Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 77.0

529US1

Unit: $U32

[10-04-01 09:20:53] PAGES PGT: OPIN

2

SHALALA v. ILLINOIS COUNCIL ON LONG
TERM CARE, INC.
Syllabus

did not rely on these provisions when it ﬁled suit against, inter alios,
petitioners (hereinafter Secretary), challenging the validity of Medi-
care regulations that impose sanctions or remedies on nursing homes
that violate certain substantive standards. Rather, it invoked federal-
question jurisdiction, 28 U. S. C. § 1331.
In dismissing for lack of juris-
diction, the Federal District Court found that 42 U. S. C. § 405(h), as
interpreted in Weinberger v. Salﬁ, 422 U. S. 749, and Heckler v. Ringer,
466 U. S. 602, barred a § 1331 suit. The Seventh Circuit reversed, hold-
ing that Bowen v. Michigan Academy of Family Physicians, 476 U. S.
667, had signiﬁcantly modiﬁed such earlier case law.

Held: Section 405(h), as incorporated by § 1395ii, bars federal-question

jurisdiction here. Pp. 10–25.

(a) Section 405(h) purports to make exclusive § 405(g)’s judicial re-
view method. While its “to recover on any claim arising under” lan-
guage plainly bars § 1331 review where an individual challenges on
any legal ground the agency’s denial of a monetary beneﬁt under the
Social Security and Medicare Acts, the question here is whether an
anticipatory challenge to the lawfulness of a policy, regulation, or stat-
ute that might later bar recovery or authorize imposition of a penalty
is also an action “to recover on any claim arising under” those Acts.
P. 10.

(b) Were the Court not to take account of Michigan Academy, § 405(h),
as interpreted in Salﬁ and Ringer, would clearly bar this § 1331 lawsuit.
The Court found in the latter cases that § 405(h) applies where “both
the standing and the substantive basis for the presentation” of a claim
is the Social Security Act, Salﬁ, supra, at 760–761, or the Medicare Act,
Ringer, 466 U. S., at 615. All aspects of a present or future beneﬁts
claim must be channeled through the administrative process.
Id., at
621–622. As so interpreted, § 405(h)’s bar reaches beyond ordinary
administrative law principles of “ripeness” and “exhaustion of admin-
istrative remedies”—doctrines that normally require channeling a legal
challenge through the agency—by preventing the application of excep-
tions to those doctrines. This nearly absolute channeling requirement
assures the agency greater opportunity to apply, interpret, or revise
policies, regulations, or statutes without possibly premature inter-
ference by individual courts applying “ripeness” and “exhaustion” ex-
ceptions case by case. The assurance comes at the price of occasional
individual, delay-related hardship, but paying such a price in the con-
text of a massive, complex health and safety program such as Medi-
care was justiﬁed in the judgment of Congress as understood in Salﬁ
and Ringer. Salﬁ and Ringer cannot be distinguished from the instant