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Hospital Can Sue Illinois to Enforce Medicaid Pay, Court Says

July 5, 2022, 11:21 PM

An Illinois hospital can sue the state Medicaid department because it allegedly failed to ensure that managed care organizations promptly paid providers, a federal appeals court said Tuesday.

Providers have a right to prompt payment under the Medicaid Act that is enforceable against the state through a lawsuit under Section 1983 of the US Code, the US Court of Appeals for the Seventh Circuit said in overturning a lower court’s dismissal of the lawsuit.

Saint Anthony Hospital said in the lawsuit against the Illinois Department of Healthcare and Family Services that Medicaid managed care organizations had repeatedly and systematically delayed ...