United States Second Circuit

In a putative class action brought by Medicare participants challenging denial of coverage for post-hospitalization care in skilled nursing facilities, decision certifying the class and granting judgment to the defendant is affirmed where: 1) the interpretation of the qualifying stay requirement set forth in the government's Medicare Benefit Policy Manual was not entitled to deference under Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (1984); 2) a Medicare beneficiary is not an inpatient within the meaning of section 1395x(i) unless he or she has been formally admitted to a hospital; 3) the rule does not violate the Constitution's guarantee of equal protection; 4) the district court correctly excluded interrogatories because they represented post hoc statements from the agency; and 5) the district court also correctly excluded plaintiff's declarations and statements of material facts. (Revised opinion)

Appellate Information

• Decided 01/15/2009
• Published 01/15/2009

Judges

• LIVINGSTON, Circuit Judge:, Before:  HALL and LIVINGSTON, Circuit Judges.

Court

• United States Second Circuit

Counsel

• For Appellees:
  
• Gill Deford, Willimantic, CT (Judith A. Stein, Brad S. Plebani, Wey-Wey Kwok, Willimantic, CT, Sally Hart, Tucson, AZ, Toby Edelman, Washington, D.C., on the brief), Center for Medicare Advocacy, for Plaintiffs-Appellants-Cross-Appellees., Lewis S. Yelin, Attorney, Appellate Staff, Civil Division, U.S. Department of Justice, Washington, D.C. (Scott R. McIntosh, Attorney, Appellate Staff, Peter D. Keisler, Assistant Attorney General, Civil Division, U.S. Department of Justice, Washington, D.C., Kevin J. O'Connor, United States Attorney for the District of Connecticut, on the brief), for Defendant-Appellee-Cross-Appellant., Carol C. Loepere (Elizabeth A. Ransom, on the brief), Reed Smith LLP, Washington, D.C., for Amici Curiae American Health Care Association, Alliance for Quality Nursing Home Care, American Association of Homes and Services for the Aging, National Association of Professional Geriatric Care Managers, Catholic Health Association of the United States, National Association for the Support of Long Term Care, and National Association of Health Care Assistances in Support of Plaintiffs-Appellants-Cross-Appellees., Stuart R. Cohen, AARP Foundation Litigation (Bruce Vignery, Stacy Canan, AARP Foundation Litigation, Michael Schuster, AARP, on the brief), Washington, DC, for Amici Curiae AARP, Alliance for Retired Americans, California Advocates for Nursing Home Reform, Greater Boston Legal Services, Long-Term Care Community Coalition, Medicine Rights Center, Michigan Campaign for Quality Care, NCCNHR, and National Senior Citizens Law Center in Support of Plaintiffs-Appellants-Cross-Appellees.