Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1114_09m1.pdf
Page Number: 11.0

8 

AMERICAN HOSPITAL ASSN. v. BECERRA 

Opinion of the Court 

review of the 2018 and 2019 reimbursement rates.  More-
over, the detailed statutory formula for the reimbursement
rates undermines HHS’s suggestion that Congress implic-
itly  granted  the  agency  judicially  unreviewable  discretion
to set the reimbursement rates.  Cf. Weyerhaeuser Co., 586 
U. S., at ___−___ (slip op., at 13−14).

HHS  cites  two  provisions—§§1395l(t)(12)(A)  and  (C)—
that preclude judicial review of HHS’s “development of the 
classification system under paragraph (2)” and “periodic ad-
justments made under paragraph [(9)].”  But both of those 
provisions refer to the general payment methodology that 
HHS employs to set rates for other Medicare outpatient ser-
vices.  By contrast, when HHS sets rates for outpatient pre-
scription drugs, it uses a different payment methodology—
namely,  the  methodology  specified  by  paragraph  (14)  of
§1395l(t).  And nothing in the statute precludes judicial re-
view of reimbursement rates set under paragraph (14). 

HHS further argues that allowing judicial review of the 
2018 and 2019 reimbursement rates would be impractical 
because the agency is required to operate the program on a 
budget-neutral  basis.    Due  to  that  budget-neutrality  re-
quirement, HHS says that a judicial ruling invalidating the 
2018  and  2019  reimbursement  rates  for  certain  hospitals
would require offsets elsewhere in the program.  The Hos-
pitals respond that various potential remedies could make
340B  hospitals  whole  for  the  past  shortfalls  without  run-
ning afoul of the budget-neutrality provision.  At this stage,
we need not address potential remedies.  Regardless, HHS’s
arguments against judicial review cannot override the text 
of the statute and the  traditional presumption in favor of 
judicial review of administrative action.

In sum, HHS’s preclusion argument lacks any textual ba-
sis.  We agree with the District Court and the Court of Ap-
peals that the Medicare statute does not preclude judicial
review of the 2018 and 2019 reimbursement rates.