United States Fourth Circuit

In a case contesting determinations of the Medicare Appeals Council (MAC) refusing to provide coverage for a device to treat osteoarthritis of the knee, the district court judgment upholding the MAC is affirmed, where: 1) the Secretary of Health and Human Services enjoys full discretion to choose to assess the Medicare Part B coverage for a device by adjudication rather than by rulemaking; 2) the Secretary's decisions were supported by substantial evidence; and 3) the plaintiff failed to demonstrate that the MAC's application of the relevant standards was plainly erroneous or inconsistent with the regulations.

Appellate Information

• Decided 04/26/2012
• Published 04/26/2012

Judges

• Wilkinson

Court

• United States Fourth Circuit

Counsel

• For Appellant:
  
• Robert Lloyd Roth, Michael Rabb