8. Plaintiffs are entitled to declaratory and injunctive relief enjoining Defendants from engaging in conduct that violates the reasonable promptness and due process requirements of Medicaid Act in 42 U.S.C. §1396a(a)(3), (8). It is now therefore, Case 2:16-cv-01205-RSM Document 21-1 Filed 04/03/17 Page 5 of 6 [PROPOSED] ORDER GRANTING PLAINTIFFS’ MOTION FOR PARTIAL SUMMARY JUDGMENT - 6 Case: 16-01205-RSM Disability Rights Washington 315 5th Avenue South, Suite 850 Seattle, Washington 98104 (206) 324-1521  Fax: (206) 957-0729 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 ORDERED that Plaintiffs’ Motion for Partial Summary Judgment is GRANTED and that a partial judgment be entered in favor of Plaintiffs providing declaratory and injunctive relief against the Defendants under the Medicaid Act.

And CMS expressed a related concern (id.) about the recent findings of a district court that Florida’s payment rates for physicians are too low to promote the quality of care and equal access to care required by 42 U.S.C. § 1396a(a)(30)(A). See Findings of Fact and Conclusions of Law at 144 (ECF # 1294), Florida Pediatric Soc’y v. Dudek, No. 05-23037-CIV (S.D. Fla. Dec. 30, 2014).8 The May 21 letter also noted that, while Florida was proposing a “modest” and “incremental” change in how LIP funds were distributed, it did not propose shifting any “net LIP dollars” into rates, Ex.

Congress imposed no sixty-percent-threshold requirement within the four corners of the Medicaid Statute. 42 U.S.C. § 1396a(a)(13)(C). RESPONSE: This paragraph constitutes a characterization of a federal statute, rather than a statement of a material fact.

This right Case 3:15-cv-00565-JWD-SCR Document 13 08/27/15 Page 15 of 23 16 subjects Louisiana Medicaid providers to the same type of regulatory framework governing the New York Medicaid providers in Plaza Health and Senape. Also relevant to the State’s determination is the Medicaid exclusion statute, found at 42 U.S.C. § 1396a(p). That statute provides in part: (p) Exclusion power of State; exclusion as prerequisite for medical assistance payments; “exclude defined (1) In addition to any other authority, a State may exclude any individual or entity for purposes of participating under the State plan under this subchapter for any reason for which the Secretary could exclude the individual or entity from participation in a program under section 1320a-7, 1320a-7a, or 1395cc (b)(2) of this title [Medicare].

The state plan is an agreement between the state and the federal government describing how that state administers its Medicaid program, including groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed, and the administrative requirements that states must meet to participate. See 42 U.S.C. §§ 1396a(a), 1396d(a). States have considerable flexibility to set eligibility standards and to construct benefit packages, as long as the state complies with federal guidelines.

The state plan is an agreement between the state and the federal government describing how that state administers its Medicaid program, including groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed, and the administrative requirements that states must meet to participate. See 42 U.S.C. §§ 1396a(a), 1396d(a). States have considerable flexibility to set eligibility standards and to construct benefit packages, as long as the state complies with federal guidelines.

(Id.) Plaintiff’s ADA and Rehabilitation Act claims are not based on a theory of vicarious liability, just as her claim for Defendants’ violation of the § 1396a(a)(8) “right to apply” provision was not based on any allegation of worker error. Instead, Plaintiff alleges that Defendants’ have promulgated and enforced the regulations that permit State actors to refuse to accept and process TennCare applications in violation of the ADA and Rehabilitation Act.

However, that automatic reinstatement of benefits for inmates is mandated by Ohio Rev. Code §5111.0119; it is not an example of obligation under the Medicaid Act. These inconsistencies and misstatements highlight how flawed Plaintiffs’ claim is that Defendants have any legal obligation under §1396a(a)(8). E. Plaintiffs fail to state a claim under the Food Stamp Act.

See id. As to the use of federal dollars, Congress has chosen to answer those questions -- and to condition eligibility for federal funds -- on the basis of opposite- sex marital status. See, e.g., 42 U.S.C. §§ 1396a(17), 1396r-5; 38 C.F.R. § 39.5(a). Massachusetts may believe this limitation is bad policy, and that it would be better if both the Medicaid and veterans’ cemetery grant programs were expanded to include same-sex spouses.

See Sabree ex rel. Sabree v. Richman, 367 F.3d 180, 183 (3d Cir. 2004) (analyzing Gonzaga and holding that several Medicaid provisions, including 42 U.S.C. §§ 1396a(a)(8), 1396a(a)(10), and 1396d(a)(15), “unambiguously confer rights vindicable under § 1983”). M.A.C. has no persuasive power here.