Suter v. Artist M., 503 U.S. 347, 21 (1992)

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Cite as: 503 U. S. 347 (1992)

Blackmun, J., dissenting

adequate to meet the costs which must be incurred by efficiently and economically operated facilities in order to provide care and services in conformity with applicable State and Federal laws, regulations, and quality and safety standards and to assure that individuals eligible for medical assistance have reasonable access . . . to inpatient hospital services of adequate quality." 42 U. S. C. § 1396a(a)(13)(A) (emphasis supplied).

In Wilder, we had no difficulty concluding that the reimbursement provision of the Boren Amendment "was intend[ed] to benefit" the plaintiff providers of Medicaid services. 496 U. S., at 509. We also concluded that the second part of the test was satisfied. The amendment, we held, does not simply express a "congressional preference" for reasonable and adequate reimbursement rates; rather, it imposes a "binding obligation" on the State to establish and maintain such rates. Id., at 512. In so concluding, we emphasized two features of the Medicaid reimbursement scheme. First, we observed that the language of the provision is "cast in mandatory rather than precatory terms," stating that the plan "must" provide for reasonable and adequate reimbursement. Ibid. Second, we noted that the text of the statute expressly conditions federal funding on state compliance with the amendment and requires the Secretary to withhold funds from noncomplying States. Ibid. In light of these features of the Medicaid Act, we rejected the argument, advanced by the defendant state officials and by the United States as amicus curiae, that the only enforceable state obligation is the obligation to file a plan with the Secretary, to find that its rates are reasonable and adequate, and to make assurances to that effect in the plan. Id., at 512-515. Rather, we concluded, participating States are required actually to provide reasonable and adequate rates, not just profess to the Secretary that they have done so. Ibid.

Finally, we rejected the State's argument that Medicaid providers' right to "reasonable and adequate" reimburse-

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