Carol Lewis v. Xavier Becerra

111 F.4th 65
CourtCourt of Appeals for the D.C. Circuit
DecidedAugust 2, 2024
Docket23-5152
StatusPublished
Cited by2 cases

This text of 111 F.4th 65 (Carol Lewis v. Xavier Becerra) is published on Counsel Stack Legal Research, covering Court of Appeals for the D.C. Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carol Lewis v. Xavier Becerra, 111 F.4th 65 (D.C. Cir. 2024).

Opinion

United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued May 7, 2024 Decided August 2, 2024

No. 23-5152

CAROL A. LEWIS AND DOUGLAS B. SARGENT, ON BEHALF OF THEMSELVES AND ALL OTHERS SIMILARLY SITUATED, APPELLANTS

v.

XAVIER BECERRA, IN HIS CAPACITY AS SECRETARY OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, APPELLEE

Appeal from the United States District Court for the District of Columbia (No. 1:18-cv-02929)

James Pistorino argued the cause for appellants. With him on the briefs were David B. Goroff, Michael D. Leffel, and Andrew C. Gresik.

Joshua M. Koppel, Attorney, U.S. Department of Justice, argued the cause for appellee. With him on the brief were Brian M. Boynton, Principal Deputy Assistant Attorney General, Abby C. Wright, Attorney, Samuel R. Bagenstos, General Counsel, U.S. Department of Health and Human Services, and David Hoskins, Attorney. 2 Before: KATSAS, RAO, and WALKER, Circuit Judges.

Opinion for the Court filed by Circuit Judge KATSAS.

KATSAS, Circuit Judge: Carol Lewis and Douglas Sargent sued the Secretary of Health and Human Services to obtain reimbursement for the cost of certain medical equipment. They won. But they nevertheless appeal, seeking to challenge the district court’s earlier denial of class certification. By itself, their desire to serve as class representatives does not create a cognizable Article III interest. And Lewis and Sargent do not allege that the denial of class certification has caused them any other, concrete individual injury. We therefore dismiss their appeal for lack of constitutional standing.

I

A

The Medicare program provides health insurance for the elderly and disabled. See 42 U.S.C. § 1395 et seq. Part B of Medicare covers “durable medical equipment.” 42 U.S.C. § 1395m(a).

Congress has provided for limited judicial review of Medicare eligibility determinations. The Medicare Act incorporates the judicial-review provisions of the Social Security Act, which require a beneficiary to exhaust administrative remedies and then to seek review within sixty days of the final agency determination. See 42 U.S.C. §§ 1395ii, 1395ff(b)(1)(A) (Medicare); id. § 405(g) (Social Security); Am. Hosp. Ass’n v. Azar, 895 F.3d 822, 825–26 (D.C. Cir. 2018). In some circumstances, courts may excuse a beneficiary’s failure to exhaust, Bowen v. City of New York, 476 U.S. 467, 482 (1986), and may equitably toll the sixty-day deadline for seeking judicial review, id. at 481. 3 B

Diabetes is a chronic condition where the body fails to produce or properly respond to insulin, which regulates blood- sugar levels. A blood-sugar level too high or low can cause serious health problems. So, diabetics must monitor their blood-sugar levels.

Continuous glucose monitors provide one means of doing so. A sensor placed under the skin measures glucose levels and transmits the measurements to an external receiver. The Centers for Medicare & Medicaid Services, which administers Medicare for HHS, has taken different positions on whether these monitors are covered “durable medical equipment.” In 2017, CMS issued guidance concluding that Part B does not generally cover these monitors. J.A. 693–95. But in 2021, CMS promulgated a rule extending Part B coverage to continuous glucose monitors with a dedicated receiver. 86 Fed. Reg. 73,860 (Dec. 28, 2021). In 2022, CMS rescinded the 2017 guidance and instructed administrative adjudicators to apply the rule to all outstanding reimbursement claims. J.A. 587.

C

Lewis and Sargent are diabetics and Medicare beneficiaries. They sought reimbursement for their continuous glucose monitors and related supplies from 2015 to 2017. After HHS denied reimbursement, Lewis and Sargent timely pursued judicial review of the denials. They also moved to represent a class of “[a]ll persons who submitted claims for coverage of [continuous glucose monitor] equipment or supplies whose claims were denied (and not later reversed on appeal) since December 13, 2012”—regardless of whether these individuals had exhausted administrative remedies or timely sought judicial review. J.A. 48. 4 The district court denied Lewis and Sargent’s motion for class certification. The court noted that the claims of most putative class members were unexhausted, untimely, or both. J.A. 538–39. It then concluded that neither waiver of the exhaustion requirement nor equitable tolling of the limitations period would be appropriate. Id. at 539–45. The court therefore excluded individuals with unexhausted or untimely claims, which reduced the putative class to seventeen individuals. Id. at 549. Then, the court held that this group was too small to meet the numerosity requirement for class certification. Id. at 550.

After CMS issued its 2022 guidance, HHS moved for partial judgment in Lewis and Sargent’s favor. Over their objection, the district court granted the motion, set aside the denials of Lewis and Sargent’s claims, declared that continuous glucose monitors and their related supplies are durable medical equipment, and dismissed Lewis and Sargent’s other claims as moot. J.A. 625–26. Lewis and Sargent then appealed.

II

On appeal, Lewis and Sargent do not challenge any aspect of their favorable merits judgment. Instead, they challenge only the denial of their motion for class certification.

The government does not question our jurisdiction. But “federal courts have an independent obligation to ensure that they do not exceed the scope of their jurisdiction” and “must raise and decide jurisdictional questions that the parties either overlook or elect not to press.” Henderson ex rel. Henderson v. Shinseki, 562 U.S. 428, 434 (2011). In particular, federal courts of appeals lack jurisdiction if the appellant has not shown standing to pursue the appeal. See, e.g., West Virginia v. EPA, 597 U.S. 697, 718 (2022); Hollingsworth v. Perry, 570 5 U.S. 693, 715 (2013). Considering the issue on our own, we hold that Lewis and Sargent lack appellate standing.

Article III limits the judicial power of the United States to resolving “Cases” or “Controversies.” U.S. Const. Art. III, § 2. “Article III denies federal courts the power to decide questions that cannot affect the rights of litigants in the case before them, and confines them to resolving real and substantial controversies admitting of specific relief through a decree of a conclusive character.” Lewis v. Cont’l Bank Corp., 494 U.S. 472, 477 (1990) (cleaned up). To this end, any party invoking a federal court’s jurisdiction must prove its “standing.” Lujan v. Defs. of Wildlife, 504 U.S. 555, 561 (1992). In a federal district court, “a plaintiff must show (i) that he suffered an injury in fact that is concrete, particularized, and actual or imminent; (ii) that the injury was likely caused by the defendant; and (iii) that the injury would likely be redressed by judicial relief.” TransUnion LLC v. Ramirez, 594 U.S. 413, 423 (2021). Similarly, in a federal appellate court, an appellant must show a concrete and particularized injury “fairly traceable to the judgment below” and likely to be redressed by a favorable ruling on appeal. West Virginia, 597 U.S. at 718.

In Deposit Guaranty National Bank v.

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111 F.4th 65, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carol-lewis-v-xavier-becerra-cadc-2024.