Oregon v. Bowen

682 F. Supp. 1111, 1988 U.S. Dist. LEXIS 2899, 1988 WL 30291
CourtDistrict Court, D. Oregon
DecidedMarch 28, 1988
DocketCiv. No. 87-1039-MA
StatusPublished

This text of 682 F. Supp. 1111 (Oregon v. Bowen) is published on Counsel Stack Legal Research, covering District Court, D. Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Oregon v. Bowen, 682 F. Supp. 1111, 1988 U.S. Dist. LEXIS 2899, 1988 WL 30291 (D. Or. 1988).

Opinion

OPINION

MARSH, Judge.

This action arises out of the termination of Medicaid funds to Fairview Training Center (Fairview) on April 17, 1987. Defendant Bowen is the secretary of the United States Department of Health and Human Services. Defendant Roper is the Ad[1113]*1113ministrator of the Health Care Financing Administration (HCFA).

Plaintiff seeks judicial review of HCFA’s April 10, 1987 order which informed Fairview that its Medicaid funding would be terminated effective April 17, 1987, unless Fairview remedied certain conditions which “posed an immediate and serious threat to the health and safety of the residents.” Plaintiff contends that the order was “arbitrary, capricious and contrary to law.” Plaintiff also seeks a declaration and order compelling defendants to provide plaintiff with the Medicaid funds denied Fairview between April 17 and July 81, 1987.

Defendants move to dismiss the complaint for lack of subject matter jurisdiction and for failure to state a claim upon which relief can be granted. In the alternative, defendants move for judgment on the pleadings in their favor based on plaintiffs failure to exhaust its administrative remedies.

SUBJECT MATTER JURISDICTION

Plaintiff asserts that this court has federal question jurisdiction pursuant to 28 U.S.C. § 1331, '42 U.S.C. § 405(g), and 5 U.S.C. § 702 and mandamus jurisdiction pursuant to 28 U.S.C. § 1361. For the reasons set forth below, I conclude that this court lacks subject matter jurisdiction. Federal Question Jurisdiction

This court’s jurisdiction under 28 U.S.C. § 1331 is limited by sovereign immunity. Laguna Hermosa Corp. v. Martin, 643 F.2d 1376, 1378 (9th Cir.1981). While 5 U.S.C. § 7021 provides that a person suffering legal wrong because of agency action is entitled to judicial review, that statute does not affect existing limitations on district court jurisdiction. E.g., Laguna Hermosa Corp., 643 F.2d at 1379. Consequently, it is necessary to properly define the basis for jurisdiction and determine if sovereign immunity has been waived.

It is undisputed that defendants terminated Fairview’s Medicaid funding pursuant to 42 U.S.C. § 13961(c). That statute provides:

(1) The Secretary may cancel approval of any ... intermediate care facility at any time if he finds ... that a facility fails to meet the requirements contained in section 1396a(a)(28) of this title or section 1396d(c) of this title, or if he finds grounds for termination of his agreement with the facility pursuant to section 1395cc(b) of this title....
(2) Any ... intermediate care facility which is dissatisfied with a determination by the Secretary that it no longer qualifies as a ... intermediate care facility for purposes of this subchapter, shall be entitled to a hearing by the Secretary to the same extent as is provided in section 405(b) of this title and to judicial review of the Secretary’s final decision after such hearing as is provided in section 405(g) of this title. Any agreement between such facility and the State agency shall remain in effect until the period for filing a request for a hearing has expired or, if a request has been filed, until a decision has been made by the Secretary; except that the agreement shall not be extended if the Secretary makes a written determination, specifying the reasons therefor, that the continuation of provider status constitutes an immediate and serious threat to the health and safety of patients, and the [1114]*1114Secretary certifies that the facility has been notified of its deficiencies and has failed to correct them, (emphasis added).

Section 1396i(c)(2) distinguishes between two types of determinations. First, is the determination that a care facility does not meet the federal Medicaid health and safety certification standards. That determination is clearly subject to judicial review in U.S. District Court pursuant to 42 U.S.C. 405(g).2 The second determination, however, is not expressly subject to judicial review. That determination concerns whether the provider agreement should remain in effect until the period for filing a request for a hearing expires or if a request is filed, until a decision is rendered. It is this second determination, which is in effect a subcategory of the overall determination that the facility is no longer qualified for funding, which is at issue in this case.

Defendants argue that the language of § 405(g) precludes judicial review of the Secretary’s decision that a facility’s provider status constitutes an immediate and serious threat to the health and safety of its patients. I disagree.

There is a strong presumption that Congress intends judicial review of administrative action. Bowen v. Michigan Academy of Family Physicians, 476 U.S. 667, 106 S.Ct. 2133, 2135-36, 90 L.Ed.2d 623 (1986). The mere fact that some agency actions are reviewable under the provision of a statute is not sufficient to imply that others are excluded. Id. 106 S.Ct. at 2137-38.

The presumption of judicial review can be overcome only upon a showing of clear and convincing evidence of contrary legislative intent. Id. at 2136 (citing Rusk v. Cort, 369 U.S. 367, 82 S.Ct. 787, 7 L.Ed.2d 809 (1962)). Defendants have failed to make such a showing. Defendants rely exclusively upon the omission of a provision allowing judicial review of the Secretary’s decision that provider status constitutes an immediate and serious threat. Such an omission, whether “conspicuous” or not is insufficient to overcome the presumption of judicial review. As noted in Bowen:

As a general matter, “[t]he mere fact that some acts are made reviewable should not suffice to support an implication of exclusion as to others. The right to review is too important to be excluded on such slender and indeterminate evidence of legislative intent.”

106 S.Ct. at 2138; see also County of Alameda v. Weinberger, 520 F.2d 344, 347-48 (9th Cir.1975).

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Related

Rusk v. Cort
369 U.S. 367 (Supreme Court, 1962)
Mathews v. Eldridge
424 U.S. 319 (Supreme Court, 1976)
Bowen v. City of New York
476 U.S. 467 (Supreme Court, 1986)
Bowen v. Michigan Academy of Family Physicians
476 U.S. 667 (Supreme Court, 1986)
County of Alameda v. Caspar W. Weinberger, Etc.
520 F.2d 344 (Ninth Circuit, 1975)
Laguna Hermosa Corporation v. B. E. Martin
643 F.2d 1376 (Ninth Circuit, 1981)
Klein v. Heckler
761 F.2d 1304 (Ninth Circuit, 1985)

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Bluebook (online)
682 F. Supp. 1111, 1988 U.S. Dist. LEXIS 2899, 1988 WL 30291, Counsel Stack Legal Research, https://law.counselstack.com/opinion/oregon-v-bowen-ord-1988.