William J. Brennan, Jr.

“ We also reject petitioners' argument that the existence of administrative procedures whereby health care providers can obtain review of individual claims for payment evidences an intent to foreclose a private remedy in the federal courts. The availability of state administrative procedures ordinarily does not foreclose resort to § 1983. ”

“ This experience demonstrates clearly that Congress and the States both understood the Act to grant health care providers enforceable rights both before and after repeal of the ill-fated waiver requirement. ”

“ There can be little doubt that health care providers are the intended beneficiaries of the Boren Amendment. The provision establishes a system for reimbursement of providers and is phrased in terms benefiting health care providers: It requires a state plan to provide for "payment . ”

“ The Court examined the language of the provision and determined that a general statement of "findings" was "too thin a reed to support" a creation of rights and obligations. Id., at 19, 101 S.Ct., at 1541. Moreover, since neither the statute nor the corresponding regulations made compliance with the provision a condition of receipt of federal funding, the Court reasoned that "the provisions of § 6010 were intended to be hortatory, not mandatory." ”

“ Coos Bay Care Center, 803 F.2d, at 1061-1063; Nebraska Health Care Assn., Inc. v. Dunning, 778 F.2d 1291, 1295-1297 (CA8 1985) , cert. denied, 479 U.S. 1063, 107 S.Ct. 947, 93 L.Ed.2d 996 (1987) . Other courts have entertained such claims without separately considering whether the providers had a cause of action under § 1983. See Hoodkroft Convalescent Center, Inc. v. New Hampshire Division of Human Services, 879 F.2d 968, 972-975 (CA1 1989) , cert. denied, 493 U.S. 1020, 110 S.Ct. 720, 107 L.Ed.2d 740 (1990) ”