Supreme Court hears case on Medicaid patients’ rights to sue

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[MM Curator Summary]: The nursing home is saying that patient complaints should be handled via the mechanisms in place for that; opponents are saying this would take away Medicaid members ability to sue about anything.


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The Supreme Court heard oral arguments Tuesday in a case that could decide whether Medicaid beneficiaries can sue the federal government if their rights are violated. 

The case, Health and Hospital Corporation of Marion County v. Talevski, centers on whether a now-deceased nursing home patient has the right to sue an Indiana-based nursing home if the home infringed on their rights. Advocates are worried the case could have far-reaching implications and could turn off a key avenue for patients to get remedies for rights violations. 

“This court should not discard decades of precedent to stray from what Congress has written,” wrote the advocacy group National Health Law Program in an amicus “friend of the court” brief. 

The case centers on a federal law that ensures an individual can sue a state government and others for civil rights violations. A family sued the nursing home operated by Marion County, Indiana, over the treatment of a family member Gorgi Talevski, who had dementia. The family objected that the home transferred him against his will and heavily medicated him. 

The nursing home said in its initial filing before the Supreme Court that Talevski was transferred due to aggressive behavior and that such complaints shouldn’t give rise to a federal civil rights lawsuit. 

Such lawsuits allow dissatisfied nursing facility residents to circumvent important state policies,” the filing said. 

An appellate court sided with the family, but the nursing home appealed to the Supreme Court. The home has argued that programs like Medicaid represent a contract between the federal government and the state and that beneficiaries “should have no right to sue based on the contract,” according to an analysis from the Georgetown University Center for Children and Families.

Advocates have worried that the case has morphed into whether any Medicaid beneficiary has a right to sue to enforce their Medicaid rights, and the effect could be “catastrophic.”

“Many Medicaid requirements would effectively go unenforced,” the center’s analysis said. “Individuals would be unable to enforce them. Only [Health and Human Services] would be able to enforce compliance and HHS lacks the bandwidth (and sometimes the inclination) to monitor and enforce the rights of tens of millions of Medicaid beneficiaries across all 50 states.”

Patient advocacy groups also charge that federal law grants such a right to Medicaid beneficiaries.

“Adherence to precedent is a bedrock restraint on the judicial power,” wrote the National Health Law Program’s brief. 

Some justices appeared to agree with that finding. 

“We have standing precedent. You’re asking us to overrule it,” Justice Sonia Sotomayor said during the oral arguments Tuesday. 

She added that the law helps give a judicial remedy to patients as “neither the federal government nor the states can possibly investigate and remedy every violation of these rights that are given to people.”

A decision will likely be released next June.