No. 3:15-cv-1468-JAM, filed October 9, 2015Issue: Whether the extremely high denial rates (98% and higher) at the redetermination and reconsideration stages of administrative review for home health care claims violate the Medicare statute and the … [Read more...] about Olsen-Ecker v. Burwell
Archived Cases
Bremby v. Burwell
No. 3:15-cv-01397 (DJS), filed September 22, 2015Issue: Whether the Secretary violated the Medicare statute and the Due Process Clause by not recognizing that Vitamin B-12 injections represent a per se skilled nursing service and therefore the … [Read more...] about Bremby v. Burwell
Lodge v. Burwell
No. 3:15-cv-00390-JBA (D.Conn.), filed March 17, 2015Issue: Whether extraordinary dental care should be covered because the exclusion for coverage of dental care should be limited to routine dental care.Relief Sought: Reversal of the Secretary’s … [Read more...] about Lodge v. Burwell
Ryan v. Burwell
No. 5:14-cv-269 (D.Vt.), filed Dec. 19, 2014Issue: Whether the failure of the Secretary to apply the “prior favorable homebound decision” rule, which accords “great weight” to previous administrative decisions establishing homebound status, … [Read more...] about Ryan v. Burwell
Lessler v. Burwell
No. 3:14-cv-01230 (D.Conn.), filed August 26, 2014Issue: Whether the consistent failure of administrative law judges (ALJs) to issue decisions within 90 days of the request for ALJ review (with an average delay now approaching 500 days) … [Read more...] about Lessler v. Burwell
Haro v. Johnson
No. 09-cv-134-TUC-DCB (D.Ariz.), filed March 10, 2009. Appeal filed June 30, 2011 (No. 11-16606, 9th Cir.).Issue: Whether the Secretary's aggressive methods for attempting to collect payments under his Medicare Secondary Payer (MSP) program, … [Read more...] about Haro v. Johnson
Hull v. Sebelius
No. 14-801 (D.Conn.), filed June 4, 2014Issue: Whether the Secretary of Health & Human Services’ denial rate of about 98% at the lowest two levels of appeal in Medicare’s system of administrative review (redetermination and reconsideration) … [Read more...] about Hull v. Sebelius
Jimmo v. Burwell
No. 5:14-cv-128 (D.Vt.), filed June 23, 2014Issue: Whether the denial of coverage for named plaintiff Glenda Jimmo by the Medicare Appeals Council on re-review of her claim under the revised manual provisions pursuant to the Jimmo settlement … [Read more...] about Jimmo v. Burwell
Prendergast v. Leavitt
No. 3:08-CV-1148 (AHN) (D.Conn.), filed July 31, 2008Issue: 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 … [Read more...] about Prendergast v. Leavitt
Fournier v. Leavitt
No. CV 08-2309-PHX-ROS (D.Ariz.), filed December 18, 2008. Appeal filed March 6, 2012 (No. 12-15478, 9th Cir.).Issue: Whether the Secretary's exclusion of coverage for dental care in extraordinary circumstances where the care is … [Read more...] about Fournier v. Leavitt