[DO NOT PUBLISH]

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 21-11529

Non-Argument Calendar

____________________

JORG BOBER, 

Dr., 

FIRST COAST PODIATRIC SURGERY 

AND WOUND CARE, LLC, 

Plaintiffs-Appellants,

versus

SAFE GUARD SERVICES, LLC, 

Defendant-Appellee.

USCA11 Case: 21-11529 Date Filed: 10/15/2021 Page: 1 of 4
2 Opinion of the Court 21-11529

____________________

Appeal from the United States District Court

for the Middle District of Florida

D.C. Docket No. 3:19-cv-01093-BJD-PDB

____________________

Before BRANCH, LUCK, and BRASHER, Circuit Judges.

PER CURIAM:

The question in this appeal is whether a medical practice’s 

lawsuit against a federal contractor arises under the Medicare Act. 

See 42 U.S.C. § 405(h). The Centers for Medicare and Medicaid 

(CMS), the federal agency that runs Medicare, contracted Safe 

Guard Services, LLC, to audit Dr. Jorg Bober’s podiatry practice for 

potential fraud. Bober and his practice sued Safe Guard for its conduct during that audit, including its decision to suspend Medicare 

reimbursements and its treatment of Bober’s appeal of that decision. Specifically, Bober brought five causes of action: (i) tortious 

interference with business relationships; (ii) defamation; (iii) negligence; (iv) negligent hiring, retention, training, and supervision; 

and (v) violations of Florida’s Deceptive and Unfair Trade Practices 

Act. 

Under 42 U.S.C. § 405(h), the courts are stripped of subject 

matter jurisdiction over claims “arising under” the Medicare Act. 

Dial v. Healthspring of Ala., Inc., 541 F.3d 1044 (11th Cir. 2008). 

Instead, claimants must exhaust administrative remedies before 

USCA11 Case: 21-11529 Date Filed: 10/15/2021 Page: 2 of 4
21-11529 Opinion of the Court 3

seeking judicial review. Id. (citing Heckler v. Ringer, 466 U.S. 602, 

614 (1984)). The district court dismissed Bober’s claims without 

prejudice under the Medicare Act because Bober did not exhaust 

available administrative remedies before seeking relief in federal 

court. 42 U.S.C. § 405(g).

We agree that Bober’s claims arise under the Medicare Act 

and, because he did not exhaust administrative remedies, we affirm 

the district court. We review a district court’s dismissal for lack of 

jurisdiction de novo. Miccosukee Tribe of Indians v. U.S., EPA, 105 

F.3d 599, 602 (11th Cir. 1997). We must construe the “arising under” language broadly. Heckler, 466 U.S. at 615. A claim arises under the Medicare Act when it is “inextricably intertwined” with the 

Medicare Act or where “both the standing and the substantive basis 

for presentation” is the Medicare Act. Id. at 615, 624. Accordingly, 

“[a] claim may arise under the Medicare Act even though, as 

pleaded, it also arises under some other law.” Midland Psychiatric 

Assocs., Inc. v. United States, 145 F.3d 1000, 1004 (8th Cir. 1998) 

(citing Weinberger v. Salfi, 422 U.S. 749, 760-61 (1975)).

Bober argues that his claims “are wholly independent of either reimbursements or eligibility,” and thus do not arise under the 

Act. We disagree. As the district court explained, Bober’s claims 

arise under the Medicare Act because “[b]ut for the Medicare Act, 

[Safe Guard] would not have performed the investigatory functions 

complained of.” Bober’s claims are based entirely on the work that 

Safe Guard performed on behalf of CMS—auditing past Medicare 

payments, suspending future payments, addressing Bober’s appeal 

USCA11 Case: 21-11529 Date Filed: 10/15/2021 Page: 3 of 4
4 Opinion of the Court 21-11529

of the suspension, and the like. Accordingly, we agree with the district court that Bober’s claims arise under the Medicare Act and 

that he was required to administratively exhaust his claims before 

seeking judicial relief. Heckler, 466 U.S. at 615. Because he did not 

administratively exhaust his claims, the district court correctly dismissed his complaint for lack of subject matter jurisdiction.

AFFIRMED.

USCA11 Case: 21-11529 Date Filed: 10/15/2021 Page: 4 of 4