Arrow-right Camera
The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Idaho asks Supreme Court to take up Medicaid reimbursement challenge

Kimberlee Kruesi Associated Press

BOISE – The U.S. Supreme Court should consider an appeal by Idaho of a lawsuit challenging increased Medicaid reimbursement rates, according to a petition filed Wednesday.

The state’s appeal requests that the justices decide on a 2009 case where five providers say Idaho’s Medicaid rates were too low because they were kept at 2006 reimbursement levels. The Idaho private agencies that sued the state include Inclusion Inc.; Exceptional Child Center Inc.; Living Independently for Everyone Inc.; Tomorrow’s Hope Satellite Services Inc.; and WDB Inc.

In 2011, a federal judge ruled against Idaho and ordered the department to raise the payments. The increased reimbursements cost the state $12 million in 2013.

Attorney General Lawrence Wasden filed the petition paperwork on behalf of the Idaho Department of Health and Welfare. The petition is the first step to get a case in front of the U.S. Supreme Court, which typically grants and hears oral arguments in fewer than 100 appeals per year.

“There are several critical issues for Idaho in the outcome of this lawsuit,” Wasden said in a statement. “We’re asking the Supreme Court to take up this case because the 9th Circuit’s decision incorrectly permits private parties to interfere with the administration of the state’s Medicaid program and the Legislature’s choices regarding that program.”

The original lawsuit contended that Health and Welfare was wrong to keep the rates at older levels when studies showed that the costs of providing services were going up.

Health and Welfare’s own study suggested charging nearly $500 each for certain types of services, according to the lawsuit. In reality, however, those same services were being reimbursed at the rate of $268 each, the lawsuit says. Because lawmakers failed to give the department funding for the rate increase, providers were kept at the lower 2006 rates, according to the lawsuit.

In the petition, Wasden argues that the courts were wrong in siding with the providers. He says the ruling allows providers to rewrite the agreement between Idaho and the federal government on Medicaid funding.

“It also interferes with the state’s ability to deliver services effectively and efficiently while maintaining costs at an appropriate level,” Wasden said.