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SCOTUS declines review of injunction against Medicaid cap on dental work

April 22, 2013

The Supreme Court of the United States will leave undisturbed a ruling that blocked state efforts to cap dental work for Medicaid recipients at $1,000 per year.

The court on Monday denied certiorari in Indiana Family & Social Serv., et al. v. Sandra M. Bontrager, 12-1037. The denial lets stand a preliminary injunction issued by Chief Judge Philip Simon in 2011 and affirmed by the 7th Circuit Court of Appeals last year.

The 7th Circuit ruling in Sandra M. Bontrager, on her own behalf and on behalf of a class of those similarly situated v. Indiana Family and Social Services Administration, Michael A. Gargano and Patricia Casanova, affirmed that Sandra Bontrager has a private right of action under 42 U.S.C. Section 1983 to challenge the cap.

The cap was implemented as a cost-cutting measure in 2011, but Bontrager sued because she needed extensive dental work that would exceed the limitation.

Judge Michael Kanne wrote that even though the state has an interest in cost control, those interests don’t outweigh Medicaid recipients’ interests in access to medically necessary health care.

 

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