Thursday, July 20, 2006

Spencer on Circuit Split on Enforcement of Medicaid Provision

Summer is slow even in disability law land, but A. Benjamin Spencer's great Split Circuits blog has this post on the Sixth Circuit's recent Westside Mothers II decision, which widens a circuit split on the enforceability of 42 U.S.C. 1396a(a)(30). That provision requires that state Medicaid plans "provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan . . . as may be necessary to safeguard against unnecessary utilization of such care and services and to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area." Since the Supreme Court's 2002 decision in Gonzaga University v. Doe, the First and Ninth Circuits have held that individuals may not enforce that provision in suits brought under 42 U.S.C. 1983, while the Eighth Circuit has held that they may. in its recent decision, the Sixth Circuit sided with the First and Ninth Circuits and held that the provision is unenforceable.


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