Shalala v. Illinois Council on Long Term Care, Inc.
United States Supreme Court
529 U.S. 1 (2000)
The Illinois Council on Long Term Care (ICLTC, plaintiff), an association of nursing homes participating in Medicare Part A, sued the Secretary of Health and Human Services (Shalala, defendant) in federal court under general federal-question jurisdiction, alleging certain Medicare regulations were unconstitutional and violated federal statutes; the district court dismissed for lack of jurisdiction, finding that 42 U.S.C. Section 405(h) created a separate, exclusive administrative and judicial review system for Medicare claim denials that barred ordinary federal-question suits, but the court of appeals reversed, and the Supreme Court granted certiorari.
Whether an individual or entity challenging the legality of a Medicare regulation must utilize the specific review process created by the regulation.