Shalala v. Illinois Council on Long Term Care

120 S. Ct. 1084 (U.S. Feb. 29, 2000) ; Clearinghouse Number: 52891

Description

Supreme Court Holds That Medicare Act Bars Federal-Question Jurisdiction over Certain Challenges to Medicare Law

Abstract

The U.S. Supreme Court held that section 405(h) of the Social Security Act, as incorporated into the Medicare Act by 42 U.S.C. § 1395ii, barred federal-question jurisdiction in a suit challenging Medicare-related regulations that imposed sanctions or remedies on nursing homes that violated certain substantive standards. That section provides that “[n]o action . . . to recover on any claim arising under” the Medicare laws shall be “brought under [28 U. S. C. §]1331.” Suing respondent Secretary of Health and Human Services, petitioner, an association of nursing homes, claimed that certain Medicare-related regulations violated various statutes and the U.S. Constitution. The district court dismissed the suit for lack of federal-question jurisdiction. The Seventh Circuit reversed the district court’s decision. Disagreeing, the Supreme Court noted that section 405(h) channeled most, if not all, Medicare claims through a special review system. The Court found that “clearly” the scope of the term “to recover on any claim arising under” applied in a typical social security or Medicare benefit case so that the statute barred section 1331 review. However, the Court considered whether the statute’s bar also applied when one who might later seek money or other benefit from the agency challenged in advance in a section 1331 action the lawfulness of a policy, regulation, or statute that might later bar recovery or authorize imposition of a penalty. The court found that section 405(h), as interpreted in precedent, also barred such a suit and that Bowen v. Michigan Academy of Family Physicians, 476 U.S. 667 (1986), had not modified that precedent. Petitioner must proceed through the special review channel that the Medicare statutes created; thereafter it may contest the lawfulness of a regulation or statute in court. [ Editor’s note: This case is also discussed on pages xxxx in this issue.]

Additional Information

Docket Date
2000-02-29 00:00:00+00:00

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