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Page Number: 6.0

6 

BIDEN v. MISSOURI 

Per Curiam 

the various authorities at issue, contending that the seem-
ingly broad language cited above authorizes the Secretary 
to impose no more than a list of bureaucratic rules regard-
ing the technical administration of Medicare and Medicaid.
But  the  longstanding  practice  of  Health  and  Human  Ser-
vices  in  implementing  the  relevant  statutory  authorities
tells a different story.  As noted above, healthcare facilities 
that wish to participate in Medicare and Medicaid have al-
ways been obligated to satisfy a host of conditions that ad-
dress  the  safe  and  effective  provision  of  healthcare,  not
simply sound accounting.  Such requirements govern in de-
tail, for instance, the amount of time after admission or sur-
gery within which a hospital patient must be examined and 
by whom, 42 CFR §482.22(c)(5), the procurement, transpor-
tation,  and  transplantation  of  human  kidneys,  livers, 
hearts, lungs, and pancreases, §482.45, the tasks that may 
be  delegated  by  a  physician  to  a  physician  assistant  or 
nurse  practitioner,  §483.30(e),  and,  most  pertinent  here,
the programs that hospitals must implement to govern the 
“surveillance, prevention, and control of . . . infectious dis-
eases,” §482.42. 

“infection  prevention  and 

Moreover, the Secretary routinely imposes conditions of 
participation that relate to the qualifications and duties of
healthcare  workers  themselves.    See,  e.g.,  §§482.42(c) 
(2)(iv) (requiring training of “hospital personnel and staff ” 
on 
control  guidelines”),
483.60(a)(1)(ii) (qualified dieticians must have completed at
least 900 hours of supervised practice), 482.26(b)–(c) (spec-
ifying  personnel  authorized  to  use  radiologic  equipment).
And  the  Secretary  has  always  justified  these  sorts  of  re-
quirements  by  citing  his  authorities  to  protect  patient
health and safety.  See, e.g., §§482.1(a)(1)(ii), 483.1(a)(1)(ii),
416.1(a)(1).  As  these  examples  illustrate,  the  Secretary’s 
role  in  administering  Medicare  and  Medicaid  goes  far  be-
yond that of a mere bookkeeper.

Indeed,  respondents  do  not  contest  the  validity  of  this