U.S. Supreme Court: Medicaid Doctors Can’t Sue for Higher Pay

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The U.S. Supreme Court narrowly ruled Tuesday that doctors and other medical providers can’t sue state Medicaid agencies for higher pay, a practice which has been long supported by doctors and patient advocates.

In its 5-4 decision in Armstrong v. Exceptional Child Center, the court ruled that the U.S. Constitution doesn’t grant private groups a right to sue when states run afoul of federal law. Justice Stephen Breyer joined the court’s conservative wing to form a majority, which also rejected the possibility to sue under a section of federal Medicaid law that specifically deals with payment rates, arguing it would lead to a flood of litigation.

Medical providers, patient advocates and a list of former federal health officials argued lawsuits to boost pay were necessary to improve access for patients. State Medicaid directors disagreed, arguing that courts weren't the right venue for doctor grievances. They have argued the right to sue could restrict policy choices and care in difficult budget years. It’s not clear how frequently private groups sue Medicaid agencies in federal courts, but several states had suits in recent years.

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