Dive Brief:
- During the upcoming session, the US Supreme Court will decide a case that has divided several lower courts: Do Medicaid providers have a Constitutional right to take litigious action against state Medicaid agencies to increase reimbursement rates if that funding is not allocated by the state legislature?
- In a suit filed in 2009, an Idaho appeals court ordered the State Department of Health and Welfare to increase reimbursement rates with inflation, resulting in an additional $12 million in funding in 2013. The plaintiffs, a group of Idaho rehabilitation providers, argued that the only way to keep reimbursements at a sustainable level was through a lawsuit.
- The state of Idaho is appealing the case under the premise that providers are not allowed to sue the state to increase Medicaid reimbursements because of the supremacy clause—the clause in the Constitution that puts federal law above state law. The state said that requiring increases would interfere with budgeting and flexibility in the program.
Dive Insight:
"The notion that the Supremacy Clause empowers private litigants to bring 'preemption' claims against state officials who violate 'supreme' federal law has radical and far-reaching implications," said Texas attorney general Greg Abbott in a brief supporting Idaho's position. 27 states wrote amicus curiae briefs in support of the state.
States are definitely worried about the thought of allowing providers to force states to follow through on Medicaid increases. The Supreme Court considered one other case on Medicaid reimbursement in 2012. When providers in California won lower court rulings saying the state couldn't cut rates, the Supreme Court overturned the state court. They did not specifically rule on the issue of whether or not providers could sue to increase Medicaid rates, but Chief Justice John Roberts indicated that providers might not have the right to sue.