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The 3rd U.S. Circuit Court of Appeals has revived a class action lawsuit brought by retarded and mentally ill Pennsylvanians who claim the state is dragging its feet in providing Medicaid-funded services, finding that a federal statute specifically calls for states to provide those services with “reasonable promptness.” In its 21-page opinion in Sabree v. Richman, the court rejected Pennsylvania’s argument that it cannot be sued for failing to provide Medicaid services since the only remedy for its non-compliance with the Medicaid Act is suspension or revocation of its funding from Congress. The unanimous three-judge panel found that U.S. District Judge Herbert J. Hutton erred in dismissing the suit on the grounds that the rights asserted by the plaintiffs were not “unambiguously conferred” by Congress. Writing for the court, U.S. Circuit Judge Maryanne Trump Barry said, “Plaintiffs have advanced specific claims rooted in statutory text that identify them as the intended recipients of medical assistance from the commonwealth of Pennsylvania. That Congress may choose to sanction Pennsylvania for failure to comply with its own medical assistance plan does not necessarily preclude other repercussions, such as individual actions against the commonwealth.” Barry, joined by Circuit Judges Samuel A. Alito Jr. and Thomas L. Ambro, found that “Congress clearly and unambiguously conferred the rights of which plaintiffs have allegedly been deprived by Pennsylvania, and has not precluded individual enforcement of those rights.” The ruling is a victory for attorneys Stephen F. Gold, a solo practitioner, and Ilene W. Shane of the Disabilities Law Project, who filed the suit on behalf of a class of mentally retarded adults who claim they have waited sometimes for years for placements in an “intermediate care facility.” Hutton dismissed the case, finding that such a civil rights claim was barred by the U.S. Supreme Court’s 2002 decision in Gonzaga University v. Doe. Now the 3rd Circuit has ruled that while language in Gonzaga seems “at first blush” to support Hutton’s conclusion, the case must be viewed together with a long line of Supreme Court cases — some recognizing an individual’s right to sue and others rejecting it. After analyzing all the cases, the 3rd Circuit concluded that the Medicaid Act, or Title XIX, falls into the narrow category of federal statutes that were designed to create enforceable individual rights. Barry noted that Hutton relied on Chief Justice William Rehnquist’s comment in Gonzaga that “we now reject the notion that our cases permit anything short of an unambiguously conferred right to support a [civil rights claim] … under Section 1983.” With such strong language, Barry said, “the court, no doubt, has set a high bar for plaintiffs.” But Barry found that for a complete understanding of Gonzaga, it is necessary to consider four prior Supreme Court cases over the past two decades — two of which recognized a congressional intent to confer statutory rights, and two that rejected such claims. In 1987, in Wright v. Roanoke Redevelopment & Housing Authority, the court permitted a suit by tenants to recover past overcharges under a rent-ceiling provision of the Public Housing Act. In the 1990 decision in Wilder v. Virginia Hospital Association, the court allowed a suit brought by health care providers to enforce a reimbursement provision of Title XIX of the Social Security Act. But in Suter v. Artist M., handed down in 1992, the court rejected a class action by parents and children who sought to enforce provisions of the Adoption Assistance and Child Welfare Act, which required that states have a “plan” to make “reasonable efforts” to keep children out of foster homes. And in 1997′s decision in Blessing v. Freestone, the justices rejected the claims of five mothers whose children were eligible to receive child support services from the state of Arizona under Title IV-D of the Social Security Act. Barry viewed the four cases through the lens of Gonzaga and found a consistent theme. The lesson of the five decisions, Barry said, is that “to confer rights, Congress must use ‘rights-creating language,’” and “such language must clearly impart an ‘individual entitlement’ and have an ‘unmistakable focus on the benefited class.’” Barry found that Title XIX satisfies the test because the language of the statute requires that a state “must provide … medical assistance” to all “eligible individuals” with “reasonable promptness.” As a result, Barry found that linguistically, Title XIX is a close cousin to the laws at issue in Wright and Wilder in which the high court found there was a valid individual right that is enforceable under Section 1983. But the most vexing questions in the suit may be coming soon. Barry said the appellate court’s task was limited to ruling on the validity of the suit and that it was not prepared to offer Hutton any guidance for how to proceed now that it has been revived. “We need not, and do not, address the remedy that might be available to plaintiffs, but leave that to the District Court in the first instance,” Barry wrote.

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