Univ. of TX M.D. Anderson v. Sebelius, No. 10-5201 (D.C. Cir. 2011)
Annotate this CaseThis case involved cost-saving tools that Congress had devised for Medicare payments to cancer hospitals and specifically concerned Medicare reimbursements paid to one cancer hospital, appellant, in 2000 and 2001. The first issue on appeal related to the cancer hospitals' inpatient costs where appellant requested an increase to its target amount in 2000 and 2001 due to the high cost of certain new cancer drugs and where the Department of Health and Human Services ("HHS") denied that request. Appellant argued that it did not receive proper notice of the new net financial impact requirement and thus did not have a fair opportunity to satisfy the requirement at the administrative hearing. The court agreed and held that appellant did not receive timely notice of the requirement and, on remand to HHS, must be given an opportunity to satisfy it. The second issued on appeal concerned cancer hospitals' outpatient costs where appellant contended that HHS misapplied the statutory formula that provided hospitals a fraction of their reasonable costs and undercompensated appellant. The court rejected appellant's arguments and affirmed summary judgment in favor of HHS.
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