Court Opinion

ID: 9463791
Source: CourtListenerOpinion
Date Created: 2023-08-04 23:16:32.876431+00
Date Added: 2024-06-11T17:38:17.460157
License: Public Domain

CLARK, Circuit Judge,
dissenting:
The majority is able to divine a congressional intent to grant court review of the Secretary’s decisions in this Medicare matter. I am not.
The statute we interpret reads:
The provisions of sections 406 and 416(j) of this title, and of subsections (a), (d), (e), (f), (h), (i), (j), (k), and (1) of section 405 of this title, shall also apply with respect to this subchapter to the same extent as they are applicable with respect to subchapter II of this chapter.
42 U.S.C. § 1395Ü.
To give these number and subchapter references more meaning for the reader, I have paraphrased the statute in the following manner. “The provisions of certain parts of the Social Security Act shall also apply with respect to this Medicare Act to the same extent as they are applicable there. These parts include § 405(h), which provides: ‘The findings and decisions of the Secretary after a hearing shall be binding upon all individuals who were parties to such hearing. No findings of fact or decision of the Secretary shall be reviewed by any person, tribunal, or governmental agency except as herein provided.’ This does not include § 405(g), which grants the right of judicial review to a broad spectrum of the Secretary’s final decisions under the Social Security Act.”
We all must acknowledge that this court is bound by the United States Supreme Court’s determination that for Social Security purposes the bar to judicial review of section 405(h) is “sweeping and direct” and effective. Weinberger v. Salfi, 422 U.S. 749, 757, 95 S.Ct. 2457, 2463, 45 L.Ed.2d 522 (1975). Indeed, the majority admits that no review may be had of the Secretary’s action in the case at bar under the literal language of Congress and Salfi. Yet a right of court review is found.
For the accounting periods relevant to this provider reimbursement dispute, 42 U.S.C. § 1395ff(c) provided: “Any institution . . . dissatisfied with any determination by the secretary that it is not a provider of services, or with any determination [by the Secretary that an institution, which has qualified as a provider of services, is no longer eligible to maintain its provider status], shall be entitled . to judicial review of the Secretary’s final decision . . . as is provided in Section 405(g) of this title [i. e., 42 U.S.C. § 405(g)].” Because of the disparity of these review rights in contrast to that specified in Social Security matters, the majority treats the omission of § 405(g) from the list of Social Security Act provisions which were expressly incorporated as an “apparently wayward” congressional oversight which Congress later remedied by adopting 42 U.S.C. § 1395oo(f). The majority draws sustenance for its position from the mightily labored efforts of some courts to find the power to review despite this legislative error.
Yet I do not see the congressional action in not listing § 405(g) among those sections included in 42 U.S.C. § 1395H as necessarily evidencing a mistake. Congress did incorporate § 405(g) into the Medicare Act. See 42 U.S.C. § 1395ff(c). Congress limited the courts’ right to review under 42 U.S.C. § 405(g), however, to the two classes of determinations of the Secretary that are expressly set forth in 42 U.S.C. § 1395ff(c). Thus § 405(g)’s “omission” from 42 U.S.C. *719§ 1395Ü makes perfectly good sense: It was incorporated into another portion of the Act. That Congress initially precluded judicial review of provider reimbursement disputes but later chose to permit such review does not suggest that its initial decision was irrational. The desirability of assuring the correctness of the Secretary’s decisions by allowing judicial review could well have been overbalanced in the legislative mind by the need for finality and economy of administration in this remedial Act.
The judicial role of inferior federal courts is limited to the jurisdiction expressly conferred by Congress. I see a great portent for danger to this basic concept if we are able to imply jurisdiction because we think it ought to exist where Congress has literally given none. Because I am convinced the majority exceeds its interpretive license, I respectfully dissent.