Eleventh Amendment – Medicare Statue Violation

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7^th Circuit Court of Appeals

Case Name: BT Bourbonnais Care, LLC, et al. v. Felicia F. Norwood, Director, Illinois Department of Healthcare and Family Services

Case No.: 16-3655; 16-3968

Officials: WOOD, Chief Judge, and FLAUM and SYKES, Circuit Judges.

Focus: Eleventh Amendment – Medicare Statue Violation

The plaintiffs contend that their rates were not properly adjusted after a change in ownership of the nursing homes they run. Before that issue can be resolved, however, there are two significant hurdles plaintiffs must clear: first, they must show that they have a private right of action for a violation of the relevant part of the Medicaid statute, 42 U.S.C. § 1396a(a)(13)(A); and, second, they must show that the Eleventh Amendment does not categorically bar this case from going forward.

The principal question before us has been whether the Operators have an enforceable procedural right to the public process outlined in section 1396a(a)(13)(A). We conclude that they do, and that the Eleventh Amendment does not bar this case to the extent that it seeks prospective, procedural relief. Many questions remain for the district court to resolve, including whether this particular complaint states a claim upon which relief can be granted, whether the Director is entitled to partial summary judgment on identified parts of the case whether because of the Eleventh Amendment or for other reasons, and doubtless many others.

Affirmed

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Attorney Derek A. Hawkins is the managing partner at Hawkins Law Offices LLC, where he heads up the firm’s startup law practice. He specializes in business formation, corporate governance, intellectual property protection, private equity and venture capital funding and mergers & acquisitions. Check out the website at www.hawkins-lawoffices.com or contact them at 262-737-8825.