Leonard Thurman v. Medical Trans Mgmt, Inc., 982 F.3d 953

Plaintiff Leonard Thurman, a Medicaid recipient, requested non-emergency medical transportation (NEMT) to a dentist appointment; Medical Transportation Management, Inc. (MTM) did not pick him up, stating Thurman failed to provide required trip information.
Thurman sued MTM pro se, asserting, among other claims, a § 1983 action alleging a violation of a federal right to NEMT created by Medicaid regulations/statutes.
MTM moved to dismiss under Rule 12(b)(6); Thurman abandoned other claims and pursued only the § 1983 claim. The district court assumed MTM acted under color of state law but dismissed the § 1983 claim for failure to allege a federal right.
On appeal the Fifth Circuit considered whether an administrative regulation can create an individual right enforceable under § 1983 and whether 42 U.S.C. §§ 1396a(a)(8), (19), and (70), alone or with 42 C.F.R. § 431.53, create such a right.
The Fifth Circuit reviewed the dismissal de novo, accepted well-pleaded facts as true, and framed the legal question around whether Congress (not an agency) unambiguously conferred a right enforceable under § 1983.
Holding: the court affirmed — agency regulations cannot independently create § 1983 rights; the cited Medicaid statutory provisions do not unambiguously confer a private right to NEMT enforceable under § 1983.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Can an agency regulation (42 C.F.R. § 431.53) alone create an individual right enforceable under 42 U.S.C. § 1983?	§ 431.53 confers an enforceable right to NEMT that Thurman may vindicate under § 1983	Regulations cannot create federal rights under § 1983; only Congress can create such rights	No; regulations cannot independently create § 1983 rights. Court joins majority circuits following Sandoval/Gonzaga
Do 42 U.S.C. §§ 1396a(a)(8), (19), and (70), alone or together with § 431.53, unambiguously confer an individual right to NEMT enforceable under § 1983?	Those statutory provisions (and the regulation together) establish a federal right to NEMT that is enforceable under § 1983	The statutes are general/administrative directives and do not unambiguously confer an individual, enforceable right to transportation	No; §§ 1396a(a)(8), (19), (70) (even with the regulation) do not unambiguously confer a private right to NEMT actionable under § 1983
Was MTM acting under color of state law such that § 1983 could apply?	Thurman alleged MTM is a state entity jointly funded by state and federal governments	MTM did not contest state-action in district court; central dispute concerned existence of a federal right	Court assumed state action for purposes of decision but dismissed because no federal right existed

Alexander v. Sandoval, 532 U.S. 275 (regulations may not create private causes of action Congress has not authorized)
Gonzaga Univ. v. Doe, 536 U.S. 273 (§ 1983 protects only rights Congress unambiguously intended to create)
Blessing v. Freestone, 520 U.S. 329 (statute must unambiguously impose binding obligation to create enforceable right)
S. Camden Citizens in Action v. New Jersey Dep’t of Envtl. Prot., 274 F.3d 771 (3d Cir.) (regulations do not independently create § 1983 rights)
Save Our Valley v. Sound Transit, 335 F.3d 932 (9th Cir.) (same)
Caswell v. City of Detroit Hous. Comm’n, 418 F.3d 615 (6th Cir.) (post-Gonzaga alignment rejecting regulations-as-rights theory)
Harris v. James, 127 F.3d 993 (11th Cir.) (§ 1396a provisions do not unambiguously confer an individual right to transportation)
Boatman v. Hammons, 164 F.3d 286 (6th Cir.) (contrary earlier view that regulations may have force of law; discussed and distinguished)
Samuels v. District of Columbia, 770 F.2d 184 (D.C. Cir.) (narrow pre-Sandoval decision recognizing rights when Congress explicitly directs regulatory action)