Rite Aid of Pennsylvania, Inc. v. Houstoun

998 F. Supp. 522, 1997 U.S. Dist. LEXIS 22803, 1997 WL 856188
CourtDistrict Court, E.D. Pennsylvania
DecidedNovember 3, 1997
DocketCiv.A. 97-2120
StatusPublished
Cited by6 cases

This text of 998 F. Supp. 522 (Rite Aid of Pennsylvania, Inc. v. Houstoun) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rite Aid of Pennsylvania, Inc. v. Houstoun, 998 F. Supp. 522, 1997 U.S. Dist. LEXIS 22803, 1997 WL 856188 (E.D. Pa. 1997).

Opinion

MEMORANDUM

BARTLE, District Judge.

Rite Aid of Pennsylvania, Inc. (“Rite Aid”) has filed an action under 42 U.S.C. § 1983 (“ § 1983”) against Feather O. Houstoun, the Secretary of the Pennsylvania Department of Public Welfare (“Department”). Plaintiff alleges that the Department failed' to comply with Title XIX of the Social Security Act (“Medicaid Act”), 42 U.S.C. § 1396 et seq., and accompanying regulations as well as various state statutes and regulations and the Due Process clause of the Fourteenth Amendment. According to Rite Aid, the Department improperly lowered the reimbursement rates for prescription drugs and related services in Pennsylvania’s State Plan.

Before the court are the defendant’s motion for judgment on the pleadings, on all counts of the complaint while plaintiff seeks judgment on the pleadings as to Count II only. When considering these motions, the court accepts all of the opposing party’s well-pleaded allegations as true, as well as facts specifically admitted by the opposing party. See, e.g., Jablonski v. Pan American World Airways. Inc., 863 F.2d 289, 290-91 (3d Cir.1988).

Rite Aid brings three claims against the Department. Count I asserts a right to sue under § 1983 for violations of *525 § 1396a(a)(30)(A) and the regulations concerning the medical care advisory committee. Count II alleges violations of three public notice regulations. Count III asserts a Fourteenth Amendment violation.

Rite Aid requests various forms of relief, including a declaration that the Department adopted the amended regulations in violation of 42 U.S.C. § 1396a(a)(30)(A), 42 C.F.R. §§ 440.210, 447.205(a) & (c)(4), 431.12(e), and 55 Pa.Code § 1101.70 (West 1997), as well as in violation of the Fourteenth Amendment of the United States Constitution. In addition, it seeks to enjoin defendant from continuing to use the lower reimbursement rates for calculating payments to Rite Aid for prescription drugs and related services. Rite also asks this court to direct defendant to pay the higher pre-October 1, rates until the new rates are adopted in conformance with federal and state laws and regulations. Finally, it claims attorney’s fees and costs.

Medicaid is a cooperative federal-state cost sharing program to finance medical assistance to indigent, elderly and disabled individuals. See 42 U.S.C. § 1396 et seq. Since Pennsylvania has elected to participate in Medicaid, it must meet federal requirements and submit a State Elan, and any amendments thereto, to the United States Department of Health and Human Services (“HHS”) for approval. See, e.g., Wilder v. Virginia Hosp. Ass’n, 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990). The Department is responsible for implementing Pennsylvania’s State Plan.

The Medicaid Act requires states to pay for certain enumerated services and allows states to provide additional services. § 1396a(a)(10)(A); 42 C.F.R. § 440.210. Because Pennsylvania has opted to include prescription drugs and related services in its State Plan, it has contracted.with Rite Aid, among others, to provide these services. See 55 Pa.Code § 1121.

It is undisputed that the Department submitted the amended regulations, which are the subject of this lawsuit, to Pennsylvania’s Independent Regulatory Review Commission (“IRRC”) for approval on August 8, 1995. Defendant did not issue a notice of proposed rulemaking or provide Pennsylvania’s medical care advisory committee (“MAAC”) with a copy of the regulations before sending them to the IRRC. The Department, however, did publish a notice in the August 26, 1995 Pennsylvania Bulletin stating that it “will amend” the regulations effective October 1,1995. See 25 Pa.Bull. at 3540 (Aug. 26, 1995). The regulations were deemed approved by the IRRC on September 8, 1995 and took effect on October 1,1995. The text of the order of the Department adopting the regulations was published in the Pennsylvania Bulletin on September 23, 1995. 25 Pa.Bull. at 3978.

On December 29, 1995, the Department sent the amended State Plan to the Health Care Financing Administration (“HCFA”) of HHS for approval. HCFA approved Pennsylvania’s revised State Plan with the lower reimbursement rates on May 7, 1996, with the changes effective October 1,1995.

I. Enforceability

Defendant first asserts that a private party such as Rite Ad may not seek enforcement of the Medicaid regulations under § 1983, although the defendant apparently concedes that Rite Ad has a right of action to enforce § 1396a(30)(A) itself. (Br. of Def. in Opp’n to Rite Ad of Pa.Mot. for J. on the Pleadings n. 4). Accordingly, defendant moves for judgment on the pleadings on the claim in Count I of the complaint that defendant violated a regulation in not adequately consulting with the medical advisory committee before promulgating the lower reimbursement rates. Defendant has a similar argument as to the claim in Count II that it violated the public notice requirements of the regulations.

Rite Ad is suing under § 1983 to enforce requirements found in 42 C.F.R. § 447.205 and 42 C.F.R. § 431.12(e). These regulations are authorized by § 1396a(a). Section 1983 provides a remedy for deprivation under color of state law of “any rights ... secured by the Constitution and laws” of the United States. 42 U.S.C. § 1983.

It is well settled that § 1983 encompasses not only Constitutional rights but also some federal laws as well. See e.g., West Virginia Univ. Hosp. v. Casey, 885 F.2d 11, 17 (3d Cir.1989), aff'd 499 U.S. 83, 111 S.Ct. *526 1138, 113 L.Ed.2d 68 (1991). The courts use a two part test to determine which federal laws may be enforced under § 1983. First, the federal law must create a private right of action under § 1983. See Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981).

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998 F. Supp. 522, 1997 U.S. Dist. LEXIS 22803, 1997 WL 856188, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rite-aid-of-pennsylvania-inc-v-houstoun-paed-1997.