In a closely watched friend-of-the-court brief filed last week in the Supreme Court, the Justice Department said that no federal law allowed private individuals to sue state officials to challenge cuts in Medicaid payments. Federal law that says Medicaid rates must be “sufficient to enlist enough providers” so that Medicaid recipients have access to care to the same extent as the general population in an area. Essentially, the Obama administration, through the solicitor general, has informed the Supreme Court that state officials may not be sued by health care providers or Medicaid recipients wishing to challenge cuts to Medicaid payments that compromise health care for Medicaid-dependent individuals.

This is part of the ongoing California cases consolidated under the name Douglas v. Independent Living Center of Southern California, No. 09-958.

In 2008 and 2009, the California Legislature passed several laws reducing Medicaid payment rates. Recipients and providers challenged the cuts in court, arguing that the California plan violated—and was pre-empted by—the federal Medicaid statute.

The law does not explicitly allow such lawsuits. But the United States Court of Appeals for the Ninth Circuit, in San Francisco, said beneficiaries and providers could sue under the supremacy clause of the Constitution, which makes federal law “the supreme law of the land.” In reducing payment rates, the appeals court said, California violated the requirements of federal Medicaid law and threatened access to “much-needed medical care.”

California appealed to the Supreme Court, which is likely to hear oral arguments in the fall, with a decision by next spring.

View the briefs in this case.

Toby Pearson
952.851.2480
tpearson@careproviders.org

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