Opinion ID: 704023
Heading Depth: 3
Heading Rank: 2

Heading: Inconsistencies in the Secretary's Position

Text: 22 The Hospitals also contend the Secretary's interpretation of the statute is invalid because it is inconsistent with her previous positions and presented for the first time in this litigation. Citing Motor Vehicle Manufacturers Association of the United States, Inc. v. State Farm Mutual Automobile Insurance Co., 463 U.S. 29, 50, 103 S.Ct. 2856, 2870, 77 L.Ed.2d 443 (1983), they state that this Court may not accept counsels' post hoc rationalizations for the Secretary's actions. Specifically, they argue that, in previous litigation and in a number of rulemaking proceedings, the Secretary has acknowledged, directly or by implication, that the PRO Payment Rule was the basis for additional payments to hospitals for costs incurred under agreements with PROs. 20 Most importantly, the Secretary cited Sec. 1395cc(a)(1)(F) as the statutory authority for the Photocopy Rule, which clearly indicates that she previously construed the statute as paying hospitals for their review costs. See, e.g., 57 Fed.Reg. at 47,786. 21 23 Many of the inconsistencies cited by the Hospitals do not hold up under scrutiny. The Secretary has not maintained a contrary construction in previous cases. In Burlington, for example, the Secretary specifically alleged that Sec. 1395cc(a)(1)(F) was meant to ensure PROs would be adequately funded and that PPS is the sole source of photocopy costs associated with peer review. 644 F.Supp. at 1030. Also, merely because the Secretary claimed in the alternative in Burlington and at other times that photocopy costs should not be reimbursed twice, does not mean that the Secretary interpreted the PRO Payment Rule as a mechanism for reimbursing hospitals. See, e.g., id. Moreover, because the other cited cases involved different issues and unique postures, they provide little guidance as to whether the Secretary previously interpreted the PRO Payment Rule differently. 22 24 In the rule-making record, however, the Secretary did state that Sec. 1395cc(a)(1)(F) is the statutory authority for the proposed Photocopy Rule. See, e.g., 57 Fed.Reg. at 47,786. This kind of reference implies that the Secretary at one time may have viewed the PRO Payment Rule as a means for reimbursing hospitals. As the Secretary points out, however, the record contains contrary statements of statutory authority as well. See 57 Fed.Reg. 47,787; note 19, supra. 25 Nevertheless, even if these scattered statements suggest that the Secretary has been somewhat inconsistent in her view of the PRO Payment Rule, such past inconsistencies cannot override the plain language of the statute. Moreover, even if we again assume the statute is ambiguous, the Secretary's inconsistency is probably insufficient alone to invalidate her interpretation. In Good Samaritan Hospital v. Shalala, --- U.S. ----, ----, 113 S.Ct. 2151, 2161, 124 L.Ed.2d 368 (1993), the Supreme Court recently declared in the Medicare context that the consistency of the Secretary's position is one factor in determining whether to accord deference. While the Court recognized that a current agency interpretation that conflicts with a previous one is often entitled to less deference, it also recognized that the agency  'is not disqualified from changing its mind.'  Id. (quoting NLRB v. Iron Workers, 434 U.S. 335, 351, 98 S.Ct. 651, 660-61, 54 L.Ed.2d 586 (1978)). Moreover, where the agency's interpretation of a statute is at least as plausible as competing ones, there is little, if any, reason not to defer to its construction. Id. 26 As discussed above, the Secretary's interpretation is a reasonable construction of the PRO Payment Rule's plain language, is supported by the legislative history and apparent congressional intent, and is explainable in terms of the history of the peer review system and reimbursement structure. Thus, her position is, at minimum, at least as plausible as the Hospitals'. The fact that scattered references in the rule-making record leave some doubt whether the Secretary's view of the statute has always been consistent is therefore insufficient to invalidate her construction.