Legal Opinion

New Jersey Primary Care Ass'n v. New Jersey Department of Human Services

Court of Appeals for the Third Circuit

Decided July 9, 2013No. 12-3220PublishedCited by 17 opinions

1Opinion of the Court

OPINION OF THE COURT

BARRY, Circuit Judge.

Under the federal Medicaid statute, 42 U.S.C. § 1396 et seq., states participating in Medicaid and implementing a managed care environment are obligated to make, at least every fourth month, supplemental payments (known as “wraparound payments”) to federally-qualified health centers (“FQHCs”) in an amount equal to the difference between a predetermined rate set by the Medicaid statute multiplied by the number of Medicaid patient encounters, and the amount paid to FQHCs by managed care organizations (“MCOs”) 1 for all Medicaid-covered patient…

2Cases cited20 opinions

  1. Pennhurst State School and Hospital v. HaldermanSupreme Court of the United States · 1984
  2. Skidmore v. Swift & Co.Supreme Court of the United States · 1944
  3. Gonzaga University v. DoeSupreme Court of the United States · 2002
  4. Christensen v. Harris CountySupreme Court of the United States · 2000
  5. Harris v. McRaeSupreme Court of the United States · 1980

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3Cited by17 opinions

  1. Community Health Care Ass'n v. ShahCourt of Appeals for the Second Circuit · 2014
  2. Linda Migliori v. Lehigh County Board of ElectionsCourt of Appeals for the Third Circuit · 2022
  3. Saint Anthony Hospital v. Elizabeth M. WhitehornCourt of Appeals for the Seventh Circuit · 2025
  4. Alameda Health Sys. v. Ctrs. for Medicare & Medicaid Servs.District Court, N.D. California · 2017
  5. Saint Anthony Hospital v. Elizabeth M. WhitehornCourt of Appeals for the Seventh Circuit · 2024

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