Whether a State's Medicaid program violates 42 C.F.R. § 431.52(b)'s equal-payment requirement by denying supplemental payments to out-of-state hospitals, thereby paying in-state hospitals more than out-of-state hospitals that furnish the same services to the State's Medicaid patients

Under 42 C.F.R. § 431.52(b), a State’s Medicaid plan must “pay for services furnis hed in another State to the same extent that it would pay for services furnished within its boundaries if the services are furnished to a beneficiary who is a resident of the State.” Petitioners are “border hospitals” in neighboring states who are located within 55 miles of California and treat a substantial number of California Medicaid (Medi-Cal) patients. Despite Section 431.52(b)’s clear equal-payment mandate, Medi-Cal pays out-of-state hospitals less than in-state hospitals for furnishing the sa me care to California residents. Specifically, California denies out-of-state hospi-tals that treat Medi-Cal patients any portion of the more than $4 billion in additional federal supplemental funds that California distributes only to in-state hospitals. The question presented is: Whether a State’s Medicaid program violates 42 C.F.R. § 431.52(b)’s equal-payment requirement by denying supplemental payments to out-of-state hospitals, thereby paying in-state hospitals more than out-of-state hospitals that furnish the same services to the State’s Medicaid patients. (ii)