Belshe

MEMORANDUM OF OPINION AND ORDER

The question presented in this ease is whether a State may implement a change in the rate of reimbursement to certain Medicaid providers prior to approval of a State plan amendment by the Secretary of Health and Human Services (“the Secretary”). Plaintiff Exetér .Memorial Hospital Association (“Exeter”) seeks a preliminary injunction to compel the California Department of Health Services (“DHS”) to cease enforcement of its most recent amendment to its Medicaid reimbursement plan, as that amendment is applied to DHS’s payments to Exeter.

I.

Title XIX of the. Social Security Act, 42 U.S.C. §§ 1396 et seq., authorizes payment of federal matching funds to States to defray expenses that the States incur in providing medical assistance to low income persons. If a State chooses to participate in this pro-gram, it must comply with the requirements of the Act and of the regulations issued by the Secretary. Central to this litigation and to the structure of the program is the requirement that, the State submit to the Secretary a State plan that sets forth the State’s proposal for delivering medical assistance. The State plan must describe the nature and…