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A decision yesterday by the US Supreme Court reversed a Ninth Circuit decision and ruled that providers do not have the legal right to sue a state Medicaid program under the federal Medicaid act. Armstrong v. Exceptional Child Center involved an Idaho clinic suing the state because rates were too low to ensure adequate access to care, as required under federal law. The Court ruled that only the federal Medicaid agency can enforce that provision of law. Advocates are deeply concerned about the implications for access to care and protecting fragile consumers’ health in the program.