Anniken Prosser v. Xavier Becerra, 2 F.4th 708

Anniken Prosser, a Medicare Part B beneficiary, uses tumor treating fields (TTF) therapy (Novocure’s Optune) to treat glioblastoma and files Medicare claims every 3–4 months for device rental.
A local coverage determination (LCD L34823) in effect during the relevant period denied Medicare coverage for TTF therapy performed on or after Oct. 1, 2015; CMS later revised the LCD in Sept. 2019 to cover TTF for glioblastoma.
Prosser exhausted Medicare’s multi-tier administrative appeals for each claim; she obtained some favorable decisions but an ALJ in June 2019 denied coverage for the Jan–Apr 2018 period.
Novocure was left with the bill for the denied period because it had not obtained an Advance Beneficiary Notice or the separate written device-supplier patient agreement that would shift liability to Prosser.
Prosser sued in federal court seeking relief to bind future coverage decisions to prior favorable ALJ rulings; the district court ruled she lacked Article III standing because she incurred no financial injury and continued to receive therapy.
The Seventh Circuit affirmed for lack of jurisdiction: Prosser suffered no concrete, imminent injury from the past denial, and any future exposure is speculative (especially after the Sept. 2019 LCD revision).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Article III standing — injury-in-fact	Prosser says denial of coverage for Jan–Apr 2018 infringes her statutory right to Medicare payment and thus constitutes concrete injury.	Secretary says Prosser suffered no financial or other concrete injury: she received the therapy at no cost and Novocure absorbed the bill.	No standing: no concrete, particularized injury; dismissal affirmed.
Whether an ALJ coverage decision binds future coverage decisions	Prosser contends prior favorable ALJ rulings should bind future Medicare coverage determinations so she need not re-litigate each claim.	Secretary contends ALJ decisions are case-specific, nonprecedential, and do not have preclusive effect.	Court did not reach merits because of lack of jurisdiction, but district court previously held ALJ decisions are nonprecedential.
Alleged loss of one-time liability protection (§ 1395pp) or future risk of liability	Prosser argues denial eliminated her one-time protection and exposes her to future financial liability.	Secretary and record show Novocure bore the cost (no ABN or written device agreement), and future liability is speculative.	Loss of §1395pp protection did not show a present concrete injury; future risk too attenuated/speculative for standing.

Lujan v. Defenders of Wildlife, 504 U.S. 555 (standing requires concrete, particularized, and imminent injury)
Spokeo, Inc. v. Robins, 578 U.S. 330 (a statutory right alone does not automatically satisfy Article III injury-in-fact)
Thole v. U.S. Bank N.A., 140 S. Ct. 1615 (plaintiffs lacked standing where relief would not change their economic position)
Clapper v. Amnesty Int’l USA, 568 U.S. 398 (threatened injury must be certainly impending; speculative harms insufficient)
Dep’t of Commerce v. New York, 139 S. Ct. 2551 (imminence requires substantial risk of harm)
Whitmore v. Arkansas, 495 U.S. 149 (imminence and concreteness standards for standing)
Sweeney v. Raoul, 990 F.3d 555 (7th Cir. standing doctrine summary)
Casillas v. Madison Ave. Assoc., Inc., 926 F.3d 329 (Congress can elevate intangible harms but plaintiff still needs concrete injury)