ILNews

High court remands Medicaid case to lower court

Back to TopE-mailPrintBookmark and Share

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.
 

ADVERTISEMENT

Sponsored by

facebook - twitter on Facebook & Twitter

Indiana State Bar Association

Indianapolis Bar Association

Evansville Bar Association

Allen County Bar Association

Indiana Lawyer on Facebook

facebook
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. The sad thing is that no fish were thrown overboard The "greenhorn" who had never fished before those 5 days was interrogated for over 4 hours by 5 officers until his statement was illicited, "I don't want to go to prison....." The truth is that these fish were measured frozen off shore and thawed on shore. The FWC (state) officer did not know fish shrink, so the only reason that these fish could be bigger was a swap. There is no difference between a 19 1/2 fish or 19 3/4 fish, short fish is short fish, the ticket was written. In addition the FWC officer testified at trial, he does not measure fish in accordance with federal law. There was a document prepared by the FWC expert that said yes, fish shrink and if these had been measured correctly they averaged over 20 inches (offshore frozen). This was a smoke and mirror prosecution.

  2. I love this, Dave! Many congrats to you! We've come a long way from studying for the bar together! :)

  3. This outbreak illustrates the absurdity of the extreme positions taken by today's liberalism, specifically individualism and the modern cult of endless personal "freedom." Ebola reminds us that at some point the person's own "freedom" to do this and that comes into contact with the needs of the common good and "freedom" must be curtailed. This is not rocket science, except, today there is nonstop propaganda elevating individual preferences over the common good, so some pundits have a hard time fathoming the obvious necessity of quarantine in some situations....or even NATIONAL BORDERS...propagandists have also amazingly used this as another chance to accuse Western nations of "racism" which is preposterous and offensive. So one the one hand the idolatry of individualism has to stop and on the other hand facts people don't like that intersect with race-- remain facts nonetheless. People who respond to facts over propaganda do better in the long run. We call it Truth. Sometimes it seems hard to find.

  4. It would be hard not to feel the Kramers' anguish. But Catholic Charities, by definition, performed due diligence and held to the statutory standard of care. No good can come from punishing them for doing their duty. Should Indiana wish to change its laws regarding adoption agreements and or putative fathers, the place for that is the legislature and can only apply to future cases. We do not apply new laws to past actions, as the Kramers seem intent on doing, to no helpful end.

  5. I am saddened to hear about the loss of Zeff Weiss. He was an outstanding member of the Indianapolis legal community. My thoughts are with his family.

ADVERTISEMENT