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Supreme Court Begins Term with Case on Provider Cuts

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Supreme Court Begins Term with Case on Provider Cuts

October 3, 2011

The U.S. Supreme Court's term begins every year on the first Monday in October. This year, thecourt is dedicating its first case on October 3, Douglas v. Independent Living Center of Southern California, to hearing oral arguments on whether Medicaid providers have the right to legally challenge cuts to reimbursement payments, which groups in California originally litigated after the state approved a 10 percent reduction.

The broader, pivotal question is whether long-term services, physicians, hospitals and other providers, as well as beneficiaries, can sue the state on the grounds that cuts in reimbursement rates may violate the Medicaid statute, which requires states to “assure that payments are consistent with efficiency, economy and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.”

The stakes for the much-anticipated case are high as providers throughout the nation are reeling from cuts by cash-strapped states that believe they must have control over Medicaid spending. ANCOR joined with 20 national organizations in an amicus brief filed on August 5 by the National Health Law Program urging the court to uphold the right of private citizens to enforce Medicaid laws.