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Hospital Lacks Ability to Sue State to Enforce Medicaid Payments

July 12, 2021, 2:00 PM

An Illinois state official won dismissal of a lawsuit alleging her department has a duty to force Medicaid managed care organizations to promptly pay providers, as the Medicaid Act doesn’t give a health-care provider a right to sue, a federal trial court said.

A provision setting out the requirements for claims payment procedures that must be included in a state Medicaid plan doesn’t contain “rights creating” language giving providers a right to sue the government under 42 U.S.C. § 1983, the U.S. District Court for the Northern District of Illinois said.

That is, while the Medicaid Act’s Section 1396-2(f) requires ...