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      WASHINGTON (AP) — The Supreme Court began its new term Monday by
weighing whether patients and health care providers in the Medicaid
program for poor Americans can sue to block a state from cutting
reimbursement rates.


      California and the Obama administration argued that only the
U.S. Health and Human Service Department gets to determine whether
the rates a state uses to pay doctors and other providers complies
with the federal Medicaid law. There was no consensus apparent
among the justices Monday.


      Even before the arguments began, the court rejected more than
1,800 appeals that had piled up during the justice's three-month
summer break, including one from California jail officials who
forced a Muslim woman to remove her head scarf and another from
fried-chicken giant KFC Corp. objecting to taxes it has to pay in
Iowa.


      Chief Justice John Roberts also congratulated Justice Antonin
Scalia on 25 years of service on the court, noting that Scalia
listened to his first argument as a justice on the first Monday in
October in 1986. "The place has not been the same since," Roberts
said.


      The term opened with high anticipation because the justices seem
likely to confront President Barack Obama's health care overhaul.
Both the administration and opponents of the law have filed Supreme
Court appeals, setting the stage for a high court hearing in the
spring and a decision by late June.


      Monday's case does not directly implicate the new law, although
the expansion of Medicaid is a key element in the law's aim of
extending coverage to more than 30 million Americans. Medicaid
costs are shared by the federal and state governments.


      Faced with large budget deficits, the California legislature
passed a law reducing Medicaid reimbursement rates by up to 10
percent. The Medicaid law says states have to maintain
reimbursement rates that are sufficient to get providers to take
part. States must submit proposed rate reductions to HHS, but the
law is silent about whether private parties can go to court to keep
payments from going down.


      In this case, California put the some of the lower rates in
effect before submitting them to HHS. Multiple lawsuits followed
and federal courts in California stepped in to block the new rates.
Eventually, HHS also did not approve them, although California
asked the department to reconsider the rejection.


      Carter Phillips, a veteran Supreme Court lawyer who argued the
case on behalf of patients and providers, said that without the
federal court orders there was no guarantee that doctors and
hospitals would continue treating Medicaid patients.


      "My people have a life or death problem," Phillips said.


      Roberts appeared strongly inclined to vote against Phillips'
clients, saying the court generally does not allow private parties
to sue unless a law expressly says they may.


      Justice Stephen Breyer said he was troubled by giving federal
judges too much authority to weigh in on the large number of
payments made under Medicaid.


      But other justices suggested that the lawsuits were appropriate,
in part because California put new rates in place before getting
federal approval.


      Justice Elena Kagan accused the state of an end run around the
regulatory process.


      Karin Schwartz, a deputy state attorney general, disagreed,
saying the state is allowed to put new rates in effect while
awaiting HHS review.


      "We did not do an end run around anything," Schwartz said.


      A decision is expected by spring.
      

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The Supreme Court began its new term Monday by
weighing whether patients and health care providers in the Medicaid program for poor Americans can sue to block a state from cutting reimbursement rates.

Supreme Court begins new term today

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