Lee Memorial Hospital v. Becerra, No. 20-5085 (D.C. Cir. 2021)
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Eight years ago, several hospitals challenged the Department of Health and Human Services’ methodology for calculating certain Medicare payments. The hospitals had sought expedited judicial review (EJR) from the Provider Reimbursement Review Board, which is available if a hospital’s claim involves a question that the Board “is without authority to decide,” 42 U.S.C. 1395oo(f)(1). While the Board granted most of the EJR requests, it dismissed the claims of certain hospitals (appellants) for failing to comply with agency filing procedures. The Board declined to grant EJR to those hospitals. In 2018, the D.C. Circuit ruled against the hospitals on the merits.
The appellants filed suit, arguing that the Board’s dismissal of their claims was a “final decision” subject to judicial review, and urged the court not to remand their cases but to resolve the merits of their challenge to the rules for Medicare outlier payments. The district court held that the Board had lacked authority to resolve their challenges—the triggering condition for the Board’s granting of EJR—and that the court could proceed to consider the merits. The other hospitals (who had been granted EJR) joined with appellants in seeking vacatur of the challenged Medicare outlier rules. The district court rejected that suit on summary judgment.
The D.C. Circuit affirmed. For the hospitals to establish that the now-final judgment against them was void because the district court lacked jurisdiction, they would need to show that there was not even an arguable basis for that court’s conclusion—at the urging of the hospitals themselves—that jurisdiction existed. The hospitals fail to make that showing.
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