No. 18-40

Legacy Community Health Services, Inc. v. Charles Smith, Executive Commissioner, Texas Health and Human Services Commission

Lower Court: Fifth Circuit
Docketed: 2018-07-06
Status: Denied
Type: Paid
Amici (2) Experienced Counsel
Tags: circuit-split federal-grants federally-qualified-health-centers fqhc health-centers managed-care managed-care-network medicaid-reimbursement public-health-service public-health-service-act statutory-interpretation
Key Terms:
SocialSecurity Securities JusticiabilityDoctri
Latest Conference: 2018-09-24
Question Presented (AI Summary)

Whether 42 U.S.C. §§ 1396a(bb)(1)-(5) impose an independent duty on States to fully reimburse FQHCs for all services they provide to Medicaid beneficiaries regardless of how a State structures its managed-care network or whether the FQHCs are in or out of that network

Question Presented (OCR Extract)

QUESTION PRESENTED Section 330 of the Public Health Service Act provides federal grants for federally-qualified health centers (“FQHCs”) to provide primary medical care to Medicaid and other patients in medically underserved areas, regardless of a patient’s ability to pay. 42 U.S.C. § 254b. So that States do not divert those federal grants to subsidize their own Medicaid obligations, Congress provided in 42 U.S.C. §§ 1396a(bb)(1)-(5) that States must fully reimburse FQHCs for all services they provide to Medicaid the FQHCs are in or out of the State’s Medicaid managedcare network. The First, Second, Third, Fourth, and Ninth Circuits hold that States cannot avoid the duty to fully reimburse FQHCs under 42 U.S.C. §§ 1396a(bb)(1)-(5), regardless of how they structure their managed-care network or whether an FQHC is in or out of that network. In the decision below, the Fifth Circuit held the opposite: that a State can structure its managed-care network so as to avoid its duty to fully reimburse FQHCs. The question presented is: Whether 42 U.S.C. §§ 1396a(bb)(1)-(5) impose an independent duty on States to fully reimburse FQHCs for all services they provide to Medicaid beneficiaries regardless of how a State structures its managed-care network or whether the FQHCs are in or out of that network.

Docket Entries

2018-10-01
Petition DENIED.
2018-08-22
DISTRIBUTED for Conference of 9/24/2018.
2018-08-21
Reply of petitioner Legacy Community Health Services, Inc. filed. (Distributed)
2018-08-06
Brief amici curiae of Public Health Scholars filed.
2018-08-06
Brief amicus curiae of Community Health Choice, Inc. filed.
2018-08-06
Brief of respondent Charles Smith, Executive Commissioner, Texas Health and Human Services Commission in opposition filed.
2018-07-03
Petition for a writ of certiorari filed. (Response due August 6, 2018)
2018-05-09
Application (17A1237) granted by Justice Alito extending the time to file until July 3, 2018.
2018-04-05
Application (17A1237) to extend the time to file a petition for a writ of certiorari from June 3, 2018 to July 3, 2018, submitted to Justice Alito.

Attorneys

Community Health Choice, Inc.
Carlos R. SolteroCleveland Terrazas, PLLC, Amicus
Carlos R. SolteroCleveland Terrazas, PLLC, Amicus
Legacy Community Health Services, Inc.
David B. SalmonsMorgan, Lewis & Bockius LLP, Petitioner
David B. SalmonsMorgan, Lewis & Bockius LLP, Petitioner
Public Health Scholars
Thomas Richard BarkerFoley Hoag, LLP, Amicus
Thomas Richard BarkerFoley Hoag, LLP, Amicus