Planned Parenthood of Greater Texas Family Planning and Preventative Health Services, Inc. v. Kauffman

Summary

In this en banc decision, the Fifth Circuit vacated a preliminary injunction, holding that Medicaid patients have no private right under 42 U.S.C. § 1396a(a)(23) (the "any-qualified-provider" provision) to challenge a state's determination that a provider is not "qualified," and thus cannot bring such a claim under 42 U.S.C. § 1983. The court relied on the Supreme Court's decision in *O'Bannon v. Town Court Nursing Center* and the text and structure of the statute, which does not unambiguously confer a right to contest qualification decisions. The court overruled its prior panel decision in *Planned Parenthood of Gulf Coast, Inc. v. Gee*. Key topics: Medicaid, § 1396a(a)(23), § 1983, private right of action, Spending Clause, preliminary injunction, provider qualification determinations.

Holdings

1. No. Medicaid patients do not have a right under § 1396a(a)(23) to contest a state's determination that a provider is not qualified. The statute does not unambiguously confer such a right, and the Supreme Court's decision in O'Bannon v. Town Court Nursing Center controls.

Questions Presented

1. Whether 42 U.S.C. § 1396a(a)(23) gives Medicaid patients a right to challenge, under 42 U.S.C. § 1983, a State's determination that a health care provider is not 'qualified' within the meaning of § 1396a(a)(23).

Disposition

vacated