Mary Bartlett, on Behalf of Josephine Neuman v. Otis R. Bowen, Secretary, Department of Health and Human Services

816 F.2d 695, 259 U.S. App. D.C. 391
Court of Appeals for the D.C. Circuit·Decided July 31, 1987·No. 85-5233·Published·Cited by 79 cases

Opinions

HARRY T. EDWARDS, Circuit Judge, and J. SKELLY WRIGHT, Senior Circuit Judge:

Appellant Mary Bartlett, plaintiff below, brought suit in the District Court on behalf of her sister, the deceased Josephine Neuman. She challenged the constitutionality of Part A of the Medicare Act on the ground that its partial bar to payment of benefits burdened the free exercise of her sister’s Christian Science faith. The District Court dismissed the complaint for lack [697] of subject matter jurisdiction because the claim failed to meet the $1,000 amount in controversy required by the Medicare Act for judicial review of benefit decisions. On appeal, appellant argues that the jurisdictional provisions of the Medicare Act do not preclude judicial review of her constitutional claim. In the alternative, she maintains that these provisions deny her due process and equal protection of the law if they do bar review.

Upon careful review of the Medicare Act and its legislative history, and pursuant to the guidance given by the Supreme Court in Johnson v. Robison, 415 U.S. 361, 94 S.Ct. 1160, 39 L.Ed.2d 389 (1974), we find that Congress did not intend to bar judicial review of constitutional challenges to the underlying Act. Because we find that Congress did not intend the provisions to preclude review of appellant’s claim, we normally should have no need to reach her constitutional arguments. However, because the dissenting opinion has suggested that Congress may foreclose all judicial review of the constitutionality of a federal statute, we have addressed this issue. We believe that there would be a clear violation of due process if Congress did in fact preclude any opportunity for an aggrieved claimant to obtain judicial review of one of its enactments.

I. Background

Josephine Neuman, a Christian Science practitioner, suffered a terminal illness and required skilled nursing care. In February, 1976, she entered Lynn House of the Potomac, a Christian Science facility, where she received such care. In May, 1976, during the same spell of illness, Neuman left Lynn House and entered the Washington Home for Incurables, a non-Christian Science facility, where she remained, except for a week’s treatment at Georgetown University Hospital, until her death in July, 1978.

Before she died, Neuman claimed and received $377 in Medicare benefits for the post-hospital extended care provided by Lynn House under Part A of the Medicare Act. See 42 U.S.C. § 1395x(y)(l) (1982). After Neuman’s death, Mary Bartlett, executrix of Neuman’s estate, filed a Medicare claim of $286 for the post-hospital extended care Neuman had received at the Washington Home. The Social Security Administration denied that claim initially and upon reconsideration relying on 42 U.S.C. § 1395x(y)(2)(B) (1982),1 which bars payment of Part A benefits for extended care in a skilled nursing facility unaffiliated with Christian Science to anyone who has, during the same spell of illness, already received such benefits for extended care in a Christian Science skilled nursing facility. An administrative law judge (“ALJ”) upheld the denial on appeal, and the Appeals Council of the Social Security Administration adopted the AU’s decision as the final decision of the Secretary of Health and Human Services (the “Secretary”).

Bartlett does not dispute the Secretary’s reading of the Medicare Act’s provision. [698] Her claim is that the Medicare Act’s bar to payment penalizes Neuman’s estate solely on account of Neuman’s Christian Science faith in contravention of the free exercise clause of the First Amendment. The then-Secretary recognized that she had no authority to rule on constitutional challenges to the Act,2 and thus she denied Bartlett’s claim without addressing the merits of her constitutional challenge.

Having exhausted her administrative remedies, Bartlett brought this action in the United States District Court for the District of Columbia in February, 1982. She reasserts her claim that the Christian Science provisions of the Medicare Act burden Neuman’s right to free exercise of religion under the First Amendment and deny her equal protection of the law under the Fifth Amendment. Bartlett further contends that the provision defining “spell of illness”3 also violates Neuman’s right to equal protection and due process under the Fifth Amendment.

The Secretary moved to dismiss Bartlett’s action for lack of subject matter jurisdiction based on two jurisdictional provisions of the Medicare Act, 42 U.S.C. §§ 405(h)4 and 1395ff(b)(2) (1982).5 Section 405(h), incorporated from the Social Security Act into the Medicare Act by 42 U.S.C. § 1395Ü (1982), denies federal question and mandamus jurisdiction over any claim “arising under” the Medicare Act. Section 1395ff(b)(2) bars “judicial review” of any “determination” of “the amount of benefits under part A” of the Medicare Act that has become a “final decision” of the Secretary, if the “amount in controversy” is less than $1,000. The District Court initially denied the Secretary’s motion because “[t]he legislative history [of § 1395ff] is devoid of ‘clear and convincing’ evidence of a congressional purpose to preclude judicial review of substantial constitutional claims,” and noted that “if plaintiff were precluded from all judicial review of her claim in this case, the most serious constitutional questions would be present.”6 The court held in the alternative that it had independent federal question jurisdiction over Bartlett’s claim, notwithstanding § 405(h).7 After Heckler v. Ringer, 466 U.S. 602, 104 S.Ct. 2013, 80 L.Ed.2d 622 (1984), was decided, however, the Secretary renewed the motion to dismiss and the court granted it, finding the Supreme Court’s opinion in that case to be conclusive on the jurisdictional issues.8 On appeal, Bartlett claims that §§ 405(h) and 1395ff(b)(2) do not preclude judicial [699] review of her claim and that if they do, they violate her rights to equal protection and due process of law.

II. Congress’ Intent in §§ 405(h) and 1395ff(b)(2)

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Mary Bartlett, on Behalf of Josephine Neuman v. Otis R. Bowen, Secretary, Department of Health and Human Services, 816 F.2d 695, 259 U.S. App. D.C. 391 (D.C. Cir. 1987).

816 F.2d 695 (Mary Bartlett, on Behalf of Josephine Neuman v. Otis R. Bowen, Secretary, Department of Health and Human Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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