The U.S. Supreme Court issued a 5-4 majority opinion (pdf) today that will send a case back to the Ninth Circuit Court of Appeals regarding whether Medicaid providers and beneficiaries can sue the state over Medicaid reductions.
In 2008 and 2009, the California legislature passed three statues that changed the state's Medicaid plan by reducing Medicaid payments by 10 percent to hospitals, physicians and other healthcare providers. Before CMS finished its review of California's Medicaid overhaul, Medicaid providers sued the state over the payment rate reductions.
Those groups argued in five separate lawsuits that California's new Medicaid proposals went against federal law in which Medicaid must make quality and access to care sufficiently available and held that the Constitution's Supremacy Clause gives the federal statute the upper hand.
The Ninth Circuit ordered preliminary injunctions in which California could not implement the new Medicaid proposals, However, since the case was filed, CMS approved certain elements of the state's proposed changes while California withdrew others.
"All parties agree that the agency's approval of the enjoined rate reductions does not make these cases moot," according to the opinion written by Justice Stephen Breyer. "While the cases are not moot, they are now in a different posture."
Ultimately, the majority — Justices Breyer, Ruth Bader Ginsburg, Elena Kagan, Anthony Kennedy and Sonia Sotomayor — remanded the case to the Ninth Circuit so providers can challenge CMS' rate reduction decision rather than filing under the Supremacy Clause. Chief Justice John Roberts and Justices Samuel Alito, Antonin Scalia and Clarence Thomas dissented.
In 2008 and 2009, the California legislature passed three statues that changed the state's Medicaid plan by reducing Medicaid payments by 10 percent to hospitals, physicians and other healthcare providers. Before CMS finished its review of California's Medicaid overhaul, Medicaid providers sued the state over the payment rate reductions.
Those groups argued in five separate lawsuits that California's new Medicaid proposals went against federal law in which Medicaid must make quality and access to care sufficiently available and held that the Constitution's Supremacy Clause gives the federal statute the upper hand.
The Ninth Circuit ordered preliminary injunctions in which California could not implement the new Medicaid proposals, However, since the case was filed, CMS approved certain elements of the state's proposed changes while California withdrew others.
"All parties agree that the agency's approval of the enjoined rate reductions does not make these cases moot," according to the opinion written by Justice Stephen Breyer. "While the cases are not moot, they are now in a different posture."
Ultimately, the majority — Justices Breyer, Ruth Bader Ginsburg, Elena Kagan, Anthony Kennedy and Sonia Sotomayor — remanded the case to the Ninth Circuit so providers can challenge CMS' rate reduction decision rather than filing under the Supremacy Clause. Chief Justice John Roberts and Justices Samuel Alito, Antonin Scalia and Clarence Thomas dissented.
Related Articles on California Medicaid:
UC Davis Partners With State to Improve Medi-Cal Program
HHS Blocks Medicaid Co-Pays in California
Federal Judge Tentatively Blocks Medicaid Cuts in California