United States Ninth Circuit

In a Medicare provider's appeal of a determination, through the operation of the congressionally mandated Recovery Audit Contractor (RAC) program, that it was liable to repay the government for services later determined not to be medically reasonable and necessary, the district court's grant of summary judgment for the Secretary, holding that the regulations bar appeals for reopenings, is affirmed, as Congress has set the stage by establishing the RAC program aimed at recouping excessive Medicare payments and stated expressly that reopenings were to be permitted under guidelines set by the Secretary in regulations. Here, the Secretary, by her regulations made explicit that there would be no appeal of a reopening decision, and that such a decision was "final."

Appellate Information

• Decided 09/11/2012
• Published 09/11/2012

Judges

• Gould

Court

• United States Ninth Circuit

Counsel