Legal News

As CA goes, so DE should go in Medicaid case, says lawyer

By Richard Binder

A lawyer representing pharmacy groups suing Delaware for cutting Medicaid drug reimbursement rates believes a recent U.S. Court of Appeals for the 9th Circuit ruling stopping California from trimming state Medicaid payments to medical providers strengthens the groups' position in the Delaware case.

That case, filed in Delaware federal court, echoes claims in a recently resolved Washington state federal case that state reimbursement cuts violate the Social Security Act (or Medicaid Act)'s "quality of care" and "access" requirements for Medicaid beneficiaries. It also claims that the cuts, or proposed cuts, violate state and federal laws because Delaware failed to seek approval from federal Medicaid officials.

The 9th Circuit ruling, issued on July 9, upheld a lower court's order stopping California from reducing state Medicaid reimbursement rates to certain medical providers. The opinion in that case said that the plaintiffs could sue the state under the U.S. Constitution's supremacy clause, which says federal laws trump conflicting state laws.

Fredrick "Rick" Ball, a Chicago litigation partner at Philadelphia's Duane Morris who represents the pharmacy groups in the Delaware case, said the 9th Circuit ruling is important because "it reaffirmed that the states have to comply with federal law, and the supremacy cause provides a pathway," for cases against states that fail to comply.

Full story at NLJ.com.

Full post as published by Legal Pad | LA on July 14, 2009 (boomark / email).