Minnesota Ass'n of Health Care Facilities, Inc. v. Minnesota Department of Public Welfare

742 F.2d 442
CourtCourt of Appeals for the Eighth Circuit
DecidedAugust 28, 1984
DocketNos. 83-2446, 83-2447
StatusPublished
Cited by51 cases

This text of 742 F.2d 442 (Minnesota Ass'n of Health Care Facilities, Inc. v. Minnesota Department of Public Welfare) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Minnesota Ass'n of Health Care Facilities, Inc. v. Minnesota Department of Public Welfare, 742 F.2d 442 (8th Cir. 1984).

Opinion

FAGG, Circuit Judge.

Thege consolidated actions were brought to challe the constitutionality of a Minnegota gtatute wbich; as a condition of par. tid tíon in the state>8 Medicaid program, limitg the rateg nursi homeg charge regidentg who do not receive Btate medical agsigtance benefits, and retroactively mandates restitution to such residents of charges that exceeded a specified rate differential based on the rates approved by the state for medical assistance recipients, We affirmed the denial of a preliminary injunction, Minnesota Association of Health Care Facilities, Inc. v. Minnesota Department of Public Welfare, 602 F.2d 150 (8th Cir.1979), and following trial by consent before a magistrate, the district court entered judgment for the defendants,

jn jq0 83-2446, Minnesota Association of Health Care Facilities, Inc. (MAHCF) and the individual plaintiffs contend that the statute violates due process and equal protection guarantees, deprives them of property without iust compensation, and unconstitutionally impairs the obligation of contracts- In No- 83-2447> Minnesota Hospital Association (MHA) and the individual plaintiffs challenge only the retroactive “payback Provision” of the statute as an unconstitutional impairment of contracts. We hold unconstitutional the part of the statute which retroactively requires refund of collected charges, but reject the remaining constitutional challenges.

I. Background

The federal Medicaid program authorizes grants to the states to help fund medical assistance programs and specifies requirements for the administration of the state [445]*445programs. Social Security Act, Title XIX, §§ 1901-1917, 42 U.S.C. §§ 1396-1396p. The Minnesota Department of Public Welfare administers the Minnesota state plan for medical assistance. A system of reimbursement to nursing homes for their care of medical assistance recipients is established by departmental regulations. See Minnesota Rules, ch. 9510 (1983) (formerly 12 Minn.Code Agency R. § 2.049). The regulations specify criteria for prospective determination of the per diem reimbursement rate to a nursing home for each resident in its care receiving medical assistance. In this appeal the plaintiffs do not challenge these regulations.

If a nursing home chooses to participate in the Medicaid program it must comply with conditions established by Minn.Stat. § 256B.48. On April 13,1976, the Minnesota legislature approved the following pertinent language:

Subdivision 1. No nursing home shall be eligible to receive medical assistance payments unless it agrees in writing that it will refrain from:
(a) Charging nonmedical assistance residents rates for similar services which exceed by more than ten percent those rates which are approved by the state agency for medical assistance recipients; effective July 1, 1978, no nursing home shall be eligible for medical assistance if it charges nonmedical assistance recipients rates for similar services which exceed those which are approved by the state agency for medical assistance recipients; provided, however, that the nursing home may (1) charge nonmedical assistance residents a higher rate for a private room, and (2) charge for special services which are not included in the daily rate if medical assistance patients are charged separately at the same rate for the same services in addition to the daily rate paid by the state agency;

Minn.Stat. § 256B.48 (1976) (amended 1977, 1978, 1983).

The magistrate found that following enactment of this provision consumers complained that some nursing homes raised to the statutory limit the rates charged residents not receiving state medical assistance. In 1977, the legislature amended section 256B.48 by adding the underlined language below:

(a) Charging nonmedical assistance residents rates for similar services which exceed by more than ten percent those rates which are approved by the state agency for medical assistance recipients. For nursing homes charging nonmedical assistance residents rates less than ten percent more than those rates which are approved by the state agency for medical assistance recipients, the maximum differential in rates between nonmedical assistance residents and medical assistance recipients shall not exceed that differential which was in effect on April 13, 1976. If a nursing home has exceeded this differential since April 13, 1976, it shall return the amount collected in excess of the allowable differential stated by this subdivision to the nonmedical assistance resident, or that person’s representative, by July 1, 1977. Effective July 1, 1978, no nursing home shall be eligible * * *.

Minn.Stat. § 256B.48(l)(a) (1977) (amended 1978, 1983).

II. Due Process

MAHCF contends that by limiting the rates charged to residents not receiving medical assistance, the statute, in combination with an already inadequate level of reimbursement provided nursing homes under state regulations for their care of medical assistance recipients, deprives Minnesota nursing homes of substantive due process and results in a taking of their property without just compensation in violation of the Fifth and Fourteenth Amendments. Although MAHCF now also maintains that the statute contravenes similar provisions of the Minnesota Constitution, these state constitutional claims were not advanced in MAHCF's second amended complaint and we do not consider them on appeal.

[446]*446With respect to the claim of an uncompensated taking, MAHCF urges that we examine the scheme of reimbursement under the principles enunciated in cases dealing with the regulation of rates charged by public utilities:

Rates which are not sufficient to yield a reasonable return on the value of the property used at the time it is being used to render the service are unjust, unreasonable and confiscatory, and their enforcement deprives the public utility company of its property in violation of the Fourteenth Amendment.

Bluefield Water Works & Improvement Co. v. Public Service Commission, 262 U.S. 679, 690, 43 S.Ct. 675, 678, 67 L.Ed. 1176 (1923). The extent of state regulation of the standards of operation for nursing homes and of the rates charged by them are cited by MAHCF as reasons for treating public utilities and nursing homes similarly with respect to state rate regulation.

Cases concerning public utilities are inapposite, however, because the present case simply does not involve a forced taking of property by the state. Minnesota nursing homes, unlike public utilities, have freedom to decide whether to remain in business and thus subject themselves voluntarily to the limits imposed by Minnesota on the return they obtain from investment of their assets in nursing home operation. Cf. Permian Basin Area Rate Cases, 390 U.S. 747, 772-73, 88 S.Ct. 1344, 1362-63, 20 L.Ed.2d 312 (1968) (in examination of area maximum rates it was pertinent that abandonment of unprofitable activities may be permitted).

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Bluebook (online)
742 F.2d 442, Counsel Stack Legal Research, https://law.counselstack.com/opinion/minnesota-assn-of-health-care-facilities-inc-v-minnesota-department-of-ca8-1984.