Supreme Court watchers are looking for clues about the new conservative majority, and on Monday they were offered a surprising one. The Justices chose not to hear Gee v. Planned Parenthood of Gulf Coast, drawing a sharp rebuke from three of the Court’s conservatives.

At issue is whether patients may sue states in federal court for restricting or removing providers from their Medicaid programs. Many states excluded Planned Parenthood amid reports that the outfit illegally harvested fetal organs and engaged in fraudulent billing. Louisiana in Gee terminated its at-will contract with Planned Parenthood for reproductive services.

Federal law gives states substantial discretion to administer Medicaid programs but establishes guidelines for receiving matching federal dollars. The Health and Human Services secretary may withhold funds from states that don’t comply.

One federal requirement is that Medicaid patients may obtain care from any provider “qualified to perform the service or services required.” The law does not define “qualified,” and states can exclude providers “for any reason . . . authorized by state law.” States must also provide an administrative appeal and judicial review for excluded providers.

But Planned Parenthood has leapfrogged state adjudication by recruiting plaintiffs to sue in federal court to vindicate their putative right to their preferred provider. Five appellate courts including the Fifth, Sixth, Seventh, Ninth and Tenth Circuits have recognized a private right of action while the Eighth has not.