First Circuit Holds Providers Can’t Enforce Equal Access Provision (March '04)
- Organization: National Health Law Program
- Document Type: Article/News
- Creation Date: Friday, March 26, 2004
- Submitted: Friday, March 04, 2005
- Attachment: HTM
First Circuit Holds Providers Can’t Enforce Equal Access Provision (posted March 26, 2004)
First Circuit Holds Providers Can’t Enforce Equal Access Provision
The First Circuit Court of Appeals has held that providers cannot enforce the "equal access" provision of the Medicaid Act, 42 USC 1396a(a)(30)(A). See Long Term Care Pharmacy Alliance v. Ferguson, No. 03-1895, 2004 U.S. App. LEXIS 5002 (1st Cir. Mar. 17, 2004). The case challenged a reduction in pharmacy payments implemented by the Massachusetts Medicaid agency.
The decision relies on Gonzaga University v. Doe, 536 U.S. 273 (2002). It is significant because the First Circuit previously has issued post-Gonzaga opinions that allowed private enforcement of other Medicaid provisions. Also, the Court abandoned an earlier decision (one of the oldest from a circuit court) that had allowed (30)(A) to be enforced (Visiting Nurse Ass'n v. Bullen, 93 F.3d 997 (1st Cir. 1996)).
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