OPINION OF THE COURT
ROSENN, Circuit Judge.
This appeal raises issues emanating from the ongoing struggle of the Federal Government and the Commonwealth of Pennsylvania to contain costs in the delivery of health care services under the cooperative federal-state Medicaid program, Title XIX of the Social Security Act, 42 U.S.C.A. § 1396 et seq. (1983 and West Supp.1991). Plaintiff-appellants, the Erie County Geriatric Center (ECGC or the Center...
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