Lankford v. Sherman case brief summary
451 F.3d 496 (2006)
CASE FACTS
Because plaintiffs were not entitled to DME items under Mo. Code Regs. Ann. tit. 13, § 70-60.010, which eliminated coverage of most DME items for the categorically-needy who were aged or disabled but gave full DME coverage to the blind, they sought to enjoin its enforcement.
DISCUSSION
CONCLUSION
The court vacated the district court's order and remanded for the district court to evaluate all the evidence and weigh the factors to determine whether a preliminary injunction should issue.
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451 F.3d 496 (2006)
CASE SYNOPSIS
Plaintiffs, disabled
Medicaid recipients, sought review of an order from the United States
District Court for the Western District of Missouri, which denied
their motion for a preliminary injunction barring defendant Director
of the Missouri Department of Social Services from enforcing Mo. Code
Regs. Ann. tit. 13, § 70-60.010 (2005), which curtailed the
provision of durable medical equipment (DME) to most
categorically-needy Medicaid recipients.CASE FACTS
Because plaintiffs were not entitled to DME items under Mo. Code Regs. Ann. tit. 13, § 70-60.010, which eliminated coverage of most DME items for the categorically-needy who were aged or disabled but gave full DME coverage to the blind, they sought to enjoin its enforcement.
DISCUSSION
- The district court denied their motion, but the court vacated the district court's order.
- The court found that the regulation did not violate the comparability requirement of 42 U.S.C.S. § 1396a(a)(10)(B)(i) because Missouri was independently funding the provision of additional DME services to the blind. Plaintiffs did not have a private right of action to enforce Medicaid's reasonable-standards provision, 42 U.S.C.S. § 1396a(a)(17), under 42 U.S.C.S. § 1983 when the Medicaid Act had been enacted pursuant to the Spending Clause.
- Because Missouri's regulation restricted available DME and plaintiffs had no other procedure to obtain non-covered DME items, however, the regulation appeared unreasonable and preempted by the Supremacy Clause.
- As plaintiffs had thus established a likelihood of success on the merits, the court remanded for the district court to determine if an injunction should issue.
CONCLUSION
The court vacated the district court's order and remanded for the district court to evaluate all the evidence and weigh the factors to determine whether a preliminary injunction should issue.
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