SCOTUS Hears Medicaid Rate Case

On January 20th, the Supreme Court of the United States heard arguments in Armstrong v. Exceptional Child Center, Inc., a case filed against Idaho by residential service providers challenging the adequacy of Medicaid reimbursement rates. Under Federal Law, states are required 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.” The case has the potential to significantly impact state Medicaid programs nationwide if the Court rules that private providers have legal standing to hold states accountable for setting adequate Medicaid rates. 

The primary question being considered by the court is whether the Supremacy Clause gives Medicaid providers a private right of action to sue to enforce the Federal Rules against a state where Congress chose not to create enforceable rights under the statute in question. If the court rules for the providers, there will be far-reaching effects, including the potential loss of the ability of a state to reduce rates based on budgetary constraints. 

Several national organizations, including ANCOR, have submitted briefs arguing for the affirmation that providers have the right to sue under the supremacy clause. INARF will be following this case with interest and will update the membership as more information is released. If you have any questions,please contact your INARF office.