When the feds need medical care for prisoners, by statute, the Medicare rate is set as the full compensation owed to medical services providers. One of those providers, Baker County Medical Services, sued in U.S. District Court, seeking a declaration that the statute is a taking because, "it is forced to render emergency medical care to federal detainees but its compensation for such treatment is limited to the Medicare rate, an amount less than its actual costs."
Short answer, according to the 11th Circuit in Baker County Medical Services, Inc. v. U.S. Att'y General, No. 13-13917 (Aug. 14, 2014): no.
The reason: Baker County Medical chose to treat all emergency patients, including federal prisoners, so can't complain that the pay is not enough:
Even so, a long line of cases instructs that no taking occurs where a person or entity voluntarily participates in a regulated program or activity. We have said that “[i]t is well established that government price regulation does not constitute a taking of property where the regulated group is not required to participate in the regulated industry.” Whitney v. Heckler, 780 F.2d 963, 972 (11th Cir. 1986). See also Yee v. City of Escondido, Cal., 503 U.S. 519, 527 (1992) (“the Takings Clause requires compensation if the government authorizes a compelled physical invasion of property”); Franklin Mem. Hosp. v. Harvey, 575 F.3d 121, 129 (1st Cir. 2009) (“Of course, where a property owner voluntarily participates in a regulated program, there can be no unconstitutional taking.”); Garelick v. Sullivan, 987 F.2d 913, 916 (2d Cir. 1993) (“[W]here a service provider voluntarily participates in a price-regulated program or activity, there is no legal compulsion to provide service and thus there can be no taking.”); Burditt v. U.S. Dept. of Health and Human Servs., 934 F.2d 1362, 1376 (5th Cir. 1991) (holding that physician could not challenge imposition of a penalty for violation of EMTALA under Takings Clause because, among other things, he voluntarily accepted “responsibility to facilitate a hospital’s compliance with EMTALA”); Minn. Ass'n of Health Care Facilities, Inc. v. Minn. Dep’t of Pub. Welfare, 742 F.2d 442, 446 (8th Cir. 1984) (finding no taking because “Minnesota nursing homes . . . have freedom to decide whether to remain in business and thus subject themselves voluntarily to the limits imposed by Minnesota on the return they obtain from investment of their assets in nursing home operation”); St. Francis Hosp. Ctr. v. Heckler, 714 F.2d 872, 884 (7th Cir. 1983) (holding that diminished market value does not constitute a taking where plaintiffs “retain full rights and control over their net investment”).
Slip op. at 5-6. And even though a hospital must opt-into the federal statute which requires emergency departments to take all comers as a condition of getting Medicare payments, Baker County Medical was a voluntary participant. The court recognized the "harsh reality" that a rural county hospital doesn't really have much choice and the payments are insufficient, "but conclude[d] that the Takings Clause of the Fifth Amendment is not the proper vehicle" for redress. Slip op. at 14-15.
Dismissal of complaint affirmed.
Baker County Medical Services, Inc.. v. U.S. Att'y General, No. 13-13917 (11th Cir. Aug. 14, 2014)
