Armstrong v. Exceptional Child Center, Inc.
Issues
Does section (30)(A) of the Medicaid Act provide a private right of action for Medicaid providers against states under the Supremacy Clause, even when Congress has not explicitly created the right?
The Supreme Court will consider whether individual Medicaid providers have a private right of action under the Supremacy Clause to enforce section (30)(A) of the Medicaid Act (“§ (30)(A)”), which requires state Medicaid agencies to take provider costs into account when setting reimbursement rates, when Congress has not explicitly granted a private right of action. Richard Armstrong, the Director of Idaho’s Department of Health and Welfare, argues that individuals do not have a private right of action under § (30)(A) or the Supremacy Clause because a private remedy cannot exist without congressional intent and private litigants should not play a role in determining whether a state gets federal funding. According to Exceptional Child Center, however, when a state law conflicts with federal law, individuals have a private right of action under the Supremacy Clause to bring an injunction and prevent harm that would result from the conflicting state statute. The Court’s ruling will impact the right of individuals to recover under the Supremacy Clause as well as the administration of Medicaid and other statutory schemes that provide funding to states as long as they comply with federal law.
Questions as Framed for the Court by the Parties
Does the Supremacy Clause give Medicaid providers a private right of action to enforce § 1396a(a)(30)(A) against a state where Congress did not expressly create enforceable rights under that statute?
Exceptional Child Center, Inc., and four other companies (collectively, “ECC”) offer in-home healthcare and other services for those who are Medicaid-eligible in Idaho. See Inclusion, Inc. v. Armstrong, 835 F. Supp. 2d 960, 961 (D.
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Additional Resources
• Robert Pear: As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care, The New York Times (Dec. 27, 2014).
• Peyton M. Sturges: High Court to Review Medicaid Dispute, Providers' Rights to Force Higher Payments, Bloomberg BNA's Health Law Reporter (Oct. 9, 2014).
• Steve Vladeck: Enforcing Medicaid Against Recalcitrant States: The Former HHS Officials' Amicus Brief in Armstrong, PrawfsBlawg (Dec. 23, 2014).