Can private medical providers facing rising medical costs sue a state to raise Medicaid reimbursement rates? This is one of the questions the U.S. Supreme Court will hear during its upcoming session.
Last December, the 9th U.S. Circuit Court of Appeals ruled in favor of Idaho Medicaid providers, ordering the state to increase payments. According to Reuters, state officials recommended increases in reimbursement rates in the late 2000s, but the Idaho legislature declined to appropriate funds.
While federal law requires state Medicaid plans to include certain provisions concerning sufficient payments, it does not establish a right to enforce those payments. The question the question before the Supreme Court is whether Medicaid providers have a private right of action to enforce the sufficient payment provisions against a state.
The case is Armstrong v. Exceptional Child Center, Inc., and documents concerning the case are available at SCOTUSblog.
