Supreme Court Sides With Idaho Over Medicaid Rates, Providers Fear Patients Will Be Hurt

Apr 1, 2015

Credit Wally Gobetz / Flickr Creative Commons

The U.S. Supreme Court ruled 5-4 Tuesday in favor of the State of Idaho in a fight over Medicaid payments to providers. The decision could impact Medicaid's low-income patients across the state. 

The case began after a 2009 lawsuit against the state. Officials with Idaho's Department of Health and Welfare had recommended increasing payment rates to private medical providers who serve Medicaid patients.

But the Idaho Legislature didn't act on the recommendations and the rates stayed the same.

Tuesday's decision reverses a lower court's ruling, asserting that private medical companies don't have a right to enforce federal Medicaid rules. Justices in the majority said it's up to federal agencies to decide whether a state is following the law.

Boise Attorney James Piotrowski argued on behalf of healthcare providers. Piotrowski says his client named in the suit – a rehab center for developmentally delayed patients – was already being underpaid.

"It will be harder and harder for healthcare providers to justify participating in the Medicaid program," he says. "The rates were low to begin with and they're likely to get lower."

He says Idaho is violating the federal Medicaid Act by not paying providers a rate consistent with rising costs and inflation, putting healthcare providers in a tough spot.

"We already have a problem in Idaho because our state is so rural with being able to access services. This is going to make that problem even worse."

Piotrowski says the decision could force some healthcare centers to close.

Attorney General Lawrence Wasden, meanwhile, hailed the decision. He's argued the authority to set Medicaid reimbursement rates should rest with the state Legislature.

Find Frankie Barnhill on Twitter @FABarnhill

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