Kathleen Sebelius, Secretary of Health and Human Services, Petitioner v. Auburn Regional Medical Center et al. (568 U.S. 145)
U.S. Supreme Court · decided January 22, 2013 · Supreme Court Database (Spaeth)
- Citation
- 568 U.S. 145 · 133 S. Ct. 817
- Decided
- January 22, 2013
- Term
- October Term 2012
- Vote
- 9–0
- Majority author
- Justice Ginsburg
- Issue area
- Judicial Power
- Disposition
- Reversed and remanded
- Outcome
- Petitioning party won
- Ideological direction
- Liberal
Opinion excerpt
Justice Ginsburg delivered the opinion of the Court. This case concerns the time within which health care providers may file an administrative appeal from the initial determination of the reimbursement due them for inpatient services rendered to Medicare beneficiaries. Government contractors, called fiscal intermediaries, receive cost reports annually from care providers and notify them of the reimbursement amount for which they qualify. A provider dissatisfied with the fiscal intermediary’s determination may appeal to an administrative body named the Provider Reimbursement Review Board (PRRB or Board). The governing statute, § 602(h)(1)(D), 97 Stat. 165, 42 U. S. C. § 1395oo(a)(3), sets a 180-day limit for filing appeals from the fiscal intermediary to the PRRB. By a regulation promulgated in 1974, the Secretary of the Department of Health and Human Services (HHS) authorized the Board to extend the 180-day limitation, for good cause, up to three years. The providers in this case are hospitals who appealed to the PRRB more than ten years after expiration of the 180-day statutory deadline. They assert that the Secretary’s failure to disclose information that made the fiscal intermediary’s reimbursement calculation incorrect prevented them from earlier appealing to the Board. Three positions have been briefed and argued regarding the time for providers’ appeals to the PRRB.…
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