Lee Memorial Hospital v. Xavier Becerra

10 F.4th 859
CourtCourt of Appeals for the D.C. Circuit
DecidedAugust 20, 2021
Docket20-5085
StatusPublished
Cited by5 cases

This text of 10 F.4th 859 (Lee Memorial Hospital 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
Lee Memorial Hospital v. Xavier Becerra, 10 F.4th 859 (D.C. Cir. 2021).

Opinion

United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued February 25, 2021 Decided August 20, 2021

No. 20-5085

LEE MEMORIAL HOSPITAL, ET AL., APPELLANTS

BILLINGS CLINIC, ET AL., APPELLEES

v.

XAVIER BECERRA, SECRETARY, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, APPELLEE

Appeal from the United States District Court for the District of Columbia (No. 1:13-cv-00643)

Keith R. Bradley argued the cause for appellants. With him on the briefs was Sven C. Collins.

Benjamin M. Shultz, Attorney, U.S. Department of Justice, argued the cause for appellee. With him on the brief were Jeffrey Bossert Clark, Acting Assistant Attorney General at the time the brief was filed, and Michael S. Raab, Attorney.

Before: SRINIVASAN, Chief Judge, MILLETT, Circuit Judge, and RANDOLPH, Senior Circuit Judge. 2

Opinion for the Court filed by Chief Judge SRINIVASAN.

Concurring opinion filed by Senior Circuit Judge RANDOLPH.

SRINIVASAN, Chief Judge: Eight years ago, a number of hospitals brought a suit challenging the Department of Health and Human Services’ methodology for calculating certain Medicare payments. Throughout those proceedings, the hospitals contended that the district court had jurisdiction to consider their suit, and they thus urged both the district court and our court to resolve the merits of their challenge. Both courts did so, ultimately ruling against the hospitals on the merits. Billings Clinic v. Azar, 901 F.3d 301, 311 (D.C. Cir. 2018).

Having persuaded both the district court and our court to reach the merits of their challenge but neither court that they should prevail, some of the hospitals now reverse course and contend that the district court lacked jurisdiction to entertain their challenge after all. Those hospitals now maintain that the judgment against them should be deemed void due to the supposed lack of jurisdiction to have issued it.

The district court declined to give effect to the hospitals’ about-face, and so do we. In order for the hospitals to prevail in showing that the now-final judgment against them was void because the district court ostensibly lacked jurisdiction to enter it, they would need to show that there was not even an arguable basis for that court’s conclusion—at the urging of the hospitals themselves—that jurisdiction existed over their challenge. The hospitals fail to make that showing. 3 I.

Our court set out the background of this litigation in detail in Billings Clinic, 901 F.3d at 303–12. By way of summary, in 2013, a number of acute-care hospitals challenged the amount of so-called Medicare “outlier” payments they had received from the Department of Health and Human Services for the years 2008-2011. Id. at 311–12. The hospitals sought review before the Department’s Provider Reimbursement Review Board, the administrative tribunal charged with reviewing such claims. Id. at 311; 42 U.S.C. § 1395oo(a).

A hospital can seek judicial review of a “final decision” of the Board. 42 U.S.C. § 1395oo(f)(1). Additionally, if a hospital’s claim “involves a question of law or regulations relevant to the matters in controversy” that the Board “is without authority to decide,” the hospital can ask the Board to grant “expedited judicial review” (EJR), which allows the case to proceed directly to district court. 42 U.S.C. § 1395oo(f)(1); 42 C.F.R. § 405.1842; Billings Clinic, 901 F.3d at 311–12.

The hospitals challenging their 2008-2011 Medicare outlier payments each requested EJR from the Board on the ground that the Board lacked authority to resolve their claims. Billings Clinic, 901 F.3d at 312. While the Board granted most of the EJR requests, it dismissed the claims of a subset of the hospitals for failing to comply with certain agency filing procedures. In light of the dismissal, the Board declined to grant EJR to those hospitals.

That subset of hospitals, who are now the appellants here, then filed a suit against the Department in district court. Appellants contended that the Board’s dismissal of their claims was a “final decision” subject to judicial review. If the court agreed, appellants urged the court not to remand their cases 4 back to the Board but rather to proceed to resolve the merits of their challenge to the Department’s rules for Medicare outlier payments. Appellants argued that a remand to the Board would be pointless because the Board would “simply grant EJR” and send their claims right back to the district court for resolution of the merits. Compl. ¶ 9, J.A. 169. The Department agreed with that approach.

The district court held that the Board had lacked authority to resolve appellants’ challenges—the triggering condition for the Board’s granting of EJR—and that the court could proceed to consider the merits of their challenges pursuant to the EJR provision in § 1395oo(f)(1) without the need for any remand to the Board. The other hospitals (who, unlike appellants, had been granted EJR by the Board) then joined with appellants in together filing a second amended complaint seeking vacatur of the challenged Medicare outlier rules.

The district court rejected the hospitals’ challenge, granting summary judgment to the Department. Lee Mem. Health Syst. v. Burwell, 206 F. Supp. 3d 307, 336 (D.D.C. 2016). The hospitals appealed. Billings Clinic, 901 F.3d at 312.

During the pendency of the appeal, our court decided Allina Health Servs. v. Price, 863 F.3d 937 (D.C. Cir. 2017), aff’d sub nom. Azar v. Allina Health Servs., 139 S. Ct. 1804 (2019). Allina Health addressed whether the district court had correctly concluded that it could address the dispute at issue in that case or instead should have remanded the matter to the Board. Id. at 941–42. Allina Health explained that “[t]he statute conditions expedited judicial review in the district court on the existence of [a] no-authority determination” by the Board. Id. at 941. As a result, Allina Health raised questions about the validity of the district court’s rationale in Billings 5 Clinic for exercising jurisdiction over the merits of appellants’ claims—i.e., the claims dismissed by the Board without granting EJR—absent a remand to the Board.

The hospitals addressed the implications of Allina Health for our court’s consideration of appellants’ claims during the oral argument before our court in Billings Clinic. The hospitals advanced two alternative theories under which we would have jurisdiction to consider the merits of appellants’ claims.

The first theory was that, regardless whether the district court correctly exercised jurisdiction over the merits of appellants’ challenges, there was at least one hospital with a valid EJR certification for each of the payment years in question. And because the hospitals all sought identical, non- individualized relief, they argued, we could address the merits of their common challenges without resolving whether the district court specifically had jurisdiction over appellants’ claims. The hospitals’ second theory was that, even if the district court otherwise would have been obligated to send appellants’ challenges back to the Board to permit the Board to grant EJR, any such requirement was waivable and the Department had expressly waived it.

Our decision in Billings Clinic adopted the hospitals’ first theory and did not reach the second. 901 F.3d at 312.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Baxley v. Wormuth
District of Columbia, 2024
Ioan Micula v. Government of Romania
101 F.4th 47 (D.C. Circuit, 2024)

Cite This Page — Counsel Stack

Bluebook (online)
10 F.4th 859, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lee-memorial-hospital-v-xavier-becerra-cadc-2021.