# Opposition — Group Health Inc. v. Heckler

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URL: https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385011_0420%3A2

## Record

- **Collection:** Supreme Court brief
- **Document type:** Opposition
- **Published:** January 1, 1984
- **Citation:** 467 U.S. 1225

## Text

GrRoUP HEALTH INCORPORATED, PETITIONER
Vv.

MARGARET M. HECKLER, SECRETARY OF A
HEALTH AND HUMAN SERVICES, ET AL.

ON PETITION FOR A WRIT OF CERTIORARI 1 oN
ag TO THE UNITED STATES COURT OF APPEALS 2
¢ is FOR THE SECOND CIRCUIT

BRIEF FOR THE RESPONDENTS IN OPPOSITION

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ites it eRe

py vs Pipes

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A OOM ete

tioner, a provider of health services under the Medicare
statute, 42 U.S.C. (& Supp. V) 1395 et seg., was not :

: entitled to reimbursement of certain “interest” ex-

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TABLE OF CONTENTS

TABLE OF AUTHORITIES

Cases:

American Hospital Management Corp. v.
Batterton v. Francis, 482 U.S. 416........
Committee for Public Education v.
Nyquist, 413 U.S. T66 ......-..ee eens
Community Health Services of Crawford
County, Inc. v. Califano, 698 F.2d 615,
cert. granted, No, 8-56 (Oct. 3,

BEND sci sinc cdehwaa teccwtateesess Ny key ae

Dandridge v. Williams, 397 U.S. 471'.....
FCIC v. Merrill, 382 U.S. 380.........5..
Goleta Valley Community Hospital v.
Schweiker, 647 F.2d 894.........0000005
Hillside Community Hospital of Ukiah v.
Mathews, 423 F. Supp. 1168 ............
INS v. Hibi, 414.U.8. 6...66.ccececeeeeee:

INS v. Miranda, No. 82-29 (Nov. 8, 1982) .

lowa-Des motiee.: Vational Bank v.—

cos ron Saas iad HIS ay

tee

13 €
Rly
13 4
|
10
x
s

IV
Cases—Continued: Page
Lindsley v. Natural Carbonic Gas Co., 220

RIRAEL, ia baer Mphdacdhidnr boss Verncmene 11
Marina Mercy Hospital v. Harris, 633 F.2d

PEGS ¢ eeR tak veks cuhhsty 6apabaiwess 13
Medical Center of Independence v. Harris,

Wee SABE Koes 20s ceccd vcs cocceyes 13
Montana v. Kennedy, 366 U.S. 908 ....... 15
Mourning v. Family Publications Service,

$000.5 SUE Rick CO -¥4a 00 a 08 vi 0c ved cvece 13
Northwest Hospital, Inc. v. Hospital Serv-

ice Corp., 687 F.2d 985.............. 9, 11, 12
Pasadena Hospital Ass’n vy. United States,

OB A, a) 7 eee ee 13

Schweiker v. Hansen, 460 U.S. 785 .... 8, 14, 15

Shaker Medical Center Hospital v. Secre-
tary of Health and Human Services, 686

PO OU vn 5 hs TREC sak ik cpl 11, 13
Skinner v. Oklahoma ex rel. Williamson,
SAU GEBK s. odibess ates s ae 11

South Boston General Hospital v. Blue
Cross of Virginia, 409 F. Supp. 1380 .... 6, 13

Stevens Park eee ae Vv.
United States, TOD cncdbeccrde’ 13

Indiana co v. United

whim ds le 6, 9, 12

u no” afer ee
8 me ee eee ~ ‘
: : 3 2 Ae:

F Constitution, statutes and regulations
| U.S. Const.:
Amend. I ....... SI Pita Sh bs SuRates
RNG Voix Fo tenk ota tenn ahd ewtaccrs
Social Security Act, 42 U.S.C. (& Supp. V)
101 et seq.:
Title XVIII, 42 U.S.C. (& Supp. V) 1395
Oh... MO OTe eee er press 1 7 if
42 U.S.C. (& Supp. V) a
1We-1SMIAG oii os i von cases ee 2
; 42 U.S.C. (€ Supp. V) 1396f........ 2 .
; 42 U.S.C. (Supp. V) 1396f(b)........ 2 ;
, 42 U.S.C. (& Supp. V) 1395g ....... 2 ;
ea 42 U.S.C. 1895g(a)........0ceeeeees 3 5
42 U.S.C. (& Supp. V) 1895h ....... 8 3
42 U.S.C. (Supp. V) 1396h(aX2XA).. 8 %
42 U.S.C. 1895x(vX1MA) ........... 2, 18 a
42 U.S.C. 1395x(VXIMAMH) ......., BO
42 U.S.C. (Supp. V) 1395y(aX1)..... 2 ia
‘ 42 U.S.C. 1806HN .........-sqreeeee 2 /
. 42 U.S.C. (& Supp. V) 189600 ...... 4 i
& 42 C.F.R. Pt. 406 6 809. ..secesesevereene Bo
z Section 406.419 «....+++.+0+++004 6, 7,6,13° a

Section 406.419(ox2X) Owe eee eeeeeee ee 4°
Pa, oud rere.

Section ¢ see enne peeweee 8 i
: e+« + o

= ORIG RA : ' | "@) ;
t Pp . ) Lod *
Section ‘ 4. ’ . _ 4 a af had '
PALIN B | sees eer 10, : ey |
ena aie dae?

Section 406.1801 et seq.
Section 405.1808(b) ....

i

co & co rm m co ht m& SO

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In the Supreme Court of the Ginited States 2
OCTOBER TERM, 1983 -

No. 83-422

GRoUP HEALTH INCORPORATED, PETITIONER
v. s
MARGARET M. HECKLER, SECRETARY OF
HEALTH AND HUMAN SERVICES, ET AL.

ON PETITION FOR A WRIT OF CERTIORARI
TO THE UNITED STATES COURT OF APPEALS
FOR THE SECOND CIRCUIT

BRIEF FOR THE RESPONDENTS IN OPPOSITION

OPINIONS BELOW
The opinions of the court of appeals (Pet. App. Sas
la-4a), the district court (Pet. App. 5a-13a), and the -
Provider Reimbursement Review Board (Pet. App. "4
14a-23a) are unreported. z
JURISDICTION ics
The judgment of the court of wasenteredon

May 9, 1983. On August 2, 1983, Justice Marshall

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IF that under this type of reimbursement system it was k
likely that health care providers would receive over- r
payments or underpayments at various times. There-
fore, it instructed the Secretary to “provide for the

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responded
ing 42 C.F.R. 405.1885, which provides for the reopen-
ing, within a three-year period, of any reimbursement

determination made by an intermediary, a hearing offi-
cer, the Provider Reimbursement Review Board

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istrative and judicial review. 42 U.S.C. (& Supp. V)
139500; 42 C.F.R. 405.1801 et seq.

lees Hosp rom s partnership of py

(ibid.). eat ie min tte: tax
retary of HHS provide that only proprietary (i.e., for-

profit) providers may receive a return on equity capital |
as part of their Medicare reimbursement. 42 C.F.R. a
405.429. In addition, the Secretary's regulations pro- mi
vide that interest expenses generally are not reimburs- ad
able if a transaction involves related parties. 42 C.F.R. we
405.41%¢X1). However, New York State agencies and
Blue Cross-Blue Shield of Greater New York, the fiscal

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Hillcrest Hospital division, it cannot be characterized as
a ‘loan’ under applicable regulations” (id. at 1la-2a). The
court concluded that even if the Hillcrest transaction
could be characterized as a loan (which the court
pe vonage tyrmaanayen tray Vaal yp Rigas
a loan from “donor-restricted” funds the mean-

th. a4 af:

raed. ted petitioner's esto
RYO ge tan: \ the gov.
ee ne A 3m<8 ‘elm Soult v “eas

The court of appeals’ holding is correct and does not
conflict with any decision of this Court or any other
court of appeals. Further review is not warranted.

1. Petitioner first contends (Pet. 13-18) that 42
C.F.R. 405.419—the regulation relied on by the PRRB

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attention to the fact that Section 405.41%cX1), which

States, 618 F.2d 736, 740 (1980), have questioned the
of 42 C.F.R. 405.41%c) on the basis
that it affords favored treatment to religious entities.

10

Fifth Amendment because it favors providers operated
by religious orders over secular providers,® such a con-

5 It seems clear that petitioner lacks standing to raise the
constitutional issue. This Court recently noted in Valley Forge
Christian College v. Americans United for Separation of
Church and State, Inc., 454 U.S. AOA, 418 SHR) (Cahatione,
omitted; footnote omitted):

{A}t an irreducible minimum, Art, III satuleed tis mate
whe kavolen hoa coatt’s auttecily to “show that he povesn
bre hapten see Bonne lane pnt ontnge ma as a re-

tule “hit arte maebia ak ” and

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would not aid petitioner in any event. The prop-

clusion
remedy

ception for
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since the rule clearly

reimbursement of interest payments between related
reasonable purpose.” A court presumably
the related
ption,
is more
See
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that
(Pet. 25-26

providers. The alternative—strik-

the broad prophylactic rule against

in such a case would be to eliminate the ex-

alisan

parties—would be inappropriate

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tant

nicety or because in

397 U.S. 471, 486 (1970) (quoting Lindsley v. Natural Carbonic

Gas Co., 220 U.S. 61, 78 (1911)). Accord, Weinberger v.

422 U.S. 749, 769-770 (1975).

practice it results in some inequality.'’” Dandridge v. Williams,

because it “‘is not made with

647 F.2d 894, 897
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4 ‘hc petition for a writ of certiorari should be denied.
| Alternatively, the Court may wish to hold the petition
i pending a decision in Heckler v. Community Health
Services of Crawford County, Inc., No. 88-56.

Respectfully submitted.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385011_0420%3A2. Public record. Not legal advice.