Supreme Court rules against disability providers

The justices of the U.S. Supreme Court, Courtesy of Disablity Scoop
(The Collection of the Supreme Court of the United States/TNS)

DISABILITY SCOOP - Developmental disability service providers cannot sue to force state Medicaid programs to raise their reimbursement rates, the U.S. Supreme Court has ruled.

In a 5-4 decision Tuesday, the high court ruled against a group of Idaho agencies serving people with developmental disabilities.

The service providers had argued that the state failed to raise Medicaid payments as outlined in a federally-approved formula for years even as such agencies faced rising costs.

But, in a blow to the providers, the Supreme Court ruled that private companies currently lack any right to enforce Medicaid requirements. Rather, it is up to the U.S. Secretary of Health and Human Services to ensure that states comply with the program’s rules, the court said.

“Our precedents establish that a private right of action under federal law is not created by mere implication, but must be ‘unambiguously conferred,'” wrote Justice Antonin Scalia for the majority. “Nothing in the Medicaid Act suggests that Congress meant to change that.”

Joining Scalia in the majority were Chief Justice John Roberts and Justices Clarence Thomas, Stephen Breyer and Samuel Alito.

Justice Sonia Sotomayor said in her dissent that the decision will have significant consequences.

“Previously, a state that set reimbursement rates so low that providers were unwilling to furnish a covered service for those who need it could be compelled by those affected to respect the obligation imposed by (the Medicaid Act),” Sotomayor wrote. “Now, it must suffice that a federal agency, with many programs to oversee, has authority to address such violations through the drastic and often counterproductive measure of withholding the funds that pay for such services.”

Sotomayor was joined in dissent by Justices Anthony Kennedy, Ruth Bader Ginsburg and Elena Kagan.

Disabilityscoop.com