A 9th U.S. Circuit Court of Appeals has ruled against Arizona's assessment of mandatory co-pays for some Medicaid recipients. The Arizona state legislature originally began the implementation of mandatory co-pays in 2003 for some patients, with payments that ranged from $4-$30. According to the policy, if the patient could not pay the co-pay, the medical provider could refuse to provide health services to the patient.
In November 2010, the state started to assess co-pays again and a class-action lawsuit was initiated. The lawsuit claimed that the medically needy shouldn't be required to make co-payments for health services, that the co-pays violated the Medicaid Act cost-sharing restrictions and that notices patients received about changes in their health coverage was inadequate.