United States v. Memorial Sloan-Kettering Cancer Center

CourtCourt of Appeals for the Second Circuit
DecidedMarch 25, 2009
Docket07-0926-cv(L) & 07-0949-cv(Con)
StatusPublished

This text of United States v. Memorial Sloan-Kettering Cancer Center (United States v. Memorial Sloan-Kettering Cancer Center) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Memorial Sloan-Kettering Cancer Center, (2d Cir. 2009).

Opinion

07-0926-cv(L) & 07-0949-cv(Con) United States of America v. Memorial Sloan-Kettering Cancer Center

UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT _____________________

August Term, 2007 (Argued: July 8, 2008 Decided: March 25, 2009) Docket Nos. 07-0926-cv(L), 07-0949-cv(Con) _____________________

UNITED STATES OF AMERICA ,

Plaintiff-Appellee,

-v.-

MEMORIAL SLOAN -KETTERING CANCER CENTER ,

Defendant-Appellant.

_______________________

ALBANY MEDICAL CENTER ,

Plaintiff-Appellant,

Defendant-Appellee.

These two cases, Albany Medical Center v. United States (“AMC”) and United States v.

Memorial Sloan-Kettering Cancer Center (“Sloan-Kettering”), decided respectively by the

United States District Courts for the Northern and Southern Districts of New York, both raise the question of whether post-graduate medical residents can invoke the Federal Insurance

Contributions Act (“FICA”) tax exemption for “students.” In each case, the district court ruled

that, as a matter of law, post-graduate medical residency programs are not “schools” and medical

residents are not “students.” Sloan-Kettering raises the further question of whether the monies

that the Cancer Center pays to its residents are “scholarships” and therefore exempt from FICA

taxes. The district court answered “no” to that question.

We hold that both district courts erred in ruling as a matter of law that medical residents

are categorically ineligible for the FICA tax exemption for students. We affirm the United States

District Court for the Southern District of New York, however, insofar as it determined that the

monies paid by the Cancer Center to medical residents are not scholarships. We remand both

cases to the respective district courts for further proceedings consistent with this opinion.

MARK H. CHURCHILL, McDermott Will & Emery LLP, Washington, D.C. (Joel E. Cohen, McDermott Will & Emery LLP, New York, New York, Christopher Kliefoth, Sarah E. Hancur, McDermott Will & Emery LLP, Washington, D.C., on the brief), for Plaintiff-Appellant Albany Medical Center.

MARK H. CHURCHILL, McDermott Will & Emery LLP, Washington, D.C. (Christopher Kliefoth, Teresa M. Goody, McDermott Will & Emery LLP, Washington, D.C., Joel E. Cohen, McDermott Will & Emery LLP, New York, New York, on the brief), for Defendant-Appellant Memorial Sloan-Kettering Cancer Center.

TERESA E. MCLAUGHLIN , Attorney, Tax Division, Department of Justice, Washington, D.C. (Richard T. Morrison, Acting Assistant Attorney General, Gilbert S. Rothenberg, Acting Deputy Assistant Attorney General, Michelle B. Smalling, Attorney, Tax Division, Department of Justice, Washington, D.C., on the brief, Glenn T. Suddaby, United States Attorney for the Northern District of New York, of counsel), for Defendant-Appellee United States of America.

2 ROSS E. MORRISON , Assistant United States Attorney (David S. Jones, Assistant United States Attorney, on the brief), for Michael J. Garcia, United States Attorney for the Southern District of New York, New York, New York, for Plaintiff-Appellee United States of America.

BEFORE: POOLER, HALL, Circuit Judges, and TRAGER, District Judge.*

Judge TRAGER dissents in a separate opinion.

HALL, Circuit Judge:

These two cases, Albany Medical Center v. United States (“AMC”) (Scullin, J.) and

United States v. Memorial Sloan-Kettering Cancer Center (“Sloan-Kettering”) (Hellerstein, J.),

decided respectively by the United States District Courts for the Northern and Southern Districts

of New York, both raise the question of whether post-graduate medical residents can invoke the

Federal Insurance Contributions Act (“FICA”) tax exemption for “students.” In each case, the

district court ruled that, as a matter of law, post-graduate medical residency programs are not

“schools” and medical residents are not “students.” Sloan-Kettering raises the further question of

whether the monies that the Cancer Center pays to its residents are “scholarships” and therefore

exempt from FICA taxes. The district court answered “no” to that question.

We hold that both district courts erred in ruling as a matter of law that medical residents

are categorically ineligible for the FICA tax exemption for students. We affirm the District Court

for the Southern District of New York, however, insofar as it determined that the monies paid by

* The Honorable David G. Trager, of the United States District Court for the Eastern District of New York, sitting by designation.

3 the Cancer Center to medical residents are not scholarships. We remand both cases to their

respective district courts for further proceedings consistent with this opinion.

BACKGROUND 1

I. Overview of Post-Graduate Medical Residency Programs

After completing medical school and receiving a doctor of medicine (“M.D.”) degree,

prospective physicians commence the graduate phase of their medical education. Generally,

graduate medical education consists of a residency or fellowship. Most states, including the

State of New York, require physicians to complete a residency program of at least one year

before becoming eligible for a medical license. Residency programs typically last between three

and five years.

These residency programs are accredited by organizations such as the Accreditation

Council for Graduate Medical Education (“ACGME”). The ACGME requires residency

programs to be organized educational programs that combine a didactic curriculum with direct

exposure to patient care under the supervision of attending physicians. Accordingly, these

programs include classroom lectures, daily rounds with an attending physician, Grand Rounds in

which experts present research, morbidity and mortality conferences, and reading assignments.

Residents are tested and evaluated at times, and those residents who have not mastered necessary

skills are given remedial instruction or required to repeat the program. Both Memorial Sloan-

Kettering Cancer Center (“the Cancer Center”) and the Albany Medical Center (“AMC”)

(collectively, “the Hospitals”) claim that residents participate in patient care only as a way of

1 Most of the facts are not in dispute, and those facts that are in dispute are noted.

4 learning how to care for patients; that any benefit to the hospitals resulting therefrom is entirely

incidental; that the hospitals do not meet staffing needs through their residents; and that the

hospitals cannot bill for care provided by a resident.

Residents receive funds from the hospital. The Hospitals characterize these monies as “a

scholarship or fellowship to aid in the pursuit of their graduate medical education” or as a

“stipend.” The Government characterizes these monies as compensation for the provision of

services. The Hospitals point out that the ACGME requires, as a condition of accreditation, that

the Hospitals provide residents with the financial support needed to ensure the residents’

participation in the residency programs.

Although we refer to the Cancer Center and AMC as “the Hospitals,” the precise

institutional arrangements are slightly more complicated than that term would suggest. The

Albany Medical Center is a private corporation that administratively links the Albany Medical

College with the Albany Medical Center Hospital. Graduate medical programs, including the

residency program, are under the primary control of the College, but AMC and the Albany

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