Abbott Radiology Associates v. Shalala, X-R

Decision Date13 November 1998
Docket NumberX-R,Docket No. 97-6322
Citation160 F.3d 137
CourtU.S. Court of Appeals — Second Circuit
PartiesABBOTT RADIOLOGY ASSOCIATES; Javaid Asgher, M.D., P.C.; Bailey Radiology, P.C.; Batavia Radiology Group, P.C.; Buffalo Generalay Associates; Clarence Sheridan Radiology Group, P.C.; Elmwood Radiologists, P.C.; Diagnostic Imaging Associates; Saleh A. Petouh, d/b/a Breast Screening Center of WNY, M.D., P.C.; A. Paul Greiner, M.D., P.C.; Harlem Radiology, P.C.; Lancaster Radiology; Meadowlands Imaging Group, P.C.; Millard Fillmore Hospital Radiologists, M.D., Billing Agent; Niagara Radiologists, P.C.; North Tonawanda X-ray Center, P.C.; Nuclear Medicine Associates; Olean Radiology Associates, P.C.; Alvin M. Panahon, M.D.; Radiologic Physicians Of W.N.Y., P.C.; C. Riggio, M.D.; Riggio & Tetwesky, M.D.S., P.C.; Sisters Diagnostic Imaging Associates; Southtowns Radiological Group, P.C.; Gowanda Radiologists; Lakeshore Radiologists; Hamburg Radiologists; Tremont Radiological Group, and Ultrasound Associates, Plaintiffs-Appellants, v. Donna E. SHALALA, as Secretary of the Department of Health and Human Services and Department of Health and Human Services, Defendants-Appellees.

Robert J. Lane, Jr., Buffalo, NY (Ellen V. Weissman, Hodgson, Russ, Andrews, Woods, & Goodyear, LLP, Buffalo, NY, of counsel), for Plaintiffs-Appellants.

David A. Rawson, Assistant Regional Counsel, Office of the General Counsel, Department of Health and Human Services, New York City (Patrick H. NeMoyer, United States Attorney for the Western District of New York, Buffalo, NY, of counsel), for Defendants-Appellees.



Abbott Radiology Associates, et al. ("Plaintiffs"), appeal from a judgment of the United States District Court for the Western District of New York (Carol E. Heckman, Magistrate Judge ) entered November 20, 1997 in accordance with a decision and order of the same day granting summary judgment in favor of Donna E. Shalala, as Secretary of the Department of Health and Human Services (the "Secretary"), and the Department of Health and Human Services (together with the Secretary "Defendants"). Abbott Radiology Assocs. v. Shalala, 992 F.Supp. 212 (W.D.N.Y.1997).

On May 23, 1994, Plaintiffs commenced this action against Defendants, alleging that the Secretary had improperly calculated Plaintiffs' reimbursement for services rendered under the Medicare statute and regulations by applying the doctrine of "comparability." See 42 U.S.C. § 1395u(b)(3)(B); 42 C.F.R. § 405.508. After a series of adverse carrier rulings, Plaintiffs sought a hearing before a Health And Human Services ("HHS") Administrative Law Judge ("ALJ"), which was held on March 24 and 25, 1992. On June 25, 1992, ALJ Margaret Quinn denied Plaintiffs' requests for review and reopening of their reimbursement determinations. Plaintiffs' appeal to the HHS Appeals Council was unsuccessful. 1 In a November 20, 1997 decision and order, Magistrate Heckman affirmed ALJ Quinn's June 25, 1992 determination.

On appeal, Plaintiffs make substantially the same arguments asserted before the Magistrate Judge, which can be summarized as follows: (1) the Secretary's comparability policy is inconsistent with and in violation of the comparability statute and regulation; (2) the Secretary's interpretation of the Medicare statute and regulation represents an arbitrary and capricious alteration unsupported by a justification in the administrative record; (3) the...

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1 cases
  • Yale-New Haven Hosp. v. Leavitt
    • United States
    • U.S. Court of Appeals — Second Circuit
    • November 16, 2006
    ... ... Ctr. v. Shalala, 939 F.Supp. 1457, 1460 (C.D.Cal.1996), is the federally subsidized ... Ctr. v. Leavitt, 443 F.3d 163, 173-74 (2d Cir. 2006); see Abbott" Radiology Assocs. v. Shalala, 160 F.3d 137, 139 (2d Cir.1998) ...   \xC2" ... ...

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