Big Case for Doctors and Hospitals to be Heard by SCOTUS on Tuesday

The United States Supreme Court will hear arguments from the state of Idaho on one side and Medicaid health care providers on the other, about whether those providers can sue the State over low reimbursement rates under the Supremacy Clause of the Constitution.

The underlying dispute stems from how much (or how little) Medicaid providers are paid. In many cases, the providers argue, they are reimbursed less than it costs to provide care. The American Hospital Association and Federation of American Hospitals filed a brief in the case, stating that the cost of providing care to Medicaid beneficiaries exceeded payments by $13.7 billion in 2012.

If payment rates stay low, fewer providers will be willing to accept patients with Medicaid - at the same time the Medicaid market is expanding in many states and more people are covered by Medicaid than ever before. That would have serious implications on access to care.

Idaho argues that Congress has not authorized suits by private parties to enforce the Medicaid law and that lawsuits are not the best way to handle a dispute over rates. Providers argue that lawsuits are a key tool to ensuring adequate rates.

The case Armstrong v. Exceptional Child Center, Inc., will be heard Tuesday, Jan. 20, 2015, and will have major repercussions either way it turns out.

PLDO will be watching this issue closely and provide updated information as it unfolds, as well as information on other important ACA topics. If you have questions about Medicaid, the ACA or other health care-related issues, please call Attorney Jillian Jagling at 401.824.5100 or email [email protected] We welcome your comments, questions and suggestions.

No Comments

Leave a comment
Comment Information

Contact Our Firm And Schedule A Consultation

Work with our experienced team of lawyers. Call 866-353-3310 or email us today to schedule a consultation.

View Office Locations

Bold labels are required.

Contact Information

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

Email Us For A Response

Rhode Island
Northwoods Office Park
1301 Atwood Ave.
Suite 215 N
Johnston, RI 02919

Toll Free: 866-353-3310
Phone: 401-824-5100
Fax: 401-824-5123
Map & Directions

One International Place
Suite 1400
Boston, MA 02110

Toll Free: 866-353-3310
Fax: 866-353-5020
Map & Directions

Boca Raton Office
Peninsula Plaza
2424 North Federal Highway
Suite 204
Boca Raton, FL 33431

Phone: 561-362-2030
Fax: 866-353-5020
Map & Directions

901 Main Street
Suite O
Osterville, MA 02655

Phone: 508-420-7159
Fax: 508-420-7162
Map & Directions

GPS Directions to this office: 555 Valley Street, Providence, RI 02908