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
New Poll: Voters Want New Leadership – and They’re Turning to Independents
A new poll from the Independent Center highlights a clear message from the public: Americans are fed up with the current political leadership, and they’re ready for change....
12 Nov, 2025
-
2 min read
Ranked Choice Voting Momentum Surges in Massachusetts as Cities Push for Local Control
Ranked choice voting (RCV) continues to see a surge in momentum across the U.S. However, the state that has seen the largest reform growth in the last 5 years -- Massachusetts -- has received little attention. This is because the 10 cities that have approved RCV have not been able to implement it due to state law....
14 Nov, 2025
-
5 min read
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


