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High court remands Medicaid case to lower court

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The Indiana Supreme Court ordered a Marion Superior Court to let Medicaid recipients involved in a decades-long lawsuit present evidence to demonstrate the transportation they may be entitled to by law and if they have been or will be denied services because of lower pay rates to Medicaid transportation providers.

The high court granted transfer Monday and released a 7-page per curiam opinion in Anne W. Murphy, et al. v. Jannis Fisher, et al., No. 49S02-1008-CV-463, a suit first filed in 1992 by Medicaid recipients and transportation service providers when federal officials found the state’s Medicaid transportation costs were high, leading the state to implement lower pay rates to those that provide Medicaid transportation services.

The plaintiffs sued under the federal Medicaid statute, 42 U.S.C. Section 1396a(a)(30)(A), arguing the reimbursement rates were so low they violated the law and the recipients’ access to medical care was reduced in violation of the statute.

The trial court ordered the state to increase the reimbursement rate, but ordered that the higher rate be applied prospectively; the trial court didn’t enter any specific relief for the recipients except that the state must pay the plaintiffs’ attorney fees. The Indiana Court of Appeals reversed and directed judgment for the state, finding neither plaintiff group had a private right of action to challenge the reimbursement rates.

The Supreme Court summarily affirmed the lower appellate court’s ruling that the transportation providers do not have a private right to sue the state based on Gonzaga University v. Doe, 536 U.S. 273 (2002). The justices also agreed that the Medicaid recipients do have a right to sue. The state had conceded in the trial court that the recipients had a private right of action and the state invited any court error with respect to the right of recipients to sue for relief in this case, wrote the justices.

“We acknowledge the State’s argument that the rights of Medicaid recipients may have been in a state of flux at the time the State filed its trial court brief in 2004, but the issue appears to have been in play by that time, and federal circuit courts of appeal began issuing decisions applying Gonzaga before the State filed its opening appellate brief. Accordingly, the State will be held to its concession that Recipients have a private right of action in this case,” the justices wrote.

The high court ordered the trial court to allow the recipients to present evidence establishing the transportation to which they may be entitled under Section 30(A), that they have been or will be denied the services to which they are entitled, and what relief they are due. Any relief will be prospective only.

Justice Frank Sullivan did not participate in the ruling.
 

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  1. File under the Sociology of Hoosier Discipline ... “We will be answering the complaint in due course and defending against the commission’s allegations,” said Indianapolis attorney Don Lundberg, who’s representing Hudson in her disciplinary case. FOR THOSE WHO DO NOT KNOW ... Lundberg ran the statist attorney disciplinary machinery in Indy for decades, and is now the "go to guy" for those who can afford him .... the ultimate insider for the well-to-do and/or connected who find themselves in the crosshairs. It would appear that this former prosecutor knows how the game is played in Circle City ... and is sacrificing accordingly. See more on that here ... http://www.theindianalawyer.com/supreme-court-reprimands-attorney-for-falsifying-hours-worked/PARAMS/article/43757 Legal sociologists could have a field day here ... I wonder why such things are never studied? Is a sacrifice to the well connected former regulators a de facto bribe? Such questions, if probed, could bring about a more just world, a more equal playing field, less Stalinist governance. All of the things that our preambles tell us to value could be advanced if only sunshine reached into such dark worlds. As a great jurist once wrote: "Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman." Other People's Money—and How Bankers Use It (1914). Ah, but I am certifiable, according to the Indiana authorities, according to the ISC it can be read, for believing such trite things and for advancing such unwanted thoughts. As a great albeit fictional and broken resistance leaders once wrote: "I am the dead." Winston Smith Let us all be dead to the idea of maintaining a patently unjust legal order.

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  3. Do you know who the sponsor of the last-minute amendment was?

  4. Law firms of over 50 don't deliver good value, thats what this survey really tells you. Anybody that has seen what they bill for compared to what they deliver knows that already, however.

  5. As one of the many consumers affected by this breach, I found my bank data had been lifted and used to buy over $200 of various merchandise in New York. I did a pretty good job of tracing the purchases to stores around a college campus just from the info on my bank statement. Hm. Mr. Hill, I would like my $200 back! It doesn't belong to the state, in my opinion. Give it back to the consumers affected. I had to freeze my credit and take out data protection, order a new debit card and wait until it arrived. I deserve something for my trouble!

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