This case presents exceptionally important questions about the correct interpretation of the Federal Arbitration Act and Spending Clause legislation. At stake is whether, unless Congress unambiguously provides otherwise, a law enacted pursuant to Congress's spending power operates solely as a condition on the receipt of federal funds enforceable, by the federal government, and not as an exercise of sovereign authority. The answer to that question has sweeping implications for the enforceability of arbitration agreements in the long-term care context, for the correct interpretation of Spending Clause legislation more broadly, and for the balance of authority between federal agencies, private parties, and the courts.

Whether a federal agency's rule prohibiting pre-dispute arbitration agreements in long-term care facilities as a condition of Medicare and Medicaid funding impermissibly conflicts with the Federal Arbitration Act