Medicaid Contractors – Outstanding Bills

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7^th Circuit Court of Appeals

Case Name: Bria Health Services, LLC, et al. Theresa A. Eagleson

Case No.: 18-3076

Officials: SYKES, HAMILTON, and BRENNAN, Circuit Judges.

Focus: Medicaid Contractors – Outstanding Bills

Plaintiffs are consultants who provide services to nursing homes and long‐term care facilities. They say they are bringing this suit on behalf of seriously ill nursing home residents receiving care under Medicaid. The residents, however, are not parties to this suit, and it seems unlikely that they would benefit at all if plaintiffs win. By all appearances, plaintiffs have brought this suit in an effort to push the State of Illinois and its Medicaid contractors to pay outstanding bills owed to the consultants’ clients.

Third parties can bring claims on behalf of others under some circumstances. Guardians, next friends, and associations, for example, can have representative standing. This case does not involve such established standing doctrines. Instead, plaintiffs rely on a Medicaid regulation. As we read that regulation, however, it does not permit authorized representatives to bring civil lawsuits on behalf of Medicaid beneficiaries. We affirm the district court’s dismissal for lack of standing and thus lack of subject matter jurisdiction.

Affirmed

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Derek A Hawkins is trademark corporate counsel for Harley-Davidson. Hawkins oversees the prosecution and maintenance of the Harley-Davidson’s international trademark portfolio in emerging markets.