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Public Health — Medicare

U.S. Court of Appeals for the 7th Circuit


Public Health — Medicare

The Secretary of Health and Human Services reasonably has interpreted the Medicare Act to exclude compensation for pure research activities.

“In fact, there are good reasons to think that Congress affirmatively wanted to grant the Secretary the power to exclude pure research time from the IME costs calculation for periods before 2001. As the Secretary explained when promulgating the new regulations, her view on ‘non-patient care activities’ is that the concept of ‘care’ remains important; the activities must relate to the treatment of patients. For example, she explained, ‘didactic conferences and seminars’ can include ‘administrative rotation[s], which would include resident training in the administrative aspects of medical care such as practice management,’ and may also ‘involve presentations or discussions related to the treatment of current patients.’ 75 Fed. Reg. 71,800, 72,144, 72,146 (Nov. 24, 2010). Moreover, didactic non-patient care activities tend to take place ‘when an intern or resident is otherwise as-signed to a rotation primarily requiring the provision of patient care,’ whereas pure research is usually conducted in large blocks of time when a resident is not expected to render care to patients. Id. at 72,145–46. We can assume that this understanding of ‘non-patient care activities’ is not required under the statute, but it is rational and consistent with the distinction Congress drew and the scope of its delegation to the Secretary.”

Reversed and Remanded.

13-3285 Rush University Medical Center v. Burwell

Appeal from the United States District Court for the Northern District of Illinois, Lefkow, J., Wood, J.

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