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Long Term Care Pharm. Alliance v. Ferguson
362 F.3d 50 (1st Cir. 2004) ; Clearinghouse Number: 55579
Description
Pharmacy Group Challenging Reimbursement Rate Reduction Has No Private Right of Action to Enforce Medicaid “Equal Access” Provision, First Circuit Rules
Abstract
Vacating a preliminary injunction from the district court, the
First Circuit held that providers, in this case pharmacies
supplying prescription drugs only to nursing home patients, had no
private right of action to enforce the “equal access”
provision of the Medicaid Act. Plaintiff sought to enjoin
Massachusetts from implementing an emergency regulation that
reduced the rate at which the state reimbursed pharmacies supplying
prescription drugs to Medicaid patients. Plaintiff charged that the
lack of a hearing before implementation violated a Medicaid Act
provision (42 U.S.C. § 1396a(a)(13)(A)) requiring such a
public hearing to set payment rates for nursing facility services.
Plaintiff charged that the rate reduction violated the Act’s
requirement (42 U.S.C. 1396a(a)(30)(A)) that rates for services
generally be “sufficient to enlist enough providers to
provide services similar to those generally available in the
area.” That a public hearing had been held by the time the
case reached the First Circuit did not render the case moot, the
court said, because the state had not yet adopted a final rule. The
First Circuit said that the Section (13)(A) protection procedures
did not apply to plaintiff because the pharmacies were not
providing “nursing facility services” within the scope
of the provision’s intent and protection. The First Circuit
found that Section (30)(A), the “equal access”
provision, set forth only general objectives. Citing Gonzaga
University v. Doe, 536 U.S. 273 (2002) (Clearinghouse No.
54643), the First Circuit saw in section (30)(A) no
“rights-creating language” and no discrete class of
beneficiaries. The statute gives enforcement authority to the
secretary of health and human services, not providers, the First
Circuit held.
