QUESTIONS PRESENTED
Under 42 U.S.C. 1396a(a)(30)(A), a State??s plan for medical assistance under the Medicaid Act must ??provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan * * * as may be necessary * * * to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.?? The questions presented are:
1. Whether Section 1396a(a)(30)(A) requires States to rely on ??responsible cost studies?? in setting Medicaid reimbursement rates or otherwise to consider efficiency, economy, quality of care, and access to care before reducing Medicaid reimbursement rates.
2. Whether the Supremacy Clause provides a cause of action to Medicaid providers or beneficiaries who assert that state law conflicts with the requirements of Section 1396a(a)(30)(A).
BRIEF FOR THE UNITED STATES AS AMICUS CURIAE
This brief is submitted in response to the Court??s order inviting the Solicitor General to express the views of the United States. In the view of the United States, the petition for a writ of certiorari should be denied.
STATEMENT
1. The Medicaid program established in 1965 by Title XIX of the Social Security Act, 42 U.S.C. 1396 et seq., is a cooperative federal-state program to provide medical care to needy individuals. Wilder v. Virginia Hosp. Ass??n, 496 U.S. 498, 502 (1990); Atkins v. Rivera, 477 U.S. 154, 156 (1986). State participation in Medicaid is voluntary, but those States that elect to participate must comply with requirements imposed by the Medicaid Act and by the Secretary of Health and Human Services (HHS) in her administration of the Act. See 42 U.S.C. 1396a; Wilder, 496 U.S. at 502; Rivera, 477 U.S. at 157. Within those basic limits, however, each State enjoys great flexibility in designing and administering its own program.
To qualify for federal funds, participating States must submit to the Secretary, and receive approval of, ??a plan for medical assistance?? detailing the nature and scope of the State??s Medicaid program. 42 U.S.C. 1396a(a); 42 C.F.R. 430.10; Wilder, 496 U.S. at 502. Among other requirements, a State??s plan must
provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan * * * as may be necessary to safeguard against unnecessary utilization of such care and services and to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.
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