Shalala v. Illinois Council on Long Term Care, Inc., 529 U.S. 1 (2000)

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CASES ADJUDGED

IN THE

SUPREME COURT OF THE UNITED STATES

AT

OCTOBER TERM, 1999

SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES, et al. v. ILLINOIS COUNCIL ON LONG TERM CARE, INC.

certiorari to the united states court of appeals for the seventh circuit

No. 98-1109. Argued November 8, 1999—Decided February 29, 2000

Under the Medicare Act's special review provisions, a nursing home that is "dissatisfied . . . with a determination described in subsection (b)(2)" is "entitled to a hearing . . . to the same extent as is provided in" the Social Security Act, 42 U. S. C. § 405(b), "and to judicial review of the Secretary's final decision after such hearing as is provided in section 405(g) . . . ." 42 U. S. C. § 1395cc(h)(1) (emphasis added). The cross-referenced subsection (b)(2) gives petitioner Secretary of Health and Human Services (HHS) power to terminate a provider agreement with a home where, for example, she determines that a home has failed to comply substantially with the statute and the regulations. The cross-referenced § 405(b) describes the administrative hearing to which a "dissatisfied" home is entitled, and the cross-referenced § 405(g) provides that the home may obtain federal district court review of the Secretary's "final decision . . . made after a hearing . . . ." Section 405(h), a provision of the Social Security Act incorporated into the Medicare Act by 42 U. S. C. § 1395ii, provides that "[n]o action . . . to recover on any claim arising under" the Medicare laws shall be "brought under [28 U. S. C. § ]1331." It channels most, if not all, Medicare claims through this special review system. Respondent, the Illinois Council on Long Term Care, Inc. (Council), an association of nursing homes,

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