Opinion ID: 429783
Heading Depth: 1
Heading Rank: 2

Heading: timeliness of the secretary's decision.

Text: 17 Because the timeliness of the Secretary's decision necessarily determines whether we must consider the merits, we address this issue first. 18 Both the Secretary's review process and judicial review of her decisions are governed by 42 U.S.C. Sec. 1395oo(f)(1). This section provides in pertinent part: 19 (1) A decision of the Board shall be final unless the Secretary, on his own motion, and within 60 days after the provider of services is notified of the Board's decision, reverses, affirms, or modifies the Board's decision. Providers shall have the right to obtain judicial review of any final decision of the Board, or of any reversal, affirmance, or modification by the Secretary, by a civil action commenced within 60 days of the date on which notice of any final decision by the Board or of any reversal, affirmance, or modification by the Secretary is received. 20 Thus, under the plain wording of the statute, the Secretary's decision is without legal effect if it was rendered more than 60 days after the provider of services [was] notified of the Board's decision .... 21 The Board's decision is dated January 2, 1980. On the same day it was mailed to the plaintiffs and hand-delivered to the Office of the Attorney-Advisor, which is responsible for preparing the Deputy Administrator's decisions. The plaintiffs received the Board's decision on January 7, 1980. 22 The Deputy Administrator's decision reversing the Board on all four issues presently upon appeal is dated March 6, 1980, 64 days after the Board's decision was rendered but 59 days after it was received by the plaintiffs. The letters transmitting copies of the Deputy Administrator's decision are dated March 11, 1980, 69 days after the Board's decision and 64 days after the plaintiffs received the Board's decision. 23 The plaintiffs contend that the Secretary's decision is untimely for three reasons. First, they argue that the 60-day statutory period allowed for secretarial reversals of the Board begins to run from the date the Board's decision is rendered and mailed to the parties. Thus, the Secretary's decision is invalid because it is dated more than 60 days after the Board's decision was mailed to the parties. Second, the plaintiffs maintain that the Secretary is collaterally estopped from contesting that the 60-day period runs from the date of the Board's decision as a result of an earlier court decision adverse to the Secretary on this issue. Third, the plaintiffs argue that the date the Secretary's reversal became effective is the date on which the decision became a matter of public record, rather than the date affixed to the decision. Therefore, the Secretary's decision became public when mailed to the plaintiffs on March 11, 1980, more than 60 days after the Board's decision was rendered and received by the plaintiffs. 24
25 The plaintiffs contend that the term is notified, as used in the first sentence of section 1395oo(f)(1), should be interpreted as occurring on the date the Board's decision is mailed to the provider, rather than the date on which the provider receives this decision. Thus, they argue that the Secretary's decision was untimely because it is dated March 6, 1980, 64 days after the Board's decision was mailed to the plaintiffs. In support of this contention, they note the term is notified, used in the first sentence of the section 1395oo(f)(1), is in marked contrast to the second sentence establishing a 60-day period for obtaining judicial review. The second sentence expressly states that a civil action seeking review of the agency's decision must be commenced within 60 days of the date on which notice is received. (Emphasis added.) The plaintiffs note also that we have held that it is an established rule of construction that a term carefully employed in one place and excluded in another should not be implied where excluded. KCMC, Inc. v. F.C.C., 600 F.2d 546, 550 (5th Cir.1979). See also Diamond Roofing Co. v. Occupational Safety and Health Review Commission, 528 F.2d 645, 648 (5th Cir.1976). Thus, they contend that the fact that the second sentence of section 1395oo(f)(1) expressly refers to the receipt of notice but the first sentence does not clearly indicates that receipt is not a requirement of the notice referred to in the first sentence of the section. 26 We do not find that the use of the term is received in the second sentence of section 1395oo(f)(1) precludes us from interpreting is notified to mean when notice of the Board's decision is received. Arguably, the common understanding of is notified is that of actual notice, and the term is synonymous with is received. Simply because Congress used is notified with regard to the secretarial review provision, rather than is received, as was used in connection with judicial review, is not reason enough for us to find that the terms were intended to have different meanings. 27 Our review of the statute's legislative history, which the plaintiffs ignore, lends considerable weight to this view. In its original form section 1395oo(f) read, in pertinent part, as follows: 28 (f) A decision of the Board shall be final unless the Secretary, on his own motion, and within 60 days after the provider of services is notified of the Board's decision, reverses or modifies (adversely to such provider) the Board's decision. In any case where such a reversal or modification occurs the provider of services may obtain a review of such decision by a civil action commenced within 60 days of the date he is notified of the Secretary's reversal or modification. 29 86 Stat. 1420, 1422 (1972) (emphasis added). 30 Thus, section 1395oo(f), when enacted in 1972, employed the term is notified with respect to both the secretarial and judicial review portions of the statute. The House Committee on Ways and Means report accompanying this legislation interpreted the is notified language of the secretarial review provision to mean that the Board's decision shall be final unless reversed or modified ... within 60 days after the provider receives notification of the Board's decision. H.R.Rep. No. 92-231, 92d Cong., 1st Sess., reprinted in 1972 U.S.Code & Ad.News 4989, 5309 (emphasis added). Similarly, with regard to the judicial review portion of the statute, the Committee interpreted the is notified language to mean that a provider could obtain judicial review of the Secretary's decision if such action is filed within 60 days of receipt of notice of the Secretary's determination. Id. (emphasis added). Thus, the legislative history of section 1395oo(f)(1) demonstrates that Congress interpreted the term is notified to mean the date upon which notice is received. The terms is notified, receives notification, and receipt of notice were used interchangeably and treated as being synonymous. 31 In 1974, Congress amended section 1395oo(f) to expand the availability of judicial review of cases where the Secretary chooses not to modify or reverse a Board decision. The second sentence of section 1395oo(f)(1) was modified to read that an action for judicial review would have to be commenced within 60 days of the date on which notice of any final decision by the Board or of any reversal, affirmance, or modification by the Secretary is received. In enacting this amendment, Congress left untouched the is notified language of the secretarial review portion of section 1395oo(f)(1). 32 The plaintiffs would have us believe that Congress' failure to change the is notified language of the secretarial review provision so as to parallel the is received modification in the judicial review provision demonstrates that Congress intended is notified to mean something other than receipt of notice. We note that the Congressional reports accompanying the 1974 amendment fail to suggest that Congress, in enacting the amendment, intended to alter its understanding of is notified to mean something different than is received. Furthermore, when the amendment was first introduced to the Senate, Senator Walter F. Mondale explained that the amendment was for the sole purpose of offering providers the right of judicial review of any Board decision or subsequent modification or reversal by the Secretary. Senator Mondale noted that [t]his amendment would not alter in any way the administrative appeals procedures currently provided for in [section 1395oo(f)(1) ]. 119 Cong.Rec. 38,631 (1974). In light of this legislative history, we are reluctant to interpret is notified and is received as having different meanings. 33 The plaintiffs argue next that the term is notified contained in the secretarial review provision of section 1395oo(f)(1) must be interpreted to occur on the date of mailing in order to be consistent with the Secretary's interpretation of the word notice in 42 U.S.C. Sec. 1395oo(a)(3). That section allows a provider to appeal to the Board within 180 days after notice of the intermediary's final determination .... Id. The Secretary's regulation provides that this appeal must be filed within 180 days of the date the notice of the intermediary's determination ... was mailed to the provider .... 42 C.F.R. Sec. 405.1841(a) (emphasis added). This regulation interprets the statutory term notice as occurring on the date of mailing. Thus, the plaintiffs argue, if the intermediary's notice to the provider occurs on the date of mailing, consistency requires the Board's notice to the provider referred to in the first sentence of section 1395oo(f)(1) also to occur on the date of mailing. 34 The House Committee report accompanying section 1395oo(a)(3) states that, in order to obtain Board review, the provider must file a request for a hearing within 180 days after notice of the intermediary's final determination. H.R.Rep. No. 92-231, 92d Cong., 1st Sess., reprinted in 1972 U.S.Code Cong. & Ad.News 4989, 5309 (emphasis added). Thus, the Secretary's interpretation of notice to mean the date of mailing, rather than the date of receipt, is neither supported nor contradicted by the legislative history. But the issue of whether the Secretary's interpretation of notice in section 1395oo(a)(3) is reasonable is not before us and, in any case, we cannot allow the Secretary's interpretation of another subsection of the statute to override Congress' clear understanding of is notified as employed in section 1395oo(f)(1). While the Secretary's regulations accompanying section 1395oo(f)(1) could have been more explicit as to the meaning of is notified, 5 we interpret the term to mean receipt of notice. 6 35
36 We are not the first to wrestle with the meaning of is notified as found in the secretarial review provision of section 1395oo(f)(1). In McCoy v. Harris, No. C77-0389 L(A) (W.D.Ky. Feb. 27, 1980), the court held that the 60-day period for secretarial review begins to run as of the date of the Board's decision. The plaintiffs insist that because this issue was decided against the Secretary in McCoy, the Secretary should be collaterally estopped from litigating it here. They point out that Parklane Hosiery Co. v. Shore, 439 U.S. 322, 99 S.Ct. 645, 58 L.Ed.2d 552 (1979), has given the federal courts discretion to allow offensive use of collateral estoppel, which they maintain is appropriate here. 7 37 Subsequent to oral argument in this case, the Supreme Court decided United States v. Mendoza, --- U.S. ----, 104 S.Ct. 568, 78 L.Ed.2d 379 (1984), which held that nonmutual offensive collateral estoppel cannot be used against the government. In Mendoza, Mendoza, a Filipino national, filed a petition for naturalization under the Nationality Act of 1940, 8 U.S.C. Secs. 1001-1005 (1940 ed. Supp. V). His claim for naturalization was based on the assertion that the government's administration of the Nationality Act denied him due process of law. Neither the district court nor the Court of Appeals for the Ninth Circuit reached the merits of his claim because they held that the government was collaterally estopped from litigating that constitutional issue as a result of an earlier decision brought by other Filipino nationals in another district court. In reversing the Ninth Circuit, the Court held that Parklane Hosiery's approval of nonmutual offensive collateral estoppel is not to be extended to the United States. Mendoza, supra, at ---- - ----, 104 S.Ct. at 571-72. The Court found that a rule allowing nonmutual collateral estoppel against the government ... would substantially thwart the development of important questions of law by freezing the first final decision rendered on a particular legal issue. Allowing only one final adjudication would deprive this Court of the benefit it receives from permitting several courts of appeals to explore a difficult question before this Court grants certiorari. Id. at ----, 104 S.Ct. at 572 (citations omitted). The Court also noted that application of nonmutual estoppel against the government would force the government to appeal every adverse decision in order to avoid foreclosing further review. Id. Such a rule would tax the government's limited resources and further crowd the dockets of the courts. Id. In conclusion the Court said: 38 The conduct of government litigation in the courts of the United States is sufficiently different from the conduct of private civil litigation in those courts so that what might otherwise be economy interests underlying a broad application of collateral estoppel are outweighed by the constraints which peculiarly affect the government. We think that our conclusion will better allow thorough development of legal doctrine by allowing litigation in multiple forums. Indeed, a contrary result might disserve the economy interests in whose name estoppel is advanced by requiring the government to abandon virtually any exercise of discretion in seeking to review judgments unfavorable to it. The doctrine of res judicata, of course, prevents the government from relitigating the same cause of action against the parties to a prior decision, but beyond that point principles of nonmutual collateral estoppel give way to the policies just stated. 39 Id. at ----, 104 S.Ct. at 574 (footnote omitted). 8 Thus, we hold that Mendoza forecloses the use of nonmutual estoppel against the Secretary here. 9 40
41 Finally, the plaintiffs contend that, even if the 60 day period for secretarial review begins to run from the date that providers receive notice of the Board's decision, the Secretary's decision was untimely. Although the Deputy Administrator's decision is dated March 6, 1980, it was not mailed until March 11, 1980, 64 days after the date on which the plaintiffs received the Board's decision. The plaintiffs maintain that it was not until this second date, March 11, 1980, that the Deputy Administrator's decision became effective. 42 The plaintiffs assert that an agency decision must be placed in the public domain before it becomes effective. They cite the Federal Rules of Civil Procedure which require that a judicial decision must first be placed in the public domain before it constitutes a final judgment. 10 Yet the administrative rules governing the Secretary's review do not require the entry of her decisions in an official docket; hence, we cannot analogize the act determining the appealability of a judicial order to that determining the effectiveness of the Secretary's decision. See Chem-Haulers, Inc. v. United States, 536 F.2d 610, 615 (5th Cir.1976); Statler Distributors v. Alexander, 148 F.2d 74, 75 (1st Cir.1945). Instead, we must examine the statutory language of section 1395oo(f)(1) and the interpretation given by the agency charged with its administration to determine when the Secretary's decision became effective. Id. at 613-15. 43 Section 1395oo(f)(1) requires only that the Secretary reverse, affirm or modify the Board's decision within 60 days. There is no additional requirement that the decision must be entered on any docket or mailed within that 60-day review period. 11 The regulation promulgated under section 1395oo(f)(1) provides only that the Secretary make her decision within 60 days and that she promptly notify the parties of her decision. 12 44 In HCFA practice, once a Board decision is received for review, a master control sheet is prepared and attached to the file. As the file passes between the Deputy Administrator's Office and the Office of the Attorney-Advisor, this control sheet is signed and dated by those handling the file. In this fashion, a record is kept with regard to what action has been taken on the case. Record Vol. I at 141-43. 45 When the Deputy Administrator signs his decision, he hand-dates and signs the control sheet accompanying the file. The Secretary's position is that upon this act, her decision becomes effective. In the instant case, the Deputy Administrator signed and dated both the decision and the control sheet on March 6, 1980, 59 days after the plaintiffs received the Board's decision. Thus, the Secretary maintains her decision was timely. 46 It is established that interpretations of a statute by the agency charged with its administration should weigh heavily absent a compelling reason to the contrary. See, e.g., Red Lion Broadcasting Co. v. F.C.C., 395 U.S. 367, 381, 89 S.Ct. 1794, 1801, 23 L.Ed.2d 371 (1969). This is not the precise situation before us, but we are persuaded that the Secretary's interpretation of section 1395oo(f)(1) is similarly entitled to some deference, especially where there is no compelling precedent 13 or reason tending to support an opposite view. 14 See Chem-Haulers, Inc. v. United States, 536 F.2d at 615. We hold, therefore, that the Secretary's decision became effective on March 6, 1980, and that her reversal of the Board's decision was timely. 15 47