Florida Department of Health & Rehabilitative Services v. Florida Nursing Home Ass'n

Related Cases

Per Curiam.

Petitioners, the Florida Department of Health and Rehabilitative Services and its Secretary, seek review of a decision of the United States Court of Appeals for the Fifth Circuit ordering them to make payments to various nursing homes. These payments represent the amount that Florida was found to have underpaid these nursing homes in the course of its Medicaid reimbursements from July 1, 1976, to October 18, 1977. Because we conclude that the court below misapplied the prevailing standard for finding a waiver of the State’s immunity under the Eleventh Amendment, we grant a writ of certiorari and reverse.

*148I

In 1972, Congress amended the Medicaid Program to provide that every “skilled nursing facility and intermediate care facility” must be reimbursed by participating States on a “cost related basis.” 86 Stat. 1426, 42 U. S. C. § 1396a (a) (13)(E). This amendment was to take effect on July 1, 1976, ibid., and had the effect of altering some reimbursement arrangements based on “flat rates” established by the States. Regulations implementing this change were not promulgated by the Department of Health, Education, and Welfare (HEW) until 1976. As a result, the regulations provided that HEW would not enforce the new “cost related” reimbursement requirement until January 1, 1978. 46 CFR §250.30 (a)(3) (iv) (1976).1

In March 1977, respondents, an association of Florida nursing homes and various individual nursing homes in southern Florida, brought suit in federal court against the Secretary of HEW and petitioners. They argued that the delay in enforcement created by the implementing regulations was inconsistent with the statutory directive that cost-related reimbursements begin on July 1, 1976. In addition to prospective relief, they sought retroactive relief in the form of payments by the State of the difference between the reimbursement they had received since July 1, 1976, and the amounts they would have received under a cost-related system. The United States District Court for the Southern District of Florida held the regulations invalid, relying on its previous decision in Golden Isles Convalescent Center, Inc. v. Califano, 442 F. Supp. 201 (1977), aff’d, 616 F. 2d 1355 (CA5), cert. denied sub nom. Taylor v. Golden Isles Con*149valescent Center, Inc., 449 U. S. 872 (1980). These two cases were consolidated for consideration of the availability of retroactive relief, and the District Court held that such relief was barred by the Eleventh Amendment.

On appeal, the United States Court of Appeals for the Fifth Circuit affirmed the ruling that the regulations were invalid, but reversed the District Court’s determination that retroactive relief was barred by the Eleventh Amendment. 616 F. 2d 1355 (1980).2 The court acknowledged that retroactive monetary relief against a State in federal court is forbidden by the Eleventh Amendment “if not consented to by the state.” Id., at 1362. It found the requisite consent, however, based on two acts of the State. First, Florida law provides that the Department of Health and Rehabilitative Services is a “body corporate” with the capacity to “sue and be sued,” Fla. Stat. § 402.34 (1979). 616 F. 2d, at 1363. In addition to this general waiver of sovereign immunity, the court found a specific waiver of the Eleventh Amendment’s immunity from suit in federal court in an agreement under the Medicaid Program in which the Department agreed to “recognize and abide by all State and Federal Laws, Regulations, and Guidelines applicable to participation in and administration of, the Title XIX Medicaid Program.” Ibid. “By contracting with appellants to be bound by all federal laws applicable to the Medicaid program, the state has expressly waived its Eleventh Amendment immunity and consented to suit in federal court regarding any action by providers alleging a breach of these laws.” Ibid.

II

The analysis in this case is controlled by our decision in Edelman v. Jordan, 415 U. S. 651 (1974). There we applied *150the Eleventh Amendment to retroactive grants of welfare benefits and discussed the proper standard for a waiver of this immunity by a State. On the latter issue we stated that “we will find waiver only where stated 'by the most express language or by such overwhelming implications from the text as [will] leave no room for any other reasonable construction.’ ” Id., at 673, quoting Murray v. Wilson Distilling Co., 213 U. S. 151, 171 (1909). We added that the “mere fact that a State participates in a program through which the Federal Government provides assistance for the operation by the State of a system of public aid is not sufficient to establish consent on the part of the State to be sued in the federal courts.” 415 U. S., at 673.

The holding below, finding a waiver in this case, cannot be reconciled with the principles set out in Edelman. As the Court of Appeals recognized, the State’s general waiver of sovereign immunity for the Department of Health and Rehabilitative Services “does not constitute a waiver by the state of its constitutional immunity under the Eleventh Amendment from suit in federal court.” 616 F. 2d, at 1363. See Smith v. Reeves, 178 U. S. 436, 441 (1900). And the fact that the Department agreed explicitly to obey federal law in administering the program can hardly be deemed an express waiver of Eleventh Amendment immunity. This agreement merely stated a customary condition for any participation in a federal program by the State, and Edelman already established that neither such participation in itself, nor a concomitant agreement to obey federal law, is sufficient to waive the protection of the Eleventh Amendment.3 415 U. S., at 673-674.

We therefore reverse the decision below.

It is so ordered.

*151Justice Marshall dissents and would affirm the judgment of the Court of Appeals, substantially for the reasons stated in his dissent in Edelman v. Jordan, 415 U. S. 651, 688 (1974). Justice Blackmun also dissents and would affirm the judgment of the Court of Appeals substantially for the reasons stated in Justice Marshall’s dissent in Edelman v. Jordan, 415 U. S. 651, 688 (1974).

In a commentary accompanying the new regulations, the Secretary noted that no States would be able to accumulate needed data in time to meet the statutory deadline of July 1, 1976. For this reason, cost-related reimbursement was not required under the regulations until January 1, 1978, but the States were “encouraged to meet each requirement of the regulations as soon as possible.” 41 Fed. Reg. 27305 (1976).

The Golden Isles case and this case remained consolidated on appeal. The decision below, however, produced two separate petitions for cer-tiorari. The first, Taylor v. Golden Isles Convalescent Center, Inc., cert. denied, 449 U. S. 872 (1980), involved jurisdictional and venue issues. The present petition relates only to the availability of retroactive relief.

Petitioners argue that under Florida law a waiver of immunity can only be accomplished by a state statute. See Fla. Const., Art. 10, § 13. No such waiver is present here.

In addition, it is worth noting that in October 1976 Congress repealed *151a provision requiring States participating in Medicaid to waive their Eleventh Amendment immunity. Pub. L. 94-552, 90 Stat. 2540. This repeal was made retroactive to January 1, 1976.