Supreme Court: Medicaid Providers Can’t Sue States To Raise Reimbursement Rates
In a 5-4 decision, the high court ruled Tuesday that hospitals and other health care providers can't sue a state in an effort to have Medicaid rates increased in keeping with rising medical costs.
Reuters:
U.S. Top Court Says Medical Providers Can't Sue States Over Medicaid Funding
The U.S. Supreme Court on Tuesday ruled in a case from Idaho that private medical providers that deliver residential care services cannot sue a state in [an attempt] to raise Medicaid reimbursement rates to deal with rising medical costs. The justices, on a 5-4 vote, ruled in favor of the state of Idaho, which asserted that medical providers have no legal recourse to sue. The ruling is a loss for the healthcare industry, with trade groups and the U.S. Chamber of Commerce backing the providers in the case. (Hurley, 3/31)
The Associated Press:
Supreme Court Sides With Idaho In Medicaid Pay Dispute
Private health care providers cannot sue to force states to raise their Medicaid reimbursement rates to keep up with rising medical costs, the Supreme Court ruled Tuesday. In a 5-4 decision that broke across ideological lines, the justices said medical companies have no private right to enforce federal Medicaid funding laws against states if Congress has not created such a right. (Hananel, 3/31)
Bloomberg:
Hospitals Can’t Sue Over Medicaid Reimbursement, Court Says
Hospitals and other health-care providers can’t sue to challenge reimbursement rates set by states under the Medicaid insurance program for the poor, the U.S. Supreme Court ruled. ... Providers now will have to take any objections to rates to the U.S. agency that oversees the joint federal-state program. (Stohr, 3/31)
The Wall Street Journal:
Supreme Court Rules Medicaid Providers Can’t Sue States For Higher Pay
Federal law gives states discretion in setting Medicaid rates, as long as they follow a broad set of factors intended to ensure health services remain available to the poor without encouraging the “unnecessary utilization of such care.” In Idaho, several companies that provide home care for intellectually disabled people sued state officials claiming reimbursement rates set by the state were too low. (Bravin, 3/31)
Politico Pro:
High Court Ruling Keeps HHS As Medicaid Rates Arbiter
The Supreme Court on Tuesday punted the ball to the Obama administration to decide whether states’ Medicaid reimbursement rates are adequate for providers. In a decision with high stakes given Medicaid’s growth, the court ruled 5-4 that private parties do not have the right under the Constitution’s Supremacy Clause to sue states over low reimbursement rates. They initially must seek relief from HHS, Justice Antonin Scalia wrote in the majority opinion, and the department can withhold funds if it determines that a state is not complying with the law. (Pradhan, 3/31)
USA Today:
Justices Limit Lawsuits Against State Medicaid Programs
The court's majority said that section of the law was written too broadly to allow for private lawsuits, such as the one filed by home-care providers in Idaho claiming insufficient reimbursement rates. Justice Antonin Scalia, writing for the majority, called it "judicially unadministrable," adding, "It is difficult to imagine a requirement broader and less specific." Scalia was joined by three other conservatives and by liberal Justice Stephen Breyer. Justice Sonia Sotomayor wrote the dissent, joined by two other liberals and by Justice Anthony Kennedy, who most often is in the middle. (Wolf, 3/31)
The Washington Post:
Supreme Court Says State Medicaid Payments Not Open To Private Lawsuits
Five justices — Chief Justice John G. Roberts Jr. and Justices Antonin Scalia, Clarence Thomas, Stephen G. Breyer and Samuel A. Alito Jr. — agreed. Scalia wrote the majority opinion, but Breyer’s was the controlling vote. “I recognize that federal courts have long become accustomed to reviewing for reasonableness or constitutionality the rate-setting determinations made by agencies,” Breyer wrote. But he said he feared that siding with the providers would lead to “increased litigation, inconsistent results, and disorderly administration of highly complex federal programs that demand public consultation, administrative guidance and coherence for their success.” (Barnes, 3/31)
Los Angeles Times:
Supreme Court Bars Judges From Setting Medicaid Rates
Tuesday's ruling reverses a decision from the U.S. 9th Circuit Court of Appeals in San Francisco, which has repeatedly blocked California from making cutbacks in its Medicaid payments. It is not clear what effect the ruling will have on the Medicaid program because significant cutbacks are not pending. (Savage, 3/31)