medicare

26 cases — ← All topics

Case Title Lower Court Docketed Status Flags Tags Question Presented
25-761 Novo Nordisk Inc., et al. v. Robert F. Kennedy, Secretary of Health and Human Services, et al. Third Circuit 2025-12-29 Pending Amici (2) administrative-procedure-act agency-rulemaking constitutional-constraints medicare price-controls separation-of-powers Is the separation of powers violated when an agency exercises sweeping price-setting and rulemaking authority with no constraints to ensure that it ac…
25A115 AstraZeneca Pharmaceuticals LP, et al. v. Robert F. Kennedy, Secretary of Health and Human Services, et al. Third Circuit 2025-07-28 Presumed Complete drug-price-negotiation due-process inflation-reduction-act medicare patent-rights pharmaceutical-regulation Whether the government's mandatory drug price negotiation program under the Inflation Reduction Act violates pharmaceutical manufacturers' due process…
23-7132 Thomas G. O'Lear v. United States Sixth Circuit 2024-04-04 Denied Response WaivedIFP healthcare-fraud insurance-company medicaid medicare offense-level-enhancement sentencing-guidelines victim-definition vulnerable-victim Whether patients whose information was used in a healthcare fraud case, but who were not otherwise harmed, count as 'victims' for purposes of the vuln…
23-546 Corporate Management, Incorporated, et al. v. United States, ex rel. James Aldridge, et al. Fifth Circuit 2023-11-21 Denied Response Waived administrative-remedy cms due-process executive-compensation false-claims-act government-investigation materiality medicaid medicare medicare-reimbursement pay-and-chase Where the Centers for Medicare and Medicaid Services makes payments pursuant to a 'pay and chase' policy, are the certifications of Stone County Hospi…
22-6073 Lindsey Chow v. Ma Leyba, et al. California 2022-11-16 Denied Response WaivedIFP bodily-rights civil-rights due-process equal-protection euthanasia fourteenth-amendment medical-autonomy medicare survivorship-rights Did the Supreme Court of California violate murder victim Henry Chow's and his children's Fourteenth Amendment rights
22-339 Pfizer Inc. v. Department of Health and Human Services, et al. Second Circuit 2022-10-12 Denied Amici (5) advisory-opinion-process anti-kickback-statute criminal-intent healthcare-fraud medical-decision-making medicare mens-rea remuneration rule-of-lenity statutory-interpretation Whether the Anti-Kickback Statute is violated only if the person offering the remuneration intends to corrupt the recipient's medical decision-making
21-1308 J. Martin Robertson v. Larkspur Courts, et al. California 2022-03-31 Denied Response Waived due-process equal-protection fourteenth-amendment medicaid medicare medicare-reporting privacy settlement-disclosure social-security social-security-privacy Whether Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 requires settlement or judgment debtors to report the Social Security n…
21-1140 UnitedHealthcare Insurance Company, et al. v. Xavier Becerra, Secretary of Health and Human Services, et al. District of Columbia 2022-02-16 Denied Amici (5) actuarial-equivalence administrative-law cms cms-rule healthcare-insurance medicare medicare-advantage overpayment-rule same-methodology statutory-interpretation Whether the Overpayment Rule violates the statutes' actuarial-equivalence and same-methodology mandates
21-528 Willie H. Goffney, Jr., et al. v. Xavier Becerra, Secretary of Health and Human Services Ninth Circuit 2021-10-08 Denied Response Waived administrative-law agency-interpretation civil-procedure due-process judicial-review medicare medicare-claims regulatory-deference regulatory-interpretation statutory-construction statutory-interpretation Whether the regulatory deference test set forth in Auer v. Robbins and Kisor v. Wilkie should be retired or revised to allow courts to interpret admin…
21-408 Gertrude Parker v. United States Fifth Circuit 2021-09-15 Denied Response Waived conspiracy-charge criminal-intent criminal-procedure effective-assistance-of-counsel general-verdict insufficient-evidence jury-verdict medicare medicare-statutes reasonable-interpretation sixth-amendment Whether Parker was denied effective assistance of counsel
21-61 CHS-Glenwell Inc., et al. v. Ohio Department of Medicaid Ohio 2021-07-16 Denied Response Waived administrative-law agency-deference due-process federal-preemption federal-regulation judicial-deference judicial-review medicaid-agency medicare state-medicaid Is a state Medicaid agency entitled to deference in judicial review of the agency's interpretation of an unambiguous, inapplicable federal Medicare re…
20-1694 Gregory Molden v. United States Fifth Circuit 2021-06-08 Denied Response Waived civil-procedure constitutional-rights criminal-procedure criminal-prosecution due-process fifth-amendment health-care-fraud medicare medicare-regulations regulatory-compliance Is it a constitutional Fifth Amendment Due Process violation when a Health Care provider under the Federal Title XVIII Medicare Program is pursued by …
20-1692 Henry Evans v. United States Fifth Circuit 2021-06-07 Denied Response Waived administrative-law criminal-procedure criminal-prosecution expert-testimony health-care-fraud healthcare-fraud medicaid medicare medicare-regulations statutory-interpretation Whether Medicare regulations are controlling in a criminal prosecution under 18 U.S.C. § 1347
20-1486 Empire Health Foundation, for Valley Hospital Medical Center v. Xavier Becerra, Secretary of Health and Human Services Ninth Circuit 2021-04-22 Denied Relisted (2) administrative-law agency-rulemaking disproportionate-share-hospital disproportionate-share-hospital-payments due-process logical-outgrowth medicare medicare-payments notice-and-comment Whether agencies must accurately include key facts and data in notices of proposed rulemaking to satisfy fair-notice, public-comment
20-1114 American Hospital Association, et al. v. Xavier Becerra, Secretary of Health and Human Services, et al. District of Columbia 2021-02-12 Judgment Issued Amici (15)Relisted (3) administrative-law chevron-deference healthcare-regulation hospital-acquisition-cost medicare medicare-reimbursement reimbursement-rates statutory-interpretation survey-data Whether Chevron deference permits HHS to set reimbursement rates based on acquisition cost and vary such rates by hospital group if it has not collect…
20-805 RollinsNelson LTC Corp., et al. v. United States, ex rel. Jane Winters Ninth Circuit 2020-12-14 Denied civil-rights due-process false-claims-act healthcare-provider inpatient-care medical-judgment medical-necessity medicare medicare-reimbursement objective-falsehood objective-falsity Whether the False Claims Act requires pleading and proof of an objectively false statement
20-566 United States, ex rel. Diana Juan v. Stephen Hauser, et al. Ninth Circuit 2020-10-30 Denied Response Waived authority defendant-knowledge failure-to-act medicare medicare-fraud overbilling plausible-claim qui-tam remediation-authority systemic-automated systemic-overbilling Must a Qui Tam Relator in a systemic automated Medicare overbilling case specify more than each Defendant's knowledge that the systemic automated syst…
20-371 Care Alternatives v. United States, et al. Third Circuit 2020-09-23 Denied Amici (2)Response RequestedRelisted (2) circuit-split clinical-judgment false-claims-act hospice-care life-expectancy medical-certification medicare medicare-claims physician-opinion Whether a physician's honestly held clinical judgment regarding hospice certification can be 'false' under the False-Claims-Act based solely on a reas…
20-286 United States, ex rel. Stacey L. Janssen, as Special Administrator of the Estate of Megen Corin Duffy v. Lawrence Memorial Hospital Tenth Circuit 2020-09-04 Denied Response Waived circuit-split false-claims-act materiality medicare medicare-reimbursement patient-arrival-times quality-reporting reimbursement statutory statutory-quality-reporting Whether a Medicare provider's knowing falsifications of hospital patient arrival times, known by the hospital to be material to statutory quality repo…
19-1425 Palm Valley Health Care, Inc. v. Alex M. Azar, II, Secretary of Health and Human Services Fifth Circuit 2020-06-26 Denied Response Waived administrative-procedure administrative-process delay due-process fundamental-unfairness homebound-status medicare medicare-appeals overpayment overpayment-determination provider-rights statistical-sampling Whether an administrative process that is fraught with delay and fundamental unfairness and that clearly violates the provider's constitutional Due Pr…
19-1407 Mercy O. Ainabe v. United States Fifth Circuit 2020-06-24 Denied Response Waived corporate-entities health-care-claims health-care-fraud loss-calculation medicare medicare-fraud relevant-conduct sentencing-guidelines victim-definition Whether Medicare beneficiaries are 'victims' for purposes of sentencing enhancements
19-7538 Victoria Carlson, et vir v. Jodi Harpstead, Commissioner, Minnesota Department of Human Services, et al. Minnesota 2020-02-04 Denied Response WaivedRelisted (2)IFP administrative-procedure administrative-procedures breast-cancer-treatment civil-rights constitutional-rights due-process federal-statute medicaid medicaid-coverage medical-assistance medicare state-statute statutory-interpretation Whether the applicable language requires or allows removal of Victoria from Medicaid breast cancer treatment coverage
19-866 Emmanuel E. Ubinas-Brache v. Surgery Center of Texas, LP Texas 2020-01-10 Denied Response Waived anti-kickback-statute healthcare-fraud limited-partnership medicaid medicare partnership-agreement preemption state-contract-law surgical-center Does applying state contract law to enforce a partnership agreement's clause permitting expulsion 'for any reason or no reason' obstruct Congress's ef…
19-225 United States, ex rel. Stephanie Strubbe, et al. v. Crawford County Memorial Hospital, et al. Eighth Circuit 2019-08-20 Denied Response RequestedResponse WaivedRelisted (2) billing civil-procedure false-claims-act medicare medicare-billing motion-to-dismiss pleading protected-activity qui-tam whistleblower Must these employees, Relators in a suit brought under the False Claims Act, have seen and therefore pled the exact content of billings sent to Medica…
19-68 Unity HealthCare v. Alex M. Azar, II, Secretary of Health and Human Services Eighth Circuit 2019-07-12 Denied administrative-law agency-deference agency-interpretation auer-deference civil-procedure judicial-review kisor-v-wilkie medicare medicare-regulations statutory-interpretation volume-decrease-adjustment Whether federal courts must defer to an agency's reasonable interpretation of its own regulations
18-828 Robert Ghiringhelli, et al. v. The Assurance Group, Inc. Sixth Circuit 2019-01-02 Denied Response Waived breach-of-contract civil-rights contract contract-law federal-preemption insurance insurance-industry insurance-law medicare medicare-regulations separate-accrual-rule statute-of-limitations Whether the separate accrual rule should apply to commissions earned by insurance agents and collected monthly by the insurance company, compelling ac…