American Mfrs. Mut. Ins. Co. v. Sullivan, 526 U.S. 40, 22 (1999)

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Cite as: 526 U. S. 40 (1999)

Opinion of Ginsburg, J.

hurdles: First, he must prove that an employer is liable for a work-related injury, and second, he must establish that the particular medical treatment at issue is reasonable and necessary. Only then does the employee's interest parallel that of the beneficiary of welfare assistance in Goldberg and the recipient of disability benefits in Mathews.

Respondents obviously have not cleared both of these hurdles. While they indeed have established their initial eligibility for medical treatment, they have yet to make good on their claim that the particular medical treatment they received was reasonable and necessary. Consequently, they do not have a property interest—under the logic of their own argument—in having their providers paid for treatment that has yet to be found reasonable and necessary. To state the argument is to refute it, for what respondents ask in this case is that insurers be required to pay for patently unreasonable, unnecessary, and even fraudulent medical care without any right, under state law, to seek reimbursement from providers. Unsurprisingly, the Due Process Clause does not require such a result.

Having concluded that respondents' due process claim falters for lack of a property interest in the payment of benefits, we need go no further.13 The judgment of the Court of Appeals is

Reversed.

Justice Ginsburg, concurring in part and concurring in the judgment.

I join Part III of the Court's opinion on the understanding that the Court rejects specifically, and only, respondents' de-13 Respondents do not contend that they have a property interest in their claims for payment, as distinct from the payments themselves, such that the State, the argument goes, could not finally reject their claims without affording them appropriate procedural protections. Cf. Logan v. Zimmerman Brush Co., 455 U. S. 422, 430-431 (1982). We therefore need not address this issue. See Lyng v. Payne, 476 U. S. 926, 942 (1986) (re-serving question); Walters v. National Assn. of Radiation Survivors, 473 U. S. 305, 320, n. 8 (1985) (same).

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