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Supreme Court Will Decide if Providers Can Compel States to Raise Medicaid Rates

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Supreme Court Will Decide if Providers Can Compel States to Raise Medicaid Rates

October 10, 2014
Last week, the Supreme Court said it will hear the case of Armstrong v. Exceptional Child Center, Inc. (D.C. No. 1:09-cv-00634-BLW), a case out of the U.S. District Court for the District of Idaho, that was initially brought in 2009 by a group of providers arguing that the state was unfairly keeping Medicaid reimbursement rates at prior year levels despite evidence that the cost of providing care had risen. At issue is whether it is Constitutional for private parties to enforce Medicaid funding laws against states. The state has argued that it is only federal agencies, and not private parties, that can determine whether a state is in compliance with reimbursement rules. State officials cite the Supremacy Clause within the Constitution, which it says place the onus on the federal government to enforce rules promulgated by federal agencies. 
 
If the Supreme Court sides with the providers in this case, it could have a significant impact on other state Medicaid programs as it would create a cause of action for private parties to take similar action within their own states.