Medicaid, Medicare and House representation for the District of Columbia

This week we highlight cases that ask the Supreme Court to consider, among other things, whether Florida’s Medicaid agency can recoup the cost of past medical expenses from a tort victim’s settlement fund that is intended to pay for future medical care, whether the federal government is properly calculating payments for hospitals serving low-income patients, and whether the District of Columbia deserves a voting House delegate.

Gianinna Gallardo was a 13-year-old student when she was hit by a truck after getting off a school bus. Florida’s Medicaid agency paid for the bulk of her treatment. Gallardo remains in a vegetative state. After filing a civil suit against the truck driver and others, her parents recovered $800,000 in a court-approved settlement. The Medicaid agency then sought $300,000 of this amount to cover Gallardo’s past medical expenses. That money would come from a portion of the settlement fund meant to pay for both past and future medical care. The U.S. Court of Appeals for the 11th Circuit allowed Florida’s action, even though, the Gallardos maintain, the Florida Supreme Court and other state and federal courts would not. In Gallardo v. Marstiller, they ask the justices to resolve the conflict and reverse the 11th Circuit.

Becerra v. Empire Health Foundation looks at the calculations by which hospitals that serve a “significantly disproportionate number of low-income patients” receive Medicare payments. Congress has created two proxy measures to reflect a hospital’s proportion of low-income Medicare and non-Medicare patients. In one, Congress directed the secretary of health and human services to include patient days attributable to “patients who (for such days) were entitled to benefits.” By regulation, the secretary counts such days regardless of whether the Medicare program ultimately pays the hospital for those days, perhaps because the beneficiary exhausted inpatient benefits for that particular benefit period. Dissatisfied with its total reimbursement amount for 2008, Valley Hospital Medical Center challenged this regulation. The U.S. Court of Appeals for the 9th Circuit agreed, acknowledging a split with two other circuits. The acting solicitor general asks the justices to review and reverse this decision.

In Castañon v. United States, residents of the District of Columbia have brought an ambitious legal challenge seeking voting representation in Congress. They argue that, although the Constitution states that the House of Representatives shall be chosen by “the People of the several States,” in practice people who are not state residents are still entitled to vote. For example, the Overseas Voting Act allows Americans living overseas to vote, and residents of “federal enclaves,” such as military bases, are entitled to vote in the state in which the enclave is located even if that state does not consider them to be state residents. The D.C. residents argue that there is no justification for treating them differently from other American citizens who are not state residents yet still have congressional voting representation. A three-judge district court rejected the residents’ arguments. Nonetheless, they ask the Supreme Court to review the case and to grant relief, including a declaration that the District’s House delegate (currently a non-voting member) has the power to vote on all legislation.

These and other petitions of the week are below:

Gallardo v. Marstiller
20-1263
Issue: Whether the federal Medicaid Act provides for a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the portion of the beneficiary’s tort recovery that compensates for future medical expenses.

Castañon v. United States
20-1279
Issue: Whether the three-judge district court erred by holding that residents of the District of Columbia are not entitled to voting representation in the House of Representatives because they do not live in a “State,” even though (1) Americans living overseas and residents of “federal enclaves” have voting representation in Congress despite not being State residents, (2) Congress has concluded that it may extend voting rights to District residents under the “District Clause” of the Constitution, Article I, Section 17, Clause 8, and (3) the Supreme Court has held that the right to vote is the most fundamental of all rights because it is preservative of all other rights.

Becerra v. Empire Health Foundation
20-1312
Issue: Whether, for purposes of calculating additional payment for hospitals that serve a “significantly disproportionate number of low-income patients,” the secretary of health and human services has permissibly included in a hospital’s Medicare fraction all of the hospital’s patient days of individuals who satisfy the requirements to be entitled to Medicare Part A benefits, regardless of whether Medicare paid the hospital for those particular days.

Shivkov v. Artex Risk Solutions Inc.
20-1313
Issues: (1) Whether an agreement that specifies arbitration before the American Arbitration Association as the default dispute-resolution method also must specifically mention the AAA rules to avoid being considered ambiguous about whether the parties intended to apply the AAA rules; and (2) whether the availability of class arbitration is a matter for an arbitrator to decide, or for a court to decide.

Boardman v. Inslee
20-1334
Issue: Whether a law that skews the debate over the value of public-sector unions and undermines public-sector employees’ opt-out rights by giving incumbent unions exclusive access to information necessary to communicate with public-sector employees is consistent with the First Amendment.

A.P. v. Vermont
20-1335
Issue: Whether Vermont’s criminalization of lewd and lascivious conduct violates the due process clause of the 14th Amendment to the U.S. Constitution.