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  NAHC Report: Issue# 2634, 3/31/2015
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US Supreme Court Issues Important Medicaid Decision
Senate Passes Amendment to ACA’s Full-Time Employment Definition
For Your Information: Financial Management Conference Call for Speakers – Deadline April 10
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US Supreme Court Issues Important Medicaid Decision

The US Supreme Court held today that Medicaid providers do not have the right to sue state Medicaid programs when a state allegedly has failed to comply with federal Medicaid law regarding the setting of payment rates. In Armstrong v. Exceptional Child Center, Inc., the Supreme Court decided that there is no private right of action under the Supremacy Clause of the U.S. Constitution for a provider of services to sue a state Medicaid program to enforce the federal Medicaid law that requires rates to be set at a level sufficient to secure access to care for Medicaid beneficiaries to the same extent available to individuals with private health insurance. You can read the opinion by clicking here. The lower courts had decided that the Idaho Medicaid program standards for rate setting violated federal law because those standards did not adequately consider the cost of care.

In a 5-4 ruling, the Supreme Court settled the latest chapter in the decades-long effort of providers of Medicaid services to challenge inadequate Medicaid payment rates in federal court.  In recent years, Medicaid providers held out hope that the court rulings in the U.S. Court of Appeals for the Ninth Circuit would become the law of the land. That court, which covers the states of California, Oregon, Arizona, Washington, and Idaho, had held that Medicaid providers could proceed to challenge Medicaid payment rates under the Supremacy Clause of the U.S. Constitution. That constitutional provision establishes that federal law preempts any conflicting state law—i.e. federal law is “supreme” to state law. The Court of Appeals had ruled that health care providers had a “private right of action” under the Supremacy Clause to enforce the “equal access” provision of federal Medicaid law as it relates to payment rates. In the Exceptional Child Center case, the Supreme Court reversed the Court of Appeals, holding that the Supremacy Clause does not grant any right of action itself. Instead, the Court held that the Supremacy Clause just tells a federal court how it must decide when there is a conflict between a state and federal law. 

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Senate Passes Amendment to ACA’s Full-Time Employment Definition

Last week, the US Senate passed a budget resolution that included an amendment, introduced by Senator Susan Collins (R-ME), addressing the definition of full-time employment under the Patient Protection and Affordable Care Act (ACA). Budget amendments do not have the force of law. However, the amendment’s success demonstrates the strong support in Congress to amend the ACA’s definition of full-time employment.

Senator Collins (R-ME), in January, also introduced stand-alone legislation, the “Forty Hours Is Full Time Act” (S. 30), with bipartisan original cosponsors: Senators Donnelly, Manchin, and Murkowksi.

The Collins amendment was adopted as part of the Senate budget resolution by unanimous consent. Due to parliamentary rules for budget amendments, the amendment is different than S. 30. Rather than specifically changing the definition from 30 to 40 hours, the amendment expresses support for restoring a “sensible” definition of a full-time employee.

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Financial Management Conference Call for Speakers – Deadline April 10

NAHC and it affiliate, Home Care and Hospice Financial Management Association (HHFMA), has announced its annual Call for Speakers for the 2015 Financial Management Conference. The conference will be held in Nashville from June 28-30, 2015. The conference includes four extended pre-conferences and 16 Workshops in combination with four General Sessions.

With this conference, the program content is planned by the HHFMA Education Committee and the HHFMA Workgroup. As in the past, HHFMA then looks to find the best speakers to present on the planned program content.

Individuals interested in presenting at this conference should review the program content set out here. We are looking for speakers to participate at each of the pre-conferences and the 16 workshops.

If you are interested or know someone you think would make a great speaker in a pre-conference or workshop, please submit your interest to: You should include your name, organization affiliation, the specific program(s) you wish to be considered for, and credentials that outline your expertise in the selected program(s). We will consider individuals or a panel presentation depending on the nature of the topic involved.

Please remember, this is a Call for Speakers for the programs listed in the link. We are not looking for program proposals.

The deadline for submission of interest on this Call for Speakers is April 10. 

Thank you for your consideration and recommendations. We look forward to seeing all of you at the conference in Nashville.

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