The Supreme Court will kick off its 2011-2012 term today by hearing oral arguments in Douglas v. Independent Living Center of Southern California, et al., a case that will determine whether or not Medicaid beneficiaries and providers are able to sue states that make cuts to their Medicaid programs.
The case, which consolidates three separate but similar cases, stems from cuts in Medi-Cal payments to providers enacted by the state legislature in 2008 and 2009, according to a California Healthline report. Following the cuts, several providers sued the director of the state's Department of Health Care Services arguing the cuts violated federal law requiring that state Medicaid reimbursement rates must be at a level that ensures access to Medicaid beneficiaries.
In April 2010, a federal appeal court in San Francisco ruled in favor of the providers, deeming states cannot cut payments simply to reduce costs to the state associated with running the program. The state petitioned the Supreme Court, which agreed to rule only the private right of action argument in the case. The high court will determine whether private parties have a right to sue states over Medicaid reimbursement rates through invoking the U.S. Constitution's "supremacy clause," which gives federal law supremacy over state law.
The outcome of the case has major implications for providers, many of whom believe that a ruling against private right of action would prohibit them from having any recourse for too-low payment rates.
The White House supports California in the suit, saying private parties don't have the right to sue of reimbursement rates. However, several prominent democratic leaders, House Minority Leader Nancy Pelsoi (D-Calif.) have filed a brief contending that it is Congress' intent to have the justice system determine if private actions against Medicaid rates are appropriate, according to a report by The Hill.
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The case, which consolidates three separate but similar cases, stems from cuts in Medi-Cal payments to providers enacted by the state legislature in 2008 and 2009, according to a California Healthline report. Following the cuts, several providers sued the director of the state's Department of Health Care Services arguing the cuts violated federal law requiring that state Medicaid reimbursement rates must be at a level that ensures access to Medicaid beneficiaries.
In April 2010, a federal appeal court in San Francisco ruled in favor of the providers, deeming states cannot cut payments simply to reduce costs to the state associated with running the program. The state petitioned the Supreme Court, which agreed to rule only the private right of action argument in the case. The high court will determine whether private parties have a right to sue states over Medicaid reimbursement rates through invoking the U.S. Constitution's "supremacy clause," which gives federal law supremacy over state law.
The outcome of the case has major implications for providers, many of whom believe that a ruling against private right of action would prohibit them from having any recourse for too-low payment rates.
The White House supports California in the suit, saying private parties don't have the right to sue of reimbursement rates. However, several prominent democratic leaders, House Minority Leader Nancy Pelsoi (D-Calif.) have filed a brief contending that it is Congress' intent to have the justice system determine if private actions against Medicaid rates are appropriate, according to a report by The Hill.
Related Articles on Medicaid Cuts:
New Hampshire AG Says Hospitals Don't Have Right to Certain Levels of Medicaid PaymentsArizona Court of Appeals to Consider Appeal of Reductions in State Medicaid Program
Louisiana Judge Issues Temporary Restraining Order on State's Medicaid Reform