Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 115

529US1

Unit: $U32

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40

SHALALA v. ILLINOIS COUNCIL ON LONG
TERM CARE, INC.
Thomas, J., dissenting

ski, 421 U. S. 560, 567 (1975)). But we placed at least equal
reliance on the legislative history of the 1972 amendments
to the Medicare Act, see 476 U. S., at 680, and our holding
was that challenges to particular determinations would trig-
ger § 1395ii, whereas challenges to the Secretary’s instruc-
tions and regulations governing particular determinations
would not, ibid.; see supra, at 38.
Indeed, in setting aside
the physicians’ argument that § 405(h) bars general federal-
question jurisdiction only when Congress has provided
“speciﬁc procedures . . . for judicial review of ﬁnal action
by the Secretary,” Michigan Academy, supra, at 679–680,
we expressly declined to decide the case by announcing the
“exception” suggested by the majority. While we might
have done so, cf. Mathews v. Eldridge, 424 U. S. 319, 328–
330 (1976) (describing limited exception to § 405(g)’s require-
ment that Secretary’s decision be “ﬁnal” before judicial re-
view may be sought), we simply did not phrase our holding
in those terms.

II

To be sure, the reading of Michigan Academy that I would
adopt (and that the Court of Appeals adopted below, 143
F. 3d 1072, 1075–1076 (CA7 1998)), dictates a different result
in the earlier Ringer case.
In Ringer, recall, the respond-
ents were individual Medicare claimants who brought a chal-
lenge to the Secretary’s policy regarding payment of Medi-
care beneﬁts for a speciﬁc surgical procedure. As noted, we
(and the parties) simply assumed that § 1395ii’s incorporating
reference to § 405(h) was triggered by such a challenge, and
proceeded directly to decide the case based on § 405(h). And
yet, under Michigan Academy’s gloss on § 1395ii, we would
never have reached § 405(h) because § 1395ii would not have

of Michigan Academy, not the majority’s, is consistent with the language
in Michigan Academy setting forth that case’s holding: § 1395ii “fore-
close[s] review only of ‘amount determinations,’ . . . [not] challenges to the
validity of the Secretary’s instructions and regulations.” 476 U. S., at 680.