NOT FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
AMBERCITY HOSPICE, INC., a California corporation,
Plaintiff

- Appellant,

v. XAVIER BECERRA, Secretary of Health and Human Services,

Defendant

- Appellee. No. 20

- 56242
D.C. No. 5:19

- cv - 00938

- CJC

- KK

MEMORANDUM *

Appeal from the United States District Court for the Central District of California Cormac J. Carney, District Judge, Presiding Submitted October 19, 2021 * * Pasadena, California Before: CALLAHAN, OWENS, and FORREST, Circuit Judges. Ambercity Hospice, Inc. (Ambercity) appeals the district court ’ s decision affirming that Health and Human Servic es’ (HHS) denial of Medicare coverage w a s based on the proper legal standard and supported by substantial evidence

. It also

* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36

- 3.

** The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). 

# FILED

OCT 21 2021 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS2

challenges the district court’s holding that Ambercity wa s not an i nnocent p rovider under the Medicare Act. Finally, Ambercity argues for the first time on appeal that HHS violated due process during the administrative appeals p rocess
. Under the Administrative Procedure Act, agency actions must be upheld unless they are “arbitrary, capricious, an abuse of discretion, or contrary to law.”
Nat ’ l Fam. Farm Coal. v. EPA , 966 F.3d 893, 923 (9th Cir. 2020); see 5 U.S.C. § 706. Moreover, the Me dicare Act provides that “[t]he findings of [HHS] as to any fact, if supported by substantial evidence, shall be conclusive.” 42 U.S.C. § 405(g) (made applicable to the Medicare Act by 42 U.S.C. § § 1395ii, 1395ff(b)(1)(A) and 42 C.F.R. § 405.1136(f)). Subs tantial evidence is evidence that “a reasonable mind might accept as adequate to support a conclusion.” Chu v. U.S. Commodity Futures Trading Comm ’ n , 823 F.3d 1245, 1250 (9th Cir. 2016) (quoting Gebhart v. SEC , 595 F.3d 1034, 1043 (9th Cir. 2010)

. We review the district court’s decision de novo.
Fournier v. Sebelius , 718 F.3d 1110, 1117 (9th Cir. 2013)

. We have jurisdiction under 42 U.S.C. § § 405(g) , 1395ff(b)(1)(A) and 28 U.S.C. § 1291 , and we affirm

. 1. The district court did not err in holding that HHS’s decision was based on the correct l egal standard and supported by substantial evidence. W hile a physician ’s certification establishing the patient had a terminal illness i s required, eligibility for Medicare coverage does not rest on clinical judgme nt alone. See 42 U.S.C. § 1395y(a)(1)(C); 42 C.F.R. §§ 418.200, 424.5(a)(6)

. The governing3

regulation s impose documentation requirements that must be satisfied. 42 C.F.R. §§ 418.200, 418.22, 418.24, 418.56, 424.5(a)(6). For each claim at issue here , the record demonstrates that qualified doctors and nurses applied the L ocal C overage D etermination (LCD) standards and regulatory requirements and explained why coverage was not supported by the provided medical documentation. W e conclude
t hat HHS provided evidence that “a reasonable mind might accept as adequate to support” its coverage decision s
. Chu , 823 F.3d at 1250

. 2. The district court also did not err in holding that Ambercity was not an
i nnocent p rovider under the Medicare Act. Providers are deemed to have constructive knowledge of the coverage requirements contained in the Medicare Act itself , as well as in its accompanying regulations, manual issuances, bulletins, and other written guidelines

. 42 CFR § 411.406 ; see Maximum Comf ort Inc. v. Sec ’

y of Health & Hum. Servs. , 512 F.3d 1081, 1088 (9th Cir. 2007). T he regulations make clear that unless providers submit sufficient documentation to demonstrate that their services are “reasonable and necessary” for hospice care treatment, t hey will not receive coverage. 42 C.F.R. §§ 418.200 , 424.5 (a)(6) ; see also id

. §§ 418.22, 418.24,
418.56

. Moreover, t he relevant LCDs specifically explain what clinical evidence must be shown to meet the criteria for terminal illness. See Center s for Medicare and Medica i d Services, Local Coverage Determination L33393

. And finally , 42 U.S.C. § 1395ddd provides that initia l payments are subject to review and reopening by4

HHS

. Therefore, because the statutes and regulations provide constructive notice of the requirements to receive coverage and the possibility of post

- payment audit , the district court did not err in holding that Ambercity should not be compensated as an
i nnocent p rovider.
3. Finally, w e decline to consider Ambercity’s due process argument
because it was not raise d properly for decision in the district court

. See Club One Casino, Inc. v. Bernhardt , 959 F.3d 1142, 1153 (9th Cir. 2020) , cert. denied sub

nom . Club One Casino, Inc. v. Haaland , 141 S. Ct. 2792 (2021)

. Ambercity did not raise its due process argument to the district court until its reply brief that was untime ly filed , and the district court refused to consider it

. The district court has discretion to ignore issues raised for the first time in reply, cf. El Pollo Loco, Inc. v. Hashim , 316 F.3d 1032, 1040

- 41 (9th Cir. 2003) , and to ignore untimely filings, see C

. D

. Cal. R. 7

– 12 (“The Court may decline to consider any memorandum or other document not filed within the deadline set by order or local rule.”)

. We see no abuse of discretion by the district court. Moreover, we see no “exceptional circumstances ” justifyi ng Ambercity’s failure to properly present its due process claim that warrant our considering this issue for the first time on appeal. Club One Casino, Inc. , 959 F.3d at 1153 (quoting El Paso City v. Am W. Airlines, Inc. (In re Am. W. Airlines, Inc.) , 217 F.3d 1161, 1165 (9th Cir. 2000) ). Indeed, Ambercity does not proffer any5

exceptional circumstances for our consideration or even address the issue of its waiver

. AFFIRMED.