So this is what hope feels like?

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor
I don't know when I've ever heard louder joyful shouts of, “We didn't lose!”

It's been a week since the U.S. Supreme Court decided not to rule on a case regarding California's unprecedented cuts to provider Medicaid reimbursement. And the no-decision tumult has mostly left observers scratching their heads and vowing to watch the next step even closer.

The Supremes basically played hot potato with the touchy issue. They sent it back to the 9th U.S. Circuit Court of Appeals, which had previously ruled in providers' favor by issuing a stay of the cuts.

But there was a big change since that earlier ruling: The Centers for Medicare & Medicaid Services went ahead and approved some of the reductions.

The Supreme Court justices, by a 5-4 vote, basically said they wanted the lower court to take another look at the changed case. In long-term care, anytime you don't lose, you've won. So having the case stay alive, even if the odds might not be in providers' favor, is a victory. There is apparently a good path for further appeals. Hope is alive — for now at least.

It is again up to the 9th Circuit to try to decide which entity's claim takes precedence. Providers believe federal law is on their side since they are charged with giving adequate care to the needy; the state says it has the Center for Medicare & Medicaid Services' blessing to go ahead with desired cuts.

With federal law and agency rules apparently at odds, it looks like we could be in for another government vs. government showdown.

Why can't they all be decided amicably, like the famous courtroom scene in “Miracle on 34th Street”? If you remember, that's where a member of the local judiciary gets out of a pickle by deciding not to tangle with another branch of the U.S. government (the U.S. Post Office, which delivers letters to Santa Claus in the courtroom, thereby “proving” his identity).

No, this is liable to get messier than seeing those bags and bags of letters spilling all over the judge.

And the nation will be watching. California is hardly the only state struggling with runaway healthcare costs and big deficits. If they can do it in California, they can do it anywhere, goes the thinking.Talk about a buzz kill.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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