Medicare Part B Coverage – Standing to Sue

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7^th Circuit Court of Appeals

Case Name: Anniken Prosser v. Xavier Becerra

Case No.: 20-3070

Officials: FLAUM, BRENNAN, and SCUDDER, Circuit Judges.

Focus: Medicare Part B Coverage – Standing to Sue

Anniken Prosser suffers from an aggressive brain cancer called glioblastoma multiforme. To treat her disease, Prosser uses a promising electric field treatment called tumor treating fields therapy. She will receive this therapy for the rest of her life. To pay for the therapy, Prosser enrolled in the supplemental insurance program within Medicare Part B. She files a benefits claim with Medicare for each period she receives TTF therapy. Medicare denied coverage for the treatment period January to April 2018. Though Prosser received the therapy and owed nothing out of pocket, the denial left the supplier of the treatment, Novocure, Inc., with the bill. Prosser challenged this denial by availing herself of Medicare’s multilayer appeals process, losing at each level and eventually reaching federal court.

The district court dismissed Prosser’s claim for Medicare Part B coverage, holding that she has suffered no injury-infact sufficient to satisfy Article III’s standing requirement. We agree. Prosser received—and continues to receive—the TTF therapy. She faces no financial liability for the treatment period Medicare denied coverage. And any future financial risk is too attenuated from the denial of the past coverage at issue here and far too speculative to establish standing. We therefore lack authority to hear Prosser’s claim and affirm the dismissal of her complaint.

Affirmed

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Derek A Hawkins is Corporate Counsel, at Salesforce.