WEBVTT

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Question 55.

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Was there a neutral and
accessible process to

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challenge disputed
care-management decisions?

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The 2023 report raises
a concern, not a

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finding.

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People served:

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A covered service decision
may require informed choice,

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conflict safeguards, accessible
notice, and a fair hearing.

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David Medeiros:

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Questioning authority or transitions
may be protected advocacy,

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but government action and
causation remain essential.

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ABI Resources:

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ABI may enforce actual
contracts or process rights;

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it has no presumed
property right in referrals

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or waiver placement.

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Constitutional claims
need state action;

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beneficiary choice does not
guarantee ABI referrals or

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a contract.

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Classify the issue
before choosing a remedy.

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Preserve waiver terms, amendments,
authorizations, assessments,

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consultation notes, billing
codes, notices, and appeals.

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Apply Constitution, statute,
regulation, contract, then record.