Medicaid – U.S. Supreme Court to hear case regarding Medicaid rate cuts
The Supreme Court will hear oral arguments in a case on Monday, October 3, that The Arc and the disability community are watching very closely. The case, Douglas v. Independent Living Center of Southern California,concerns whether individuals and providers can sue states to block cuts to Medicaid rates. California maintains that only the federal government can enforce the portion of the law concerning payment rates. The case began in California when the state planned to cut provider rates, some as much as 10%. The Justice Department and National Governors Association filed briefs taking the side of the state in the case, while House Minority Leader Nancy Pelosi (D-CA) and Representative Henry Waxman (D-CA), both from California , have sided with the respondents.
Medicaid law requires states to keep their payment rates high enough to attract an adequate supply of providers. The argument in the case before the Supreme Court involves whether individual beneficiaries and providers have the right to enforce that mandate while overriding the state law reducing provider rates. The respondents argue that under the Constitution’s Supremacy Clause, individuals have the right to sue a state to ensure that provider rates are adequate. The 9th Circuit Court of Appeals ruled in their favor in 2008, blocking the cuts.
If the Court finds that individuals do not have the right to sue a state to enforce the payment provision of Medicaid law, The Arc and other disability organizations fear that the federal government alone would not have the capacity to monitor over 51 different Medicaid programs to make sure that provider rates are adequate to ensure an adequate supply of providers. A decision could come at any time during the Court’s term, which runs until June 2012.