Casillas v. Daines’s Empirical Analysis

Citation profile

1 federal appellate ·

Most-quoted passages

The sentences later courts lift from this opinion, ranked by how many decisions quote each — the parts of the opinion doing the work. These counts are smaller than the citation total above because most of the 3 citing decisions cite the case generally; a passage count includes only decisions quoting that exact language verbatim.

1. “The inclusion of “utilization control procedures” as an express basis for “appropriate limits” has several important implications for this case. It captures concepts that do not relate to the care of any one particular patient but looks to actual or expected utilization over a broader population. This focus is inconsistent with a right conferred upon an individual or class of individuals. The “right” conferred in section 1396a(a)(10)(A) is not unambiguously conferred upon any individual or class of individuals because it is subject to “appropriate limits” which are based upon state-wide resources and patterns of usage---- Because section 1396a(a), as authoritatively construed, allows for categorical limits on treatments, it follows that [section 1396a(a)(10)(A) ] cannot be said to have unambiguously conferred a right upon this plaintiff to a particular service or treatment.”

   1 later decision quote this exact passage · from the majority
   e.g. Bontrager v. Indiana Family & Social Services Administration

2. “[Utilization control procedures] is susceptible to multiple plausible interpretations and lacks a fixed meaning. In terms of the second Blessing element, it is a “vague and amorphous” concept, the application of which would, therefore, strain judicial competence. “This is not an instance where a court could readily determine whether a state is fulfilling these statutory obligations by looking to sources such as a state’s Medicaid plan, agency records and documents, and the testimony of Medicaid recipients and providers.” The protections could hardly be characterized as “clear and specific.” Further, the regulation is not limited to “medical necessity” or “utilization control procedures” and a state may also employ other “such criteria” in framing “appropriate limits.” This enhances the vagueness problem.”

   1 later decision quote this exact passage · from the majority
   e.g. Bontrager v. Indiana Family & Social Services Administration

3. “medical assistance made available to any individual described in subparagraph (A) [i.e., the categorically needy]— (i) shall not be less in amount, duration, or scope than the medical assistance made available to any other such individual [i.e., any other categorically needy individual], and (ii) shall not be less in amount, duration, or scope than the medical assistance made available to individuals not described in subparagraph (A) [i.e., the medically needy].”

   1 later decision quote this exact passage · from the majority
   e.g. Pashby v. Delia