In an action by a Medicare Part B beneficiary challenging a decision by a regional Medicare contractor to reimburse for a particular drug only up to the price of its least costly alternative, summary judgment for plaintiff is affirmed where the Medicare Act unambiguously foreclosed that determination and required instead that Medicare pay for covered items or services at a statutorily prescribed rate.
Read Hays v. Sebelius, No. 08-5508
Appellate Information
Argued November 5, 2009
Decided December 22, 2009
Judges
Opinion by Judge Tatel
Counsel
For Appellants:
Samantha L. Chaifetz, Mark B. Stern and Christopher C. Fonzone, U.S. Department of Justice, Washington, DC
For Appellee:
Stuart M. Gerson and Robert E. Wanerman, Epstein Becker & Green LLP, Washington, DC
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