-management actors exercised

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authority beyond approved
program boundaries.

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00:00:06,715 --> 00:00:10,515
That is sharper than
calling every contractor

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00:00:10,515 --> 00:00:12,143
a government actor.

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00:00:12,143 --> 00:00:15,943
Constitutional claims usually
require conduct attributable to

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the state;

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00:00:17,029 --> 00:00:20,829
funding, licensing, or
contracting alone is not

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00:00:20,829 --> 00:00:21,372
enough.

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00:00:21,372 --> 00:00:25,172
Yet Medicaid law can still leave the

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state responsible for its program.

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Under 2026 HCBS grievance
rules, contractors may

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00:00:31,687 --> 00:00:35,487
administer complaints, but the
state retains responsibility.

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00:00:35,487 --> 00:00:38,744
People served need
accessible, impartial review.

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00:00:38,744 --> 00:00:42,002
Medeiros retains speech
and petition interests.

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00:00:42,002 --> 00:00:45,802
ABI Resources may have
separate process or

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00:00:45,802 --> 00:00:46,888
contract rights.

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00:00:46,888 --> 00:00:50,688
Delegation agreements, waiver terms,
authorizations, billing, supervision,

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00:00:50,688 --> 00:00:54,488
and the identity of the
decision-maker determine

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accountability.

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Function and proof—not labels—control.