Supreme Court Decision Alert - January 22, 2013

Keywords: Medicare, equitable tolling, provider-reimbursement claims

Today the Supreme Court issued one decision, described below, of interest to the business community.

Medicare—No Equitable Tolling of Provider-Reimbursement Claims

Sebelius v. Auburn Regional Medical Center, No. 11-1231

Under Medicare Part A, a health-care provider submits a cost report at the end of each fiscal year to an intermediary that determines the amount that the provider will receive in reimbursement payments for that year. A provider may obtain a hearing before the Provider Reimbursement Review Board to challenge the amount if the provider "files a request for a hearing within 180 days after notice of the intermediary's final determination." 42 U.S.C.§ 1395oo(a)(3). Today, in a unanimous decision, the Supreme Court held that the 180-day time limit is not jurisdictional. The Court further held that the Secretary of the Department of Health and Human Services reasonably construed