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  4.  | Supreme Court Upholds Right of Medicaid Beneficiaries to Sue Nursing Facilities

Supreme Court Upholds Right of Medicaid Beneficiaries to Sue Nursing Facilities

Last week, the Supreme Court held that Medicaid beneficiaries can sue nursing facilities for violations of the Federal Nursing Home Reform Act of 1987 (FNHRA). In Health & Hospital Corp. of Marion County v. Talevski, a seven-justice majority ruled that individuals can sue to enforce Spending Clause enactments under 42 U.S.C. § 1983, a civil rights statute that allows individuals to sue state actors when those actors violate rights within the Constitution and/or laws.

Under the Spending Clause in the Constitution, Congress can condition the receipt of federal funds. The FNHRA conditions the receipt of funds by requiring all nursing facilities that participate in Medicare and Medicaid to “protect and promote the rights of each resident.”

In Talevski, the family of Georgi Talevski filed a lawsuit alleging that Talevski’s rights under the FNHRA were violated by the government-owned nursing home he lived in at the time. The Court rejected the nursing home’s argument that Talevski could not sue them and held that a private right of action for beneficiaries of government programs, such as Medicaid, will continue to exist.

The Court’s decision gives reassurance to Medicaid beneficiaries, who can continue to pursue justice through a 42 U.S.C. § 1983 action. When a nursing home violates the rights of a Medicaid beneficiary under the FNHRA, the patient and their family will be able to hold the nursing home accountable in federal court.