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ALJ/MAC Decision Database


 

ACTIVE CASES
 

  • No. 06-1607 (D.D.C.), filed September 15, 2006, appeal filed September 29, 2006 (No. 06-5295, D.C.Cir.)
     

    At issue in this case is whether the Secretary's refusal to inform 230,000 Part D-enrolled beneficiaries, who mistakenly were sent money reflecting the amount of their monthly premiums, of their right to request waiver of recovery, while demanding repayment by September 30, 2006, violated the Medicare statute and the Due Process Clause.
    Updated: October 22, 2010
     

  • Anderson v. Leavitt

    No. 09-cv-16 (D.Vt.), filed January 22, 2009

     

    At issue in this case is whether the Secretary's policy of terminating Medicare coverage for a home health patient on the ground that her condition is stable or is not improving violates the Medicare statute and regulations.

    Updated: October 22, 2010
     

  • Back v. Sebelius

    No. 09-1706 (C.D.Cal.), filed September 8, 2009

     

    At issue in this case is whether the absence of an administrative appeals process for the denial of services by a hospice violates the Medicare statute and the Due Process Clause.
    Updated: October 22, 2010
     

  • Center for Medicare Advocacy, Inc. v. Department of Health and Human Services

    No. 09-cv-672 (D.Conn.), filed April 24, 2009

     

    At issue in this case is whether a request under the Freedom of Information Act (FOIA), 5 U.S.C. 552, about the possible failure of Part D plans to reimburse LIS beneficiaries for premium payments for which they were not responsible, had to be answered in a timely fashion.
    Updated: October 22, 2010

     

  • Center for Medicare Advocacy, Inc. v. Department of Health & Human Services
    No. 10-cv-645 (D.Conn.), filed April 27, 2010

    At issue in this case is whether a request under the Freedom of Information Act (FOIA), 5 U.S.C. 552, about how Medicare's Improvement Standard is explained to employees of CMS and its contractors, had to be answered in a timely fashion.
    Updated: October 22, 2010
     
  • Fournier v. Leavitt

    No. CV 08-2309-PHX-ROS (D.Ariz.), filed December 18, 2009

     

    At issue in this case is whether the Medicare program's prohibition against coverage of dental services should apply to extraordinary dental care necessary to treat a medical condition.

    Updated: October 22, 2010

     

  • Garcia v. Johnson

    No. 09-1747 (E.D.Pa.), filed April 24, 2009

     

    At issue in this case is whether the failure of the state and federal defendants to coordinate the exchange of information necessary to ensure that the beneficiaries of the Medicare Savings Program have their Medicare premiums timely paid by the Medicaid program violates the Medicare and Medicaid statutes and the Due Process Clause.

    Updated: October 22, 2010
     

  • Haro v. Johnson

    No. 09-cv-134-TUC-DCB (D.Ariz.), filed March 10, 2009

     

    At issue in this case is whether the Secretary's aggressive methods for attempting to collect payments under his Medicare Secondary Payer (MSP) program, directed at beneficiaries and their attorneys, violates the Medicare statute and the Due Process Clause.

    Updated: October 22, 2010
     

  • Prendergast v. Leavitt
    No. 3:08-CV-1148 (AHN) (D. Conn.), filed July 31, 2008

    At issue in this case is whether the use of a "stability" test to terminate home health coverage on the ground that the patient no longer needs skilled nursing care violates the Medicare statute and regulations.
    Updated: October 22, 2010
     

  • Situ v. Leavitt
    No. C06-02841-TEH (N.D.Cal.), filed April 26, 2006

    At issue in this case is w
    hether CMS' failure to correctly implement the Part D prescription benefit for hundreds of thousands of dual eligibles violates the Medicare status and the Due Process Clause.
    Updated: October 22, 2010
     

  • United Healthcare Insurance Co. d/b/a Evercare v. Sebelius & Starkowski
    No. 09-cv-1927-MJD-JSM (D.Minn.), filed July 23, 2009

     

    At issue in this case is whether the Secretary’s coverage of enteral feeding by a Part C plan on the ground that it was a skilled nursing service was correct.

    Updated: October 22, 2010
     

 
 


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