The Supreme Court last week in a 5-4 decision sent back to the lower courts a case in which California health providers are suing over state Medicaid cuts. At issue is whether providers and beneficiaries may bring legal action against the state to enforce the federal Medicaid statute. Earlier, the Centers for Medicare & Medicaid Services accepted some of the state's provider rate reductions while the case was under review. Providers are arguing that the Constitution's Supremacy Clause dictates that federal laws supersede state laws if there are contradictions. The ruling leaves the issues unsettled, but directs the lower courts to reexamine the case.