Westside Mothers v. Haveman

WESTSIDE MOTHERS, a Michigan Welfare Rights Organization;  Michigan League for Human Services, Inc.....Plaintiffs-Appellants, v. James K. HAVEMAN, Jr., Director of the State of Michigan Dept of Community Health....
133 F.Supp. 2d 549 |
6th Circuit decided 2002-05-15
Jurisdiction level:

(1) Medicaid is not a contract between the states that participate and the federal government. (2) Sovereign immunity does not bar an action against a state official who did not comply with Medicaid regulations. (3) A Plaintiff does have a private right of action under to enforce rights provided under Medicaid.

Result: Win
Importance:

Maintained current law private right of action for Medicaid beneficiaries to sue to enforce Medicaid Act in federal court. Center for Children’s Advocacy https://cca-ct.org/westside-mothers-v-haveman/: “In Westside Mothers v. Haveman, a far reaching Medicaid and federal/civil rights law decision…, the sixth circuit federal court of appeals reversed the district court’s grant of summary judgment on all substantive law issues and partially reversed on the issue of standing for organizational plaintiffs. The case was filed under 42 U.S.C. §1983 alleging that the state of Michigan failed to provide services required by the Medicaid program… This important decision reaffirms the position that Medicaid beneficiaries and providers can enforce provisions of the federal Medicaid Act in federal court.”


Law type: Civil
Topic(s): Enforcement, Medicaid, and Sovereign immunity
State of origin: MI
Attorneys:

Thomas K. Gilhool (argued and briefed), Public Interest Law Center of Philadelphia, Philadelphia, PA, Jennifer R. Clarke (argued and briefed), Kelly L. Darr (briefed), Robin P. Sumner (briefed), Jacob I. Kobrick (briefed), Dechert, Price & Rhoads, Philadelphia, PA.


Others involved: Marilyn T. Mullane (briefed), Michigan Legal Services, Detroit, MI, Lourdes A. Rivera (briefed), National Health Law Program Inc., Los Angeles, CA, Thomas K. Gilhool (argued and briefed), Public Interest Law Center of Philadelphia, Philadelphia, PA, Jennifer R. Clarke (argued and briefed), Kelly L. Darr (briefed), Robin P. Sumner (briefed), Jacob I. Kobrick (briefed), Dechert, Price & Rhoads, Philadelphia, PA, Susan K. McParland (briefed), Michigan Association for Children, Southfield, MI, Martha Jane Perkins (briefed), National Health Law Program, Chapel Jill, NC, for Plaintiffs-Appellants. Erwin Chemerinsky (briefed), Los Angeles, CA, David T. Goldberg, David T. Goldberg Law Office, New York, NY, Phyllis James (briefed), City of Detroit Law Department, Detroit, MI, James L. Feldesman (briefed), Feldesman, Tucker, Leifer, Fidell & Bank LLP, Washington, DC, Larry S. Gage (briefed), Barbara D.A. Eyman (briefed), Charles Luband (briefed), Aimee N. Wall (briefed), Powell, Goldstein, Frazer & Murphy, Washington, DC, Drew S. Days, III (briefed), Morrison & Foerster, Washington, DC, Fordham E. Huffman (briefed), Chad A. Readler (briefed), Jones, Day, Reavis, & Pogue, Columbus, OH, Timothy P. Heather (briefed), Benjamin, Yocum & Heather, Cincinnati, OH, Richard Clayton Trotter (briefed), Texas Justice Foundation, San Antonio, TX, for Amici Curiae. Mark B. Stern (briefed), Alisa B. Klein (argued and briefed), U.S. Department of Justice, Civil Division, Appellate Section, Washington, DC, for Intervenor. Patrick W. Beatty (briefed), Rebecca L. Thomas (briefed), Robert C. Maier (briefed), Darrell M. Pierre, Jr. (briefed), Office of the Attorney General of Ohio, Columbus, OH, for Amici Curiae.
Organization role: Sponsor

Last modified: 2020-04-07 06:01
Case internal grade: A | Case internal status: OK |
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CASE DETAILS

(The syllabus is not part of the opinion, but is a summary prepared by the court reporter as a convenience.)

Full case title

WESTSIDE MOTHERS, a Michigan Welfare Rights Organization;  Michigan League for Human Services, Inc.;  Families On the Move, Inc.;  American Academy of Pediatrics;  American Academy of Pediatric Dentists;  B.K., by her next friend Lois Ann K.;  D.J., by her next friend Tangela W.;  Dn.J., by her next friend Tangela W.;  Dm.J., by his next friend Tangela W.;  K.K., by her next friend Vicki K.;  K.T., by her next friend Veda T.;  J.T., by his next friend Veda T., Plaintiffs-Appellants, v. James K. HAVEMAN, Jr., Director of the State of Michigan Department of Community Health;  Robert Smedes, Deputy Director of the Medical Services Administration, Defendants-Appellees, United States of America, Intervenor.

Summary

Center for Children’s Advocacy https://cca-ct.org/westside-mothers-v-haveman/:
“In Westside Mothers v. Haveman, a far reaching Medicaid and federal/civil rights law decision issued on May 16, 2002, the sixth circuit federal court of appeals reversed the district court’s grant of summary judgment on all substantive law issues and partially reversed on the issue of standing for organizational plaintiffs.

The case was filed under 42 U.S.C. §1983 alleging that the state of Michigan failed to provide services required by the Medicaid program – specifically the “early periodic screening, diagnostic and treatment services … for individuals who are eligible under the plan and are under the age of 21.”

The key issues in the case are:

Whether Medicaid is only a contract – the circuit held that pursuant to statutes upon states participating in Medicaid and similar programs – those programs are not merely contract provisions, but federal laws.
Whether acts passed under the spending power are the supreme law – the circuit rejected the district court’s argument and found that acts passed under Congress’ spending power are supreme law, a principle that has not been abandoned in recent decisions.
Whether the suit is barred by sovereign immunity – the circuit court found that Ex Parte Young provided a foundation for an exception to the sovereign immunity doctrine.
Whether there is a private right of action under § 1983 – again, the circuit rejected the district court’s third party beneficiary theory and held that the Supreme Court’s Blessing v. Freestone three part analysis allowed the plaintiffs in this case to proceed as an intended beneficiary of the provision.

This important decision reaffirms the position that Medicaid beneficiaries and providers can enforce provisions of the federal Medicaid Act in federal court.

From the opinion

This suit filed under 42 U.S.C. § 1983 alleges that the state of Michigan has failed to provide services required by the Medicaid program.   Plaintiffs, Westside Mothers, other advocacy and professional organizations, and eight named individuals allege that defendants James Haveman, director of the Michigan Department of Community Health, and Robert Smedes, deputy director of the Michigan Medical Services Administration, did not provide the early and periodic screening, diagnosis, and treatment services mandated by the Medicaid Act and related laws.

The Medicaid program, created in 1965 when Congress added Title XIX to the Social Security Act, provides a federal subsidy to states that choose to reimburse poor individuals for certain medical care. ….Since 1997, operating under a waiver from the Health Care Finance Administration, Michigan has provided eligible residents Medicaid services by requiring them to enroll in Health Maintenance Organizations, which provide medical care in exchange for a flat monthly fee per participant.  

The Medicaid Act and related regulations set out a detailed list of services every state program must provide….

At issue here is the federal requirement that participating states provide “early and periodic screening, diagnostic, and treatment services ․ for individuals who are eligible under the plan and are under the age of 21.”