DCH Regional Medical Center v. Azar

The Medicare statute precludes judicial review of estimates used to make certain payments to hospitals for treating low-income patients. At issue was whether this preclusion provision barred challenges to the methodology used to make the estimates.The DC Circuit held that it could not review the Secretary's method of estimation without also reviewing the estimate. Therefore, the two were inextricably intertwined and 42 U.S.C. 1395ww(r)(3)(A) precludes review of both. The court held that Florida Health Sciences Center, Inc. v. Secretary of HHS, 830 F.3d 515 (D.C. Cir. 2016), -- not ParkView Medical Associates v. Shalala, 158 F.3d 146 (D.C. Cir. 1998) -- was controlling in this case. In Florida Health, the court held that section 1395ww(r)(3) barred review because the plaintiff was simply trying to undo the Secretary's estimate of the hospital's uncompensated care by recasting its challenge to the Secretary's choice of data as an attack on the general rules leading to her estimate. Here, DCH was simply trying to undo the Secretary's estimate of its uncompensated care by recasting its challenge to that estimate as an attack on the underlying methodology. View "DCH Regional Medical Center v. Azar" on Justia Law