Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 87.0

529US1

Unit: $U32

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

the challenged provision. See id., at 761. And the Court
thought this fact helped make clear that the action arose
“under the Act whose beneﬁts [were] sought.”
Ibid. But
in a later case, Ringer, the Court reached a similar result
despite the absence of any request for such relief. See 466
U. S., at 616, 623.

In Ringer, four individuals brought a § 1331 action chal-
lenging the lawfulness (under statutes and the Constitution)
of the agency’s determination not to provide Medicare
Part A reimbursement to those who had undergone a partic-
ular medical operation. The Court held that § 405(h) barred
§ 1331 jurisdiction over the action, even though the challenge
was in part to the agency’s procedures, the relief requested
amounted simply to a declaration of invalidity (not an order
requiring payment), and one plaintiff had as yet no valid
claim for reimbursement because he had not even undergone
the operation and would likely never do so unless a court set
aside as unlawful the challenged agency “no reimbursement”
determination. See id., at 614–616, 621–623. The Court
reiterated that § 405(h) applies where “both the standing and
the substantive basis for the presentation” of a claim is the
Medicare Act, id., at 615 (quoting Salﬁ, 422 U. S., at 760–761)
(internal quotation marks omitted), adding that a “claim for
future beneﬁts” is a § 405(h) “claim,” 466 U. S., at 621–622,
and that “all aspects” of any such present or future claim
must be “channeled” through the administrative process, id.,
at 614. See also Your Home Visiting Nurse Services, Inc.
v. Shalala, 525 U. S. 449, 456 (1999); Califano v. Sanders, 430
U. S. 99, 103–104, n. 3 (1977).

As so interpreted, the bar of § 405(h) reaches beyond ordi-
nary administrative law principles of “ripeness” and “ex-
haustion of administrative remedies,” see Salﬁ, supra, at
757—doctrines that in any event normally require channel-
ing a legal challenge through the agency. See Abbott Labo-
ratories v. Gardner, 387 U. S. 136, 148–149 (1967) (ripeness);
McKart v. United States, 395 U. S. 185, 193–196 (1969) (ex-