# Respondents Brief — Good Samaritan Hospital v. Shalala > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385013_0284%3A6 ## Record - **Collection:** Supreme Court brief - **Document type:** Respondents Brief - **Published:** January 1, 1993 - **Citation:** 508 U.S. 402 ## Text Supreme Court, us. | tt. & pe i No. 91-2079 DEC 39 1099 In the Supreme Court of the United Statexa~———~ OCTOBER TERM, 1992 GooD SAMARITAN HOSPITAL, ET AL., PETITIONERS Louis W. SULLIVAN, SECRETARY OF HEALTH AND HUMAN SERVICES ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE EIGHTH CIRCUIT BRIEF FOR THE RESPONDENT KENNETH W. STARR : Solicitor General SUSAN K. ZAGAME Acting General Counsel DARREL J. GRINSTEAD Associate General Counsel EpDWarp C. DuMont HENRY R. GOLDBERG Assistant to the Solicitor General STUART M. GERSON Assistant Attorney General EDWIN S. KNEEDLER Assistant to the Solicitor General Deputy Associate ANTHONY J. STEINMEYER General Counsel JOHN P. SCHNITKER GERARD KEATING Altorneys Attorney Department of Justice Department of Health Washington, D.C. 20530 & Human Services (202) 514-2217 Washington, D.C. 20201 —— rE ——————— Or QUESTION PRESENTED Whether a health care provider may invoke 42 U.S.C. 1395x(v)(1)(A) (ii), which authorizes regulations pro- viding for the making of “suitable retroactive corrective adjustments” to Medicare reimbursements, to obtain reimbursement in excess of valid regulatory cost limits that are specifically authorized by Section 1395x(v)(1)(A). (1) TABLE OF CONTENTS . os ccmessnnnegnnnenmnenneveccemusncocneresnsaesens See 8 iste eS oe Summary ofargument....__.. Argument: A medicare provider cannot circumvent valid cost limits in the Secretary’s reimbursement regulations by invoking the provision in clause (ii) of 42 U.S.C. 1395x(v) (1) (A) for “suitable retroactive correc- tive adjustments” . A. The text of the Act menmeste ( the res implementation of clause (ii) through regula- tions that provide only for a year-end, “book- balancing” adjustment of a provider's total re- imbursement within the framework of the cost EE B. The history of clause (ii) and the 1972 amend- ments authorizing cost limits both support the Secretary's interpretation of clause (ii) in this 1. Clause (ii) as originally enacted ~~ 2. The 1972 cost limit amendments .................. C. Petitioners’ reliance on clause (ii) in this case is forec'osed by this Court’s decision in Bowen v. George. cwn University Hospital D. The Secretary's interpretation of clause (ii), which is consistent both with Georgetown and with the original construction of the statute, is entitled to deference from this Court Conclusion ._—s.................. ee Page 10 13 14 19 19 28 33 37 42 IV Vv Cases—Continued : Page TABLE OF AUTHORITIES ee . | Cases : Page King v. St. Vincent’s Hospital, 112 S. Ct. 570 “ ES ae cee error Albert Einstein Medical Center v. Sullivan, Civil PR ee ) k Jewish Medical Center v. Richardson, No. 91-6119 (E.D. Pa. Nov. 24, 1992) _.. iden 39 486 F.2d 668 (2d Cir. 1973) 38 Ardestani v. INS, 112 S. Ce. GAS CIGG8) .........-....... 14 Lech "Inc. v. NLRB, 112 S. Ct. 841 (1992). 40 Batterton Vv. Francis, 432 U.S. 416 (1977) —.......... 18 M wrevenyy Sawa Hosp. v. B 839 F.2d 1504 Bethesda Hosp. Ass'n V. Bowen, 485 U.S. 399 (11th Cir. 1988) et sosnadiundininnabamas 39, 41 (3989) -.......... ce ie ee 2, 37 Memorial Hospital v. Sullivan, 779 F. Supp. 1406 Bowen v. Georgetown University Hospital, 488 (D.D.C. 1991) anaes eta heels 40 U.S. 204 (1988) 9, 10, 12, 14, 23, 25-26, 33, 34, 36, 40 Bowen Vv. Yuckert, 482 Se fll, ae 18 Chevron U.S.A. Ine. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (1984)... 14 City of Austin v. Heckler, 753 F.2d 1316 (5th Cir. 1985) ........... ARES een We OER ey See PAB TEL TAS 32 Clark v. Uebersee Finanz-Korporation, 332 U.S. RASS IES IG: REE RM ales 33 Daughters of Miriam Center for the Aged V. Mathews, 590 F.2d 1250 (2d Cir. 1978)... 39 Davis v. United States, 495 U.S. 472 (1990)... 22 EI. DuPont de Nemours & Co. v. Collins, 432 U.S. RP CITI ‘censsisisensscitasiotaciniihteiahiesaieiatecas cesta inte ta. 22 Eskaton American River Hosp. v. Aetna Life Ins. Co., [1990 Transfer Binder] Medicare and Medi- caid Guide (CCH) © 38,279 (Nov. 27. 1989) _. 40 Estate of Cowart Vv. Nicklos Drilling Co., 112 S. Ct. I i 14 Fairfax Hosp. Ass’n, Inc. v. Califano, 585 F 2d EE St 32 Fairfax Nursing Center Vv. Califano, 590 F.2d 1297 EERIE BY Oe 39 FTC v. Mandel Bros., 359 U.S. 385 (1968) ............. 22 Hazelwood Chronic & Convalescent Hospital, Inc. Vv. Weinberger, 543 F.2d 703 (9th Cir. 1976), vacated, 430 U.S. 952 (1977) 39 Hennepin County v. Sullivan, 883 F.2d 85 (D.C. Cir. 1989) , cert. denied, 493 U.S. 1043 (1990) 10, 36, 49 Humana of Illinois, Inc. v. Heckler, No. 84-1727 (7th Cir. Apr. 18, 1985) 39 Humana of South Carolina v. Califano, 590 F.2d fe sill aiaiealtida 39 Mercy Community Hosp. v. Blue Cross Associa- tion/Blue Cross of Florida, Inc., [1983-1 Trans- fer Binder] Medicare and Medicaid Guide (CCH) © 32,316 (Nov. 4, 1982)... ae 39 Mt. Diablo Hospital v. Sullivan: 963 F.2d 1175 (9th Cir. 1992), petition for cert. pending, No. 92-720 6, 35 No. C-89-2714-DLJ (N.D. Cal. May 24, 1990), rev'd, 963 F.2d 1175 (9th Cir. 1992), peti- tion for cert. pending, No. 92-720 36 Mt. Sinai Hospital of Greater Miami, Inc. v. Wein- berger, 376 F. Supp. 1099 (S.D. Fla. 1974), aff'd, 517 F.2d 329 (5th Cir. 1975) 38 Red Lion Broadcasting Co. v. FCC, 395 U.S. 367 PPS E se NETS eae. «alth maintenance organizations. If anything, that Sec- tion’s language (providing for “suitable retroactive corrective ad- justments at the end of each contract year” (emphasis added) ) and structure (as an alternative to an incentive payment system prem- ised on year-end accounting) support the Secretary's construction of the same phrase as used in clause (ii). In any event, the ruling is consistent with the proposition that any obligation to provide appropriate adjustments to cost limits of general applicability is satisfied by the exemptions and exceptions provided by the cost-limit regulations. See pages 31-32, supra. 42 thereby undermine the statutory goals of efficiency, fair- ness, and ease of administration. CONCLUSION The judgment of the court of appeals should be affirmed. Respectfully submitted. KENNETH W. STARR Solicitor General STUART M. GERSON Assistant Attorney General EDWIN S. KNEEDLER Assistant to the Solicitor General EDWARD C. DUMONT Assistant to the Solicitor General SUSAN K. ZAGAME ANTHONY J. STEINMEYER Acting General JOHN P. SCHNITKER Counsel Attorneys DARREL J. GRINSTEAD - Associate General Counsel HENRY R. GOLDBERG Deputy Associate General Counsel GERARD KEATING Attorney Department of Health & Human Services DECEMBER 1992 ov. 8. Coveenment peiwrine orrice, 1992 342479 60126 --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385013_0284%3A6. Public record. Not legal advice.