Regions Hospital v. Donna E. Shalala, Secretary of Health and Human Services (522 U.S. 448)

U.S. Supreme Court · decided February 24, 1998 · Supreme Court Database (Spaeth)

Citation
522 U.S. 448 · 118 S. Ct. 909
Decided
February 24, 1998
Term
October Term 1997
Vote
6–3
Majority author
Justice Ginsburg
Issue area
Judicial Power
Disposition
Affirmed
Outcome
Petitioning party lost
Ideological direction
Conservative

Opinion excerpt

Justice Ginsburg delivered the opinion of the Court. Section 9202(a) of the Medicare and Medicaid Budget Reconciliation Amendments of 1985, Pub. L. 99-272, 100 Stat. 151, 171-175, 42 U.S.C. § 1395ww(h) (GME Amendment), provides: “The Secretary [of Health and Human Services] shall determine, for the hospital’s cost reporting period that began during fiscal year 1984, the average amount recognized as reasonable under this subehapter for direct graduate medical education costs of the hospital for each full-time-equivalent resident.” § 1395ww(h)(2)(A). The Amendment directs the Secretary to use the 1984 amount, adjusted for inflation, to calculate a hospital’s graduate medical education (GME) reimbursement for subsequent years. § 1395ww(h) (2). The Secretary interprets the GME Amendment to permit a second audit of the 1984 GME costs to ensure accurate future reimbursements, even though the GME costs had been audited previously. 42 CFR § 413.86(e) (1996). This case presents the question whether the Secretary’s “reaudit” rule is a reasonable interpretation of the GME Amendment. We conclude that it is. I A Under the Medicare Act and its implementing regulations, 42 U. S. C. § 1395 et seq., the costs of certain educational programs for interns and residents, known as GME programs, are “allowable eost[s]” for which a hospital (a provider) may receive reimbursement. 42 CFR § 413.85(a)…

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