Fournier v. Sebelius, No. 12-15478 (9th Cir. 2013)
Annotate this CasePlaintiffs appealed the Secretary's denial of their claims for Medicare coverage for dental services. Plaintiffs contended that this denial was premised on the Secretary's unreasonable interpretation of the Medicare Act, Pub. L. No. 89-97, 79 Stat. 286, which contravened the intent of Congress and violated plaintiffs' right to equal protection under the Fifth Amendment. The court concluded that, although the statutory provision for exclusion of dental services was ambiguous in the sense that plausible divergent constructions could be urged, the Secretary's interpretation of the statute was reasonable. The court also concluded that the Secretary's statutory interpretation warranted Chevron deference and the Secretary's statutory interpretation was reasonable. Accordingly, the court affirmed the judgment.
Court Description: Medicare. The panel affirmed the district court’s judgment affirming the Secretary of Health and Human Services’ decisions denying plaintiffs’ claims for Medicare coverage for dental services. Plaintiffs are Medicare beneficiaries who suffer from medical conditions that caused significant dental problems, and they received dental services to correct those problems. The panel held that the Medicare Act under which the Secretary denied coverage was ambiguous on the question plaintiffs raised. The panel further held that Chevron deference applied, and the Secretary’s interpretation of the statute was reasonable. Finally, the panel held that the Secretary’s denial of coverage did not violate plaintiffs’ equal protection rights under the Fifth Amendment.
Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.