Supreme Court Opens Term with Medicaid Provider Cuts Case

The United States Supreme Court opened their new term on Monday by hearing a case stemming from proposed provider payment reimbursement cuts for California’s Medicaid program.  The case, Douglas v. Independent Living Centers of Southern California, centers around whether a Medicaid provider (potentially O&P Practitioners) or patient can use the courts to temporarily delay or stop potential cuts to provider reimbursements or patient access.

Earlier this year, much like many other states, the California legislature voted to reduce Medicaid provider payments by 10% across the board to account for budgetary shortfalls of the state/federal cooperative program serving the poor and disabled.  To qualify for federal matching funds for the Medicaid program, a state must ensure that provider payments are “sufficient to enlist enough providers to that care and services are available.”  Separate cases involving cuts to provider payments in California are currently being appealed by the state. 

The Obama Administration sent a top Justice Department lawyer to aid the State of California in the case; their argument is that only the federal government has the standing to rule against cuts to a Medicaid program.  Justice Elena Kagen stated that California attempted to “end run” the system by implementing rate schedules without seeking federal approval.  A clear majority was not apparent after day one of oral proceedings in the case.

Beginning the new term with a Medicaid related case sets the table for another big health care related appeal moving to the Supreme Court agenda this term, the constitutionality of the Affordable Care Act’s “individual mandate” provision which forces individuals to purchase private health insurance.  Action on this case is likely to come next summer, right in the middle of the presidential election of 2012. 

More information about the Medicaid case can be found HERE

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