Pine Tree Medical Associates v. Secretary of Health & Human Services

127 F.3d 118, 1997 U.S. App. LEXIS 24435, 1997 WL 563587
CourtCourt of Appeals for the First Circuit
DecidedSeptember 16, 1997
Docket97-1054
StatusPublished
Cited by51 cases

This text of 127 F.3d 118 (Pine Tree Medical Associates v. Secretary of Health & Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pine Tree Medical Associates v. Secretary of Health & Human Services, 127 F.3d 118, 1997 U.S. App. LEXIS 24435, 1997 WL 563587 (1st Cir. 1997).

Opinion

TORRUELLA, Chief Judge.

Pine Tree Medical Associates (“Pine Tree”) brought a suit for injunctive and declaratory relief against the Secretary of the Department of Health and Human Services (“the Secretary”) and the Director of the Bureau of Primary Health Care (collectively, “HHS”) challenging HHS’s denial of Pine Tree’s application requesting that Farming-ton, Maine be designated a “medically underserved population” (“MUP”) under the Public Health Service Act (“PHSA”), 42 U.S.C. § 254b et seq. (1997 Supp.). HHS had denied Pine Tree’s MUP application after applying criteria and standards that were issued by HHS in June 1995 (“the 1995 Guidelines”). Pine Tree contends that the standards in existence at the time that its application was first filed are the ones that should have been applied, and that Farming-ton merits MUP status under those standards. On appeal, Pine Tree repeats two legal arguments that were rejected, on summary judgment, by the district court: 1) that the 1995 Guidelines violated the notice and comment provisions of the Administrative Procedure Act (“APA”), 5 U.S.C. § 553 (1996), and the PHSA, formerly codified at 42 U.S.C. § 254c(b)(4)(B) (1991) (subsequently repealed); and 2) that the application of the 1995 Guidelines to Pine Tree’s May 18, 1995 application was impermissibly retroactive. We find the first claim to be moot, and affirm the district court’s holding on the retroactivity claim.

BACKGROUND

The pertinent facts were stipulated below, and are reviewed in the district court’s opin *120 ion. See Pine Tree Med. Assocs. v. Secretary of Health & Human Servs., 944 F.Supp. 38, 40-41 (D.Maine 1996). A brief overview will serve the purposes of this appeal. Pine Tree is a nonprofit corporation that provides primary health care services in Farmington, Maine. It sought MUP status for the low income population of Farmington in a May 18,1995 application to HHS. Pursuant to the PHSA, a health care provider that serves a MUP may qualify for substantial, cost-based reimbursement under Medicare and Medicaid programs.

The PHSA directs the Secretary to establish criteria and standards for determining whether to grant MUP status, and prescribes, inter alia, that one such criterion be “the ability of the residents of an area or population group to pay for health services.” See 42 U.S.C. § 254b(b)(3)(B) (Supp.1997) (formerly codified at 42 U.S.C. § 254c(b)). In 1976, following notice and comment, regulations were adopted regarding the factors to be taken into consideration by the Secretary, and these regulations have been periodically revised by the HHS without opportunity for notice and comment. In 1994, the HHS issued, without notice and comment, Summary Procedures for MUP designation. It is not disputed that Farmington qualified for MUP designation under the 1994 Procedures.

The 1995 Guidelines, issued on June 12, 1995, again without notice and comment, revised the 1994 Procedures. At the time the 1995 Guidelines were issued, HHS had not yet acted on Pine Tree’s May 18, 1995 application. Under the 1995 Guidelines, which altered the measurement of poverty levels by increasing the size of the overall population to be considered in the poverty calculus, Farmington was found not to qualify for MUP designation, and Pine Tree’s application was denied on June 22,1995.

On August 4, 1995, Pine Tree filed a request for reconsideration, which the HHS denied on December 8, 1995. In an explanatory letter, HHS informed Pine Tree that because the 1995 Guidelines “included a correction of analytic distortion with regard to how the poverty factor was determined,” this revision was applied immediately to pending requests. See Stipulated Facts ¶ 16.

On January 8, 1996, Pine Tree sued the defendants, seeking that the 1995 Guidelines be declared invalid for failing to comply with the notice and comment provisions • of the APA and the PHSA and, in the alternative, seeking a declaration that the 1995 Guidelines were impermissibly applied retroactively to Pine Tree’s application. Pine Tree also sought an order enjoining defendants from applying the 1995 Guidelines and requiring HHS to designate Farmington a MUP based on the standards in effect at the time it filed the application.

On October 21,1996, the district court held that under the notice and comment provision of the PHSA — which has since been repealed by Congress 1 — the 1995 Guidelines were valid despite a lack of notice and comment, because they did not modify the HHS’s initial 1976 regulation, and because the 1994 Procedures, which the 1995 Guidelines did indeed modify, were not regulations. See Pine Tree Med. Assocs., 944 F.Supp. at 42. The district court also held that the 1995 Guidelines fell within the ambit of the APA’s explicit exception to the notice and comment requirement for interpretive rules. Id. at 43; cf. 5 U.S.C. § 553(b)(3). Finally, the district court held there were no valid retroactivity issues raised by the application of the 1995 Guidelines to Pine Tree’s pending application.

DISCUSSION

We review de novo a district court’s grant of summary judgment. Ionics v. Elmwood Sensors, Inc., 110 F.3d 184, 185 (1st Cir.1997).

I. Mootness of Notice and Comment Claim

On appeal, Pine Tree does not argue that the 1995 Guidelines are something other than “interpretive rules” under section 553(b)(3) of the APA, see Brief for Appellant' at 9 (“The interpretive rule exception is not relevant to this case”), but rather argues that the interpretive rule exception is inapplicable *121 because, under the APA, an exception to the interpretive rule exception exists where “notice or hearing is required by statute.” 5 U.S.C. § 553(b). Thus, Pine Tree’s claim turns on the existence of any notice and hearing requirement that is applicable to the 1995 Guidelines under the PHSA. Unfortunately for Pine Tree, Congress deleted the notice and comment provision from the former PHSA, which was codified at 42 U.S.C. § 254e(b)(4)(B), 2 when it enacted the Health Centers Consolidation Act, Pub.L. No. 104-299, effective October 1, 1996. 3 See 42 U.S.C.

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Bluebook (online)
127 F.3d 118, 1997 U.S. App. LEXIS 24435, 1997 WL 563587, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pine-tree-medical-associates-v-secretary-of-health-human-services-ca1-1997.