The Federal District Court for Massachusetts has denied a motion to dismiss a number of Medicaid, ADA and 504 claims. Mendez v. Brown, No. 03-30160-KPN, 2004 U.S. Dist. LEXIS 5127 (D. Mass. Mar. 26, 2004). The plaintiffs, clinically obese Medicaid beneficiaries, claim that the state Medicaid agency's practice of denying them breast reduction surgery violates the ADA, Section 504 and several Medicaid Act requirements. The specific Medicaid provisions at issue are the "reasonable promptness" requirement in 42 U.S.C. 1396a(a)(8), the "comparability" provision in 42 U.S.C. 1396a(a)(10)(B) and the "reasonable standards" provision in 42 U.S.C. 1396a(a)(17).

The court found that each of these Medicaid provisions conferred individually enforceable rights upon beneficiaries, following previous cases decided both before and after Gonzaga University v. Doe. The court applied the test articulated in Blessing v. Freestone, as modified by Gonzaga, to find that each section contained "rights creating language" that "readily survived any heightened analysis which Gonzaga requires." The court specfically declined to follow the Eastern District of Pennsylvania's decision in Sabree v. Houston, which found the entire Medicaid Act unenforceable. The court cited the First Circuit's recent decision in Long Term Care Pharm. Alliance v. Ferguson, but easily distinguished it because the First Circuit was analyzing a different Medicaid provision. The district court cited Long Term Care as support for it’s finding that Gonzaga represented a "shift in emphasis" in analyzing private rights of action.

The court also held that, despite defendant's argument that obesity did not constitute a disability within the meaning of the ADA or Section 504, the plaintiffs had stated a claim that these laws had been violated. The court refused to rule that obesity is not considered a disability as a matter of law.

Western Massachusetts Legal Services is counsel in this case.