Shalala v. Illinois Council on Long Term Care, Inc., 529 U.S. 1, 16 (2000)

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16

SHALALA v. ILLINOIS COUNCIL ON LONG TERM CARE, INC.

Opinion of the Court

States v. Erika, Inc., 456 U. S. 201, 202-203 (1982). The Medicare statute, as it then existed, provided for only limited review of Part B decisions. It allowed the equivalent of § 405(g) review for "eligibility" determinations. See 42 U. S. C. § 1395ff(b)(1)(B) (1982 ed.). It required private insurance carriers (administering the Part B program) to provide a "fair hearing" for disputes about Part B "amount determinations." § 1395u(b)(3)(C). But that was all.

Michigan Academy first discussed the statute's total silence about review of "challenges mounted against the method by which . . . amounts are to be determined." 476 U. S., at 675. It held that this silence meant that, although review was not available under § 405(g), the silence did not itself foreclose other forms of review, say, review in a court action brought under § 1331. See id., at 674-678. Cf. Erika, supra, at 208 (holding that the Medicare Part B statute's explicit reference to carrier hearings for amount disputes does foreclose all further agency or court review of "amount determinations").

The Court then asked whether § 405(h) barred 28 U. S. C. § 1331 review of challenges to methodology. Noting the Secretary's Salfi/Ringer-based argument that § 405(h) barred § 1331 review of all challenges arising under the Medicare Act and the respondents' counterargument that § 405(h) barred challenges to "methods" only where § 405(g) review was available, see Michigan Academy, 476 U. S., at 679, the Court wrote:

"Whichever may be the better reading of Salfi and Ringer, we need not pass on the meaning of § 405(h) in the abstract to resolve this case. Section 405(h) does not apply on its own terms to Part B of the Medicare program, but is instead incorporated mutatis mutandis by § 1395ii. The legislative history of both the statute establishing the Medicare program and the 1972 amendments thereto provides specific evidence of Congress' intent to foreclose review only of 'amount determina-

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