SCOTUS: Medicaid Providers Cannot Sue States to Raise Reimbursement Rates

Published: 01 Apr, 2015
1 min read
The Supreme Court ruled Tuesday that doctors and health care providers cannot sue to force a state to raise reimbursement rates for Medicaid services. NPR reports that the 5-4 decision comes as a heavy blow to those who provide these services as many doctors and health care companies say stagnant rates are so low that they are losing money on Medicaid patients.
"The majority opinion, written by Justice Antonin Scalia, said that Congress, in creating the Medicaid rate-setting scheme, did not explicitly authorize private suits like the one at issue here. Instead, he said, the law mandates that state reimbursement plans are "consistent with efficiency, economy, and quality of care," all the while "safeguarding against unnecessary utilization of ... care and services." "It is difficult to imagine a requirement broader and less specific" than that, wrote Scalia. "Explicitly conferring enforcement of this judgment-laden standard upon the Secretary alone establishes, we think," that Congress wanted to make the agency cutoff of funds the "exclusive" remedy. With such a big financial club, Scalia said, "we doubt that the Secretary's notice to a state that its compensation scheme is inadequate will be ignored." - NPR, March 31, 2015
Read the full report here.
You Might Also Like
Did the Republicans or Democrats Start the Gerrymandering Fight?
The 2026 midterm election cycle is quickly approaching. However, there is a lingering question mark over what congressional maps will look like when voters start to cast their ballots, especially as Republicans and Democrats fight to obtain any electoral advantage possible. ...
11 Nov, 2025
-
8 min read
Utah Judge Delivers a Major Blow to Gerrymandering
A Utah state judge has struck down the congressional map drawn by Republican lawmakers, ruling that it violates the state’s voter-approved ban on partisan gerrymandering and ordering new district lines for the 2026 elections....
11 Nov, 2025
-
2 min read
5 Politicians Bucking Their Party on Gerrymandering
Across the country, both parties are weighing whether to redraw congressional maps ahead of the 2026 midterm elections. Texas, California, Missouri, North Carolina, Utah, Indiana, Colorado, Illinois, and Virginia are all in various stages of the action. Here are five politicians who have declined to support redistricting efforts promoted by their own parties....
31 Oct, 2025
-
4 min read


