Court Opinion

ID: 9558981
Source: CourtListenerOpinion
Date Created: 2023-08-21 17:19:50.719674+00
Date Added: 2024-06-11T09:09:41.519719
License: Public Domain

STAFFORD, District Judge,
dissenting.
Because I cannot agree that the district court erred in granting the defendant’s motion to dismiss, I must respectfully dissent. The district court determined—I believe correctly—that Appellant may not sue Appellee, a nursing home, for violations of 42 U.S.C. § 1396r under 42 U.S.C. § 1983.
The Medicaid Act (the “Act”), which contains the statutory provisions allegedly violated by Appellee, is Spending Clause legislation. Spending Clause legislation rarely confers upon funding beneficiaries the right to bring private actions “before thousands of federal- and state-court judges” against funding recipients. Gonzaga, 536 U.S. at 290, 122 S.Ct. 2268; Newark Parents Ass’n, 547 F.3d at 205, 214 (this circuit’s latest foray into the rights-creating-language thicket). The Supreme Court has been explicit: “[UJnless Congress ‘speak[s] with a clear voice,’ and manifests an ‘unambiguous’ intent to confer individual rights, federal funding provisions provide no basis for private enforcement by § 1983.” Gonzaga, 536 U.S. at 280, 122 S.Ct. 2268 (quoting Pennhurst State Sch. and Hosp. v. Halderman, 451 U.S. 1, 17, 101 S.Ct. 1531, 67 L.Ed.2d 694). In section 1396r, Congress did not speak *533with a “clear voice” or manifest an “unambiguous intent” to provide a basis for private enforcement of funding requirements under section 1983.
The Supreme Court in Gonzaga emphasized that “[statutes that focus on the person regulated rather than the individuals protected create no implication of an intent to confer rights on a particular class of persons.” Gonzaga, 536 U.S. at 287, 122 S.Ct. 2268 (internal quotations marks and citations omitted). In Newark Parents Ass’n, this court likewise recognized that “where a statute focuses on the entity to be regulated ... and the benefit to be conferred on an individual is secondary, i.e., it flows to individuals as a result of the regulation of the States and [recipient] agencies, Congress has not created the type of individual entitlement that characterize [sic] the unambiguous intent to create personal rights.” Newark Parents Ass’n, 547 F.3d at 213.6
Under the Medicaid Act, the federal government directs funding to states to assist them in providing medical assistance to certain eligible individuals. To receive federal funds under the Medicaid Act, states are required to administer low-income medical assistance programs pursuant to “State plans” approved by the Secretary of Health and Human Services. The Act sets forth detailed requirements for state plans. Among many other things, the Act provides that “[a] State plan for medical assistance must ... provide ... that any nursing facility receiving payments under such plan must satisfy all the requirements of subsections (b) through (d) of section 1396r.” 42 U.S.C. 1396a(a)(28)(A). Section 1396r lists the requirements that nursing facilities—as recipients of federal funding—must meet relating to the provision of services to its Medicaid patients. Importantly, in each of the provisions in subsections (b) through (d), namely, subsections (b){l )-(8), (e)(£ )-(8) and (d){l )-(4), Congress began by stating: “The nursing facility must ...” In each case, the focus is on what the nursing facility must do in return for federal funds; the focus is not on the individuals to. whom the benefit of each provision flows.7
*534In Gonzaga, the Supreme Court noted that its “more recent decisions ... have rejected attempts to infer enforceable rights from Spending Clause statutes.” Id. at 281, 122 S.Ct. 2268. Whatever Sabree may say as to section 1396a, I do not agree that Congress intended to confer upon nursing home residents the right to invoke section 1983 to sue individual nursing homes for alleged violations of the non-monetary service requirements set forth in section 1396r. The district court properly dismissed the case, and we should affirm.

. In Gonzaga, 536 U.S. at 285, 122 S.Ct. 2268, the Court explained that "[a] court’s role in discerning whether personal rights exist in the § 1983 context should ...-not differ from its role in discerning whether personal rights exist in the implied right of action context.” In the implied right of action context, federal courts have consistently held that no implied private right of action exists under the Medicaid Act, OBRA, or FNHRA. See, e.g., Prince v. Dicker, 29 Fed.Appx. 52, 54-55 (2d Cir.2002) (holding, with no discussion, that 42 U.S.C. § 1396r did not confer a private right of action that could be enforced against a private nursing home); Brogdon v. Nat’l Healthcare Corp., 103 F.Supp.2d 1322, 1330-32 (N.D.Ga.2000) (finding that Congress did not intend to authorize nursing home residents to file suit against nursing facilities to enforce the section 1396r standards required for participation in the Medicaid program); Sparr v. Berks County, 2002 WL 1608243 *2-3 (E.D.Pa. July 18, 2002) (dismissing action brought by executor of patient's estate against the nursing home for violations of the FNHRA, finding that although the statute was enacted to benefit the plaintiff, there was nothing in the legislative purpose or history to suggest that Congress intended to create a private right of action).

. In Newark Parents Ass'n, this court compared the language used in the No Child Left Behind Act (''NCLBA”) (the statute at issue in Newark) with the language used in the two exemplars of rights-creating language cited by the Gonzaga Court (Title VI of the Civil Rights Act of 1964 and Title IX of the Education Amendments of 1972), stating as follows:
[Tjhe terms used in the relevant provisions of the NCLBA ... are materially distinguishable from the language found in Titles VI and IX. The command used in those statutes—"No person ... shall ... be subjected to discrimination”—makes its one and only subject a "person.” In the NCLBA, there are two subjects: the primary subject is always the State and the "local educational agency,” while "the par*534ents of each student” are the secondary subject—they benefit from the provision but only as a result of regulation imposed upon the State and its actors.
Newark Parents Ass’n, 547 F.3d at 210.