Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 95

529US1

Unit: $U32

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SHALALA v. ILLINOIS COUNCIL ON LONG
TERM CARE, INC.
Opinion of the Court

sumption against preclusion of all review in light of the tra-
ditional ripeness doctrine, which often requires initial pres-
entation of a claim to an agency. As we have said, supra,
at 13, Congress may well have concluded that a universal
obligation to present a legal claim ﬁrst to HHS, though post-
poning review in some cases, would produce speedier, as well
as better, review overall. And this Court crossed the rele-
vant bridge long ago when it held that Congress, in both
the Social Security Act and the Medicare Act, insisted upon
an initial presentation of the matter to the agency. Ringer,
466 U. S., at 627; Salﬁ, 422 U. S., at 762. Michigan Acad-
emy does not require that we reconsider that longstanding
interpretation.

V

The Council argues that in any event it falls within the
exception that Michigan Academy creates, for here as there,
it can obtain no review at all unless it can obtain judicial
review in a § 1331 action.
In other words, the Council con-
tends that application of § 1395ii’s channeling provision to
the portion of the Medicare statute and the Medicare regu-
lations at issue in this case will amount to the “practical
equivalent of a total denial of judicial review.” Haitian Ref-
ugee Center, supra, at 497. The Council, however, has not
convinced us that is so.

The Council says that the special review channel that the
Medicare statutes create applies only where the Secretary
terminates a home’s provider agreement;
it is not avail-
able in the more usual case involving imposition of a lesser
remedy, say, the transfer of patients, the withholding of pay-
ments, or the imposition of a civil monetary penalty.

We have set forth the relevant provisions, supra, at 8–9;
infra. The speciﬁc judicial review provision,
Appendix,
§ 405(g), authorizes judicial review of “any ﬁnal decision of
the [Secretary] made after a [§ 405(b)] hearing.” A further
relevant provision, § 1395cc(h)(1), authorizes a § 405(b) hear-
ing whenever a home is “dissatisﬁed . . . with a determi-