Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 91.0

529US1

Unit: $U32

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

States v. Erika, Inc., 456 U. S. 201, 202–203 (1982). The
Medicare statute, as it then existed, provided for only lim-
ited review of Part B decisions.
It allowed the equivalent
of § 405(g) review for “eligibility” determinations. See 42
U. S. C. § 1395ff(b)(1)(B) (1982 ed.).
It required private in-
surance carriers (administering the Part B program) to pro-
vide a “fair hearing” for disputes about Part B “amount de-
terminations.”

§ 1395u(b)(3)(C). But that was all.

.

Michigan Academy ﬁrst discussed the statute’s total si-
lence about review of “challenges mounted against the
. amounts are to be determined.”
method by which .
476 U. S., at 675.
It held that this silence meant that, al-
though review was not available under § 405(g), the silence
did not itself foreclose other forms of review, say, review in
a court action brought under § 1331. See id., at 674–678.
Cf. Erika, supra, at 208 (holding that the Medicare Part B
statute’s explicit reference to carrier hearings for amount
disputes does foreclose all further agency or court review
of “amount determinations”).

The Court then asked whether § 405(h) barred 28 U. S. C.
§ 1331 review of challenges to methodology. Noting the Sec-
retary’s Salﬁ/Ringer-based argument that § 405(h) barred
§ 1331 review of all challenges arising under the Medicare
Act and the respondents’ counterargument that § 405(h)
barred challenges to “methods” only where § 405(g) review
was available, see Michigan Academy, 476 U. S., at 679, the
Court wrote:

“Whichever may be the better reading of Salﬁ and
Ringer, we need not pass on the meaning of § 405(h) in
the abstract to resolve this case. Section 405(h) does
not apply on its own terms to Part B of the Medicare
program, but is instead incorporated mutatis mutandis
by § 1395ii. The legislative history of both the statute
establishing the Medicare program and the 1972 amend-
ments thereto provides speciﬁc evidence of Congress’
intent to foreclose review only of ‘amount determina-