Indiana Court of Appeals Rejects Private Right of Action to Challenge Reductions in Medicaid Transportation Rates
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The Court of Appeals of Indiana followed the First, Sixth, Ninth and Tenth Circuits in holding that there is no private right of action under 42 USC § 1983 to enforce 42 U.S.C. § 1396a(a)(30)(A). Section (30)(A) requires state Medicaid programs to ensure that payments are sufficient to enlist enough providers so that care and services are available to Medicaid beneficiaries at least to the extent they are available to the general population. The suit was brought by providers and recipients challenging reductions in Medicaid transportation reimbursement rates. Roob v. Fisher, 2006 WL 3234199 (Ind.App. Nov. 8, 2006).
The Roob v. Fisher decision quotes heavily from cases in the First, Sixth, Ninth, and Tenth Circuits. Mandy R. v. Owens, 464 F.3d 1139 (10th Cir. 2006); Westside Mothers v. Olszewski, 454 F.3d 532 (6th Cir. 2006); Sanchez v. Johnson, 416 F.3d 1051 (9th Cir. 2005); Long Term Care Pharmacy Alliance v Ferguson, 362 F.3d 50 (1st Cir. 2004). It cites the Tenth Circuit in rejecting the holding to the contrary of the Eighth Circuit Pediatric Specialty Care, 443 F.3d 1005 (8th Cir. 2006).
The Indiana decision states that the court believes this result is compelled by United States Supreme Court precedent. The court opines that “the practical consequences of writing and reading the Medicaid Act and operating the Medicaid program in such a manner will be extremely deleterious to those most in need.” However, the court concludes that it is without “the responsibility of making those decisions.”