Texas Alliance For Home Care v. Kathleen Sebelius
401 U.S. App. D.C. 71
| D.C. Cir. | 2012Background
- Suppliers challenge CMS’s financial-standards regulation for DMEPOS bidding under 42 U.S.C. § 1395w-3.
- District court dismissed for (a) preclusion under § 1395w-3(b)(11), (b) lack of standing, and (c) validity of regulation.
- This appeal校 focuses on whether § 1395w-3(b)(11) precludes judicial review of the regulation.
- Statute authorizes competitive bidding and precludes review of ‘the awarding of contracts’ and related actions.
- CMS implemented financial-standards regulation in final rule of 2007; interim final rule changed standards in 2009 and rebid occurred in 2011.
- Suppliers sued in 2010 alleging APA and Medicare notice-and-comment violations and ultra vires/arbitrary conduct.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether § 1395w-3(b)(11) precludes judicial review | Suppliers argue regulation is reviewable for APA claims. | CMS argues § 1395w-3(b)(11) bars review of the awarding of contracts and related actions. | Yes; § 1395w-3(b)(11) precludes review. |
Key Cases Cited
- Shalala v. Illinois Council on Long Term Care, Inc., 529 U.S. 1 (2000) (channeling review bar extends to policy/regulation challenges)
- Amgen, Inc. v. Smith, 357 F.3d 103 (D.C. Cir. 2004) (no-review provision precludes review of challenged action)
- Bowen v. Michigan Academy of Family Physicians, 476 U.S. 667 (1986) (channeling provision may bar review of policy affecting benefits)
- Abbott Labs. v. Gardner, 387 U.S. 136 (1967) (general presumption of reviewability can be overcome by specific statutory language)
- Banzhaf v. Smith, 737 F.2d 1167 (D.C. Cir. 1984) (statutory bar effectively precludes review when Congress intends to insulate agency action)
- Cardiosom, LLC v. United States, 656 F.3d 1322 (Fed. Cir. 2011) (preclusion framework supports no-review for specified Medicare processes)