Bowen v. Michigan Academy
of Family Physicians case brief
---
Interested in learning how to get the top grades in your law school classes? Want to learn how to study smarter than your competition? Interested in transferring to a high ranked school?
476 U.S. 667, 106 S. Ct.
2133, 90 L. Ed. 2d 623 (1986)
CASE SYNOPSIS: Respondent
physicians challenged the validity of a Medicare regulation regarding
the payment of benefits for the physicians' services. The Court
granted certiorari to review the holding of the United States Court
of Appeals for the Sixth Circuit that found the regulation was
invalid and to resolve the question of whether 42 U.S.C.S. §§
1395ff or 1395ii barred judicial review of regulations promulgated
under the statute.
FACTS: Respondents, an association of physicians and several individual doctors, filed suit to challenge the validity of 42 C.F.R. § 405.504(b), which authorized the payment of benefits in different amounts for similar physicians' services. The lower appellate court affirmed the district court's holding that the regulation was invalid as inconsistent with the enabling statute's plain language. Petitioner, the Secretary of Health and Human Services, sought certiorari, contending that 42 U.S.C.S. §§ § 1395ff or § 1395ii barred judicial review of regulations promulgated under the statute. The Court granted certiorari. Beginning its analysis with the strong presumption favoring judicial review of agency action, the Court concluded that those matters that Congress did not leave to be determined in a "fair hearing" conducted by the carrier, including challenges to the validity of the Secretary's instructions and regulations, were not impliedly insulated from judicial review by 42 U.S.C.S. § 1395ff. The court further held that in § 1395ii Congress intended to foreclose review only of "amount determinations" remitted exclusively to adjudication by private insurance carriers in a "fair hearing."
CONCLUSION: The Court affirmed the holding of the lower appellate court.
FACTS: Respondents, an association of physicians and several individual doctors, filed suit to challenge the validity of 42 C.F.R. § 405.504(b), which authorized the payment of benefits in different amounts for similar physicians' services. The lower appellate court affirmed the district court's holding that the regulation was invalid as inconsistent with the enabling statute's plain language. Petitioner, the Secretary of Health and Human Services, sought certiorari, contending that 42 U.S.C.S. §§ § 1395ff or § 1395ii barred judicial review of regulations promulgated under the statute. The Court granted certiorari. Beginning its analysis with the strong presumption favoring judicial review of agency action, the Court concluded that those matters that Congress did not leave to be determined in a "fair hearing" conducted by the carrier, including challenges to the validity of the Secretary's instructions and regulations, were not impliedly insulated from judicial review by 42 U.S.C.S. § 1395ff. The court further held that in § 1395ii Congress intended to foreclose review only of "amount determinations" remitted exclusively to adjudication by private insurance carriers in a "fair hearing."
CONCLUSION: The Court affirmed the holding of the lower appellate court.
---
Interested in learning how to get the top grades in your law school classes? Want to learn how to study smarter than your competition? Interested in transferring to a high ranked school?
No comments:
Post a Comment