[JURIST] Indiana Attorney General Greg Zoeller [official website] filed an appeal [brief, PDF] Monday to lift a judge’s decision to block parts of a controversial state law [HEA 1210] denying that medicaid funds go to Planned Parenthood of Indiana (PPIN) [advocacy website]. Zoeller filed the appeal in the US Court of Appeals for the Seventh Circuit [official website] challenging the decision of Judge Tanya Walton Pratt that prevents application of the portion of the law that bans contracts between state agencies and any entity that performs abortions [JURIST news archive] or maintains a facility where abortions are performed. Indiana filed a notice of appeal [JURIST report] in June. Indiana argues that PPIN cannot force the state to fund medical centers under the “free-choice plan requirement” [42 USC § 1396a(a)(23)] that gives patients the right to choose their healthcare provider, because the state has the authority to determine what are qualified healthcare providers:
When Congress enacted Medicaid, it did not create a top-down welfare model where the national government commandeers a State administrative apparatus and instructs it to provide particular benefits through prescribed channels. Rather, it created a cooperative-federalist program offering federal reimbursement to States that choose to establish Medicaid programs that comply with federal criteria. Under this model, States decide what services and segments of the population they want to cover and determine the qualifications and standards of practice for those who seek to provide the covered services. The federal government reimburses States whose Medicaid plans conform to the Medicaid Act and may refuse to issue grants to States with non-compliant plans. … Accordingly, PPIN cannot have a right of action to “enforce” … the “free-choice plan requirement.” All concede that the Medicaid Act itself affords no right of action.
Zoeller said that the issue is between the state and federal government and not between the state and private contractor, so it should be resolved through the administrative review process already in place. PPIN and the American Civil Liberties Union (ACLU) [advocacy website] filed the lawsuit challenging HEA 1210 seeking a permanent injunction of the law.
Indiana is already appealing an administrative decision in June by Donald Berwick, administrator of the US Centers for Medicare & Medicaid Services (CMMS) [official website] to deny approval of the law [JURIST report]. He sent a letter to the Indiana state agency saying states have the ability to assign the qualified provider status, but the law violates § 1902(a)(23) of the Social Security Act [text] because it prevents Medicaid beneficiaries from receiving services from certain providers for reasons unrelated to the providers qualifications to provide those services. The Obama administration has taken a stance against the Indiana law. In addition to the CMMS denial, the US Department of Justice (DOJ) [official website] filed a brief urging the court to grant an injunction [JURIST report] to stop the enforcement of the law. The ban includes disbursement of grant money, including federal Medicare funds, a provision PPIN claims is not legal under the federal Medicaid Act’s “freedom of choice” provision, which allows states to disallow Medicare funding for medical providers based on deficiencies in quality of service. Before granting the preliminary injunction, the judge denied a request for a restraining order [JURIST report] to block implementation of the law.