Home Care Providers, Inc., et al v. Kelly Hemmelgarn, et al.

In a series of decisions over more than four decades, this Court has applied the exhaustion, exclusive remedy, and jurisdiction stripping provisions of Section 205 of the Social Security Act, 42 U.S.C. § 405, to lawsuits that are disguised claims for benefits and disguised attempts to review Medicare provider decisions made reviewable by 42 U.S.C. §§ 1395cc and 1395ii. But the Court has not barred claims for relief for independently tortious conduct that relates in some tangential way to the Social Security or Medicare programs. Here, the court of appeals applied the exhaustion provision to a fourth amendment claim simply because the State official conducting the unlawful search worked for a State survey agency, and applied the provision to equal protection and first amendment claims that did not relate to any claim for benefits, a provider penalty, or provider reimbursement status. Does the court of appeals’ decision conflict with this Court’s decisions in Shalala v. Illinois Council on Long Term Care, 529 U.S. 1 (2000); Heckler v. Ringer, 466 U.S. 602 (1984); and Weinberger v. Salfi, 422 U.S. 749 (1975) on this important question of federal law?

Section 405(g) provides a remedy under which a party may obtain judicial review of an administrative decision on benefits and §§ 1395cc and 1395ii apply that remedy to decisions involving provider eligibility or provider penalties. Section 405(h) requires the use of 405(g)’s remedy for matters within its scope and bars federal question and federal officer jurisdiction