William Rehnquist

“ Apart from its displacement of the statutory ratesetting process noted previously, the Court's suggestion that the States would deliberately disregard the requirements of the statute ignores the Secretary's oversight incorporated into the statute and does less than justice to the States. The Court itself recognizes that the basic purpose of the Boren Amendment was to allow the States more latitude in establishing Medicaid reimbursement rates. In light of that fact, the Court's interpretation takes far more liberties with the statutory language than does the position advanced by petitioners. ”

“ In light of the placement of § 1396a (a) (13) (A) within the structure of the statute, see Pennhurst, supra, 451 U.S., at 19, 101 S.Ct., at 1540 (emphasizing the statutory "context" of the provision under review) , one most reasonably would conclude that § 1396a (a) (13) (A) is addressed to the States and merely establishes one of many conditions for receiving federal Medicaid funds; the text does not clearly confer any substantive rights on Medicaid services providers. ”

“ The relevant portion of the Boren Amendment requires States to reimburse Medicaid services providers using
"rates (determined in accordance with methods and standards developed by the State . . .) which the State finds, and makes assurances satisfactory to the Secretary, are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities. ”