FI L ED U.S. COURT OF APPEAL S EL EVENTHCI RCUI T DECEMBER 8, 2011 J OHN L EY CL ERK [DO N OT PUBLISH] IN THE U

NITED STATE S COURT OF APPEALS FOR THE ELE VENTH CIRCUIT

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__ __ __ __ __ __ __ __ __ __ __ __ D.C. Dock etNo. 2 :1 0- cv -0 01 66 -KOB ALBERT T. WHITE, JR., Dr., MEDICAL ASSOCI ATES OF W EST ALABAMA, PC, NGAWA ANNA WHITE, Pl ai nt iff s –App el la nt s ve rs us BLUE CROSS AND BLUE SHIELD OF AL ABAMA, CAHABA GOVERNMENT BENEFITS ADMINISTRATORS, LLC, CAHABA SAFEGUARD ADMINISTRATORS , LLC, BLUE CROSS BLUE SHIELD ASSOCIATION, Defen da nt s –

App el le es .

__ __ __ __ __ __ __ __ __ __ __ __ App eal fro m

th e Uni te d S ta te s Di st ric t Co urt forth e Nor th ern Dis tri ctof Al ab am a

__ __ __ __ __ __ __ __ __ __ __ __ (Dece m be r 8, 2 01 1)Befo re BARKETT an d P RYOR, Ci rcu itJu dg es , andBUCKLEW , Dis tri ctJu dg e. * PER CURI AM: Dr. Alb ertWhi te , Med ic al Ass oc ia te s o f W es t Al ab am a, P.C., an d Ng awa Ann a Whit e (co ll ect iv el y , “ Whi te ”) ap pe al th e d is tri ctco urt’s d is m is sa l o f th ei r ni ne -co un t co m

pl ai ntag ai ns t Bl ue Cro ss an d B lu e Sh ie ldof Al ab am a, an d o th ers (“ th e Carrie rs ”), fo r la ckof s ub ject m at te r juri sd ic ti on . After c aref ul rev ie w and wit h t he be ne fitof o ral arg um en t, we af firm . InDecem be r of 19 99 , Ngawa An naWhi te sen t a l et te r to th e Alaba m a St at e Leg is la tu re, co m

pl ai ni ng th atth e Carrie rs ha d a ct edarb it rari ly andcap ric io us ly in refu si ng to rei m

bu rs e Whit e an d o th er m ed ic al pro vi de rs forleg it im at e m ed ic al se rv ic es . W it hi n s ix m on th s o f th atlet te r, th e Carrie rs in it ia te d an aud itof Whi te ’s pr act ic e an d d et erm in edth atWhi te ha d re cei ve d a n a ctua l o ve rp aym en t o f $8 9,6 50 , wit h apro

jecte d o ve rp aym en t o f $5 7,9 75 .20 , forservi ces Whi te bi ll edto Med ic are f

ro m Jan ua ry 1, 1 99 9 thr ou gh Ju ne 30 , 19 99 . In 2 00 4, Whi te pa idth e pr ojec te d o ve rp aym en t am ou ntun de r pr ot es t an d app eal edth e d is pu te d ov erp aym en ts . Whi te su cces sf

ul ly pur su edhi s ap pe al th ro ug h h eari ng s b efo re a Fa ir

Honora ble Susan C. Buc klew, United States District Judge f or the Middle District of * Florida , sitti ngby

desig nation. 2Heari ng Offic er i n J un e o f 20 04 , an Ad m in is tra ti ve Law Ju dg e in Ju ly of 20 05 ,

an d t he Med ic are Ap pe al s C ou nc il in Sep te m be r of 20 05 . Two y ears lat er, i n Sep te m be r of 20 07 , Whi te subm it te d aMo ti on to Reo pe n t he Heari ng Deci si on to th e Me di care App eal s C ou nc il . In h is Mo ti on to Reo pe n, Whi te all eg edbre ach of co nt ract , frau d, t ort o f ou tra ge , lo ss of c on so rti um , vi ol at io n o f th e co ns ti tu ti on al rig ht s t o e qu al pro te ct io n a nddu e p ro ces s, an d v io la ti on of c iv il rig ht s. He subm it te d a n Am en de d M ot io n t o R eo pe n i n J anua ry of 2 00 8, ad di ng a cl ai m

for RICO v io la ti on s. OnMay 19, 2 00 8, t he Med ic are Ap pe al s C ou nc il va cat edth e Adm in is tra ti ve Law Ju dg e’s de ci si on reg ard in g Whi te ’s app eal forov erp aym en t, bu t i t ru le d a ga in stWhi te on hi s s ub se qu en tl y ad de d c la im s fo r br each of c on tra ct , frau d, t ort o f ou tra ge , lo ss of c on so rti um , vi ol at io n o f th e co ns ti tu ti on al rig ht s t o equa l p ro te ct io n a nddu e p ro ces s, v io la ti on of c iv il rig ht s, an d R ICO, fi nd in g t ho se cl ai m s wer e “ ap pr op ria te ly addres se d i n t he Med ic are app eal s p ro ces s.” Th e Med ic are Ap pe al s C ou nc il de ni edWhi te ’s lat er re qu es t fo r rev ie w of t ho se subs eque nt ly add edcla im s. In st eadof s eek in g ju di ci al rev ie w of tha t d eci si on by fili ng anact io n i n di st ric t co urt ag ai ns t t he Secr et ary of th e Dep artm en t o f Heal th an d Hu m an Serv ic es (“ HHS”), as requi redby 42 U.S.C. § § 4 05 (g ) an d 1 39 5f f(b )(1 )(A), Whit e fil edth is act io n a ga in stth e Carrie rs . The co un ts in hi s co m pl ai ntco in ci de wit h 3th os e rai se d i n h is Mo ti on to Reo pe n b efo re t he Med ic are Ap pe al s C ou nc il , andall

co un ts are b as edon th e Carrie rs ’ 20 00 au di t o f Whi te ’s cla im s fo r se rv ic es bi ll ed to Med ic are. Th e Carrie rs m ov edto di sm is s t he co m pl ai nton th e g ro un ds th atth e di st ric t co urt l ack edsubjec t m at te r juri sd ic ti on be cau se th e cl ai m s ar os e u nd er t he Med ic are Actan d b ecau se th ey were en ti tl edto so ve rei gn imm un it y . The d is tri ct co urt co nc lu de d t ha t Whi te ’s cla im s ar os e u nd er the Med ic are Act , and , at the ve ry le as t, i nv ol ve d c la im s t ha t wer e in ex tri cab ly int ert win edwit h c la im s u nd er t he Med ic are Act . In l ig htof t ha t co nc lu si on , th e d is tri ctco urt d et erm in edth atit la ck edsubjec t m at te r juri sd ic ti on an d g ran te d t he Carr ie rs ’ m ot io n t o d is m is s. Pu rs ua ntto 42 U.S.C. § 4 05 (h ), fed eral co urts are s tri pp ed“ ‘of pr im ary fed eral -que st io n s ub

ject m at te r juri sd ic ti on ’ ov er cl ai m s t ha t ar is e u nd er t ha t Act ”; in st ead , “ th e Actpro vi de s fo r anad m in is tra ti ve he ari ng be fo re t he Secr et ary of [HHS] . . . [and ] ‘j ud ic ia l re vi ew of th e Sec ret ary’ s fi na l d eci si on ’ in th e fo rm of a ci vi l ac ti on in fed eral di st ric t co urt ag ai ns t t he Secr et ary. ” Dial v. Heal th sp rin g o f Ala., In c., 54 1 F .3d10 44 , 10 47 –4 8 (1 1t h C ir. 2 00 8) (in te rn al cit at io ns om it te d) (ci ti ng 42 U.S.C. §§ 40 5( g) , 13 95 w-2 2( g) (5 ); C oc hr an v. U.S. Heal th Care Fin . Adm in ., 29 1 F .3d77 5, 7 79 (11 th Cir . 20 02 )). Co ns eque nt ly, fed eral co urts ha ve juri sd ic ti on ov er o nl y

th os e cas es th atare p ro pe rly app eal edfro m a fi na l ad m in is tra ti ve de ci si on , andth atare fi le d a ga in stth e Sec ret ary of HHS. See id . 4Whi te ’s com pl ai ntall eg edcla im s t ha t wer e b as edonth e Carrie rs ’ 20 00 au di t o f Whi te ’s cla im s fo r se rv ic es bi ll edto Med ic are; th eref or e, th e d is tri ctco urt co rrec tl y co nc lu de d t ha t Whi te ’s cla im s ar os e u nd er t he Med ic are Act . Mor eo ve r, Whi te di d n otap pe al th e Me di care App eal s C ou nc il ’s dec is io n, n ordi d h e fi le su it ag ai ns t t he Secr et ary of

HHS. Accor di ng ly, th e d is tri ctco urt co rrec tl y de te rm in ed th atitdi d n otha ve subjec t m at te r juri sd ic ti on ov er Whit e’s co m pl ai ntan d g ran te d th e Carrie rs ’ m ot io n t o d is m is s. Th e co urt’s d is m is sa l o f th atco m pl ai ntis AFFIRMED.

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