Supreme Court schedules hearings in hospitals’ Medicare payment dispute and other cases

The Supreme Court announced on July 26 that it will hold oral arguments for nine cases in October and seven cases in November, including a Medicare-related appeal.

Among the other cases to be heard this fall are claims from military veterans who argue they were wrongly denied medical benefits, a claim from a truck driver who says he was mistakenly fired for marijuana use, and two immigration appeals.

The court is currently on its summer recess and will resume hearing oral arguments on the first Monday in October.

Medicare Case

The Supreme Court will hear Advocate Christ Medical Center v. Becerra on Nov. 5. Justices granted the medical organization’s petition on June 10.

Hospitals want to clarify a 2022 ruling that spelled out how Medicare calculates payments for hospitals that serve low-income patients. In the earlier decision, Becerra v. Empire Health Foundation, the justices voted 5-4 to reject a challenge from a hospital system that serves low-income people and upheld the government reimbursement formula.

At issue was how HHS calculates Medicare payments to “disproportionate share hospitals,” sometimes referred to as “DSH hospitals,” which largely serve low-income patients.

Although hospitals are paid predetermined amounts for each Medicare patient, Congress decided that DSH hospitals should receive higher fees to cover the higher cost of treating low-income individuals, who are often in worse health.

In 2017, Advocate Christ Medical Center and more than 200 hospitals claimed they were being underpaid by the system and filed suit against HHS over how the agency calculated DSH payments. They said the government’s formula failed to take into account the care rendered to patients eligible for Supplemental Security Income (SSI) benefits, which the department uses to approximate care given to low-income individuals.

Individuals with a low income, who are blind or have a disability, or who are 65 or older may qualify for SSI benefits.

The U.S. Court of Appeals for the District of Columbia Circuit upheld the existing funding formula in September 2023.

Trucker Fired After Using CBD Product

The Supreme Court said it will hear Medical Marijuana Inc. v. Horn on Oct. 15.

On April 29, the justices granted the petition of a commercial truck driver who says he lost his job after testing positive for tetrahydrocannabinol (THC), the psychoactive chemical compound in marijuana that produces a high. The driver consumed a hemp-based product that was advertised as THC-free.

The case comes as more states are legalizing marijuana and marijuana-derived products and the popularity of products made from marijuana is rising. Cannabidiol (CBD) products, often in the form of candy gummies, are also becoming more popular. Such products contain hemp, a relative of marijuana, but not THC, and aren’t impairing.

The driver, Douglas Horn, says he unwittingly consumed THC when he used a cannabis-derived product that was marketed as THC-free, and that he had never used marijuana or any THC-based products. The product he consumed, which is produced by Medical Marijuana Inc., is called Dixie X CBD Dew Drops Tincture and is supposed to alleviate pain.

After his employment was terminated following a random drug test, Mr. Horn sued in federal district court claiming the manufacturer of the product was violating federal racketeering laws. Such laws target illegal profit-making activities that are sometimes disguised as legitimate business activities. He also claimed other businesses in the product’s supply chain violated the Controlled Substances Act and committed mail and wire fraud.

The U.S. Court of Appeals for the Second Circuit ruled in August 2023 that Mr. Horn was entitled to sue for damages because his use of the product led to him losing employment-related wages and benefits.

The product maker argues that allowing the suit to proceed would open the floodgates to a wave of new racketeering lawsuits.

Veterans Benefits Case

The Supreme Court announced it will hear Bufkin v. McDonough on Oct. 16. The petition filed by two veterans was granted on April 29.

The veterans say they were improperly denied medical benefits needed to treat post-traumatic stress disorder (PTSD) alleged to have arisen during their military service.

U.S. Air Force veteran Joshua Bufkin and U.S. Army veteran Norman Thornton argue that even when it’s a close call as to whether an applicant qualifies, the Department of Veterans Affairs must still provide treatment.

The benefit-of-the-doubt rule, “which has been observed for more than a century, is now codified at 38 U.S.C. [Section] 5107(b): ‘When there is an approximate balance of positive and negative evidence regarding any issue material to the determination’ of a benefits claim, the Department of Veterans Affairs ‘shall give the benefit of the doubt to the claimant,’” according to their petition.

They argue that the U.S. Court of Appeals for Veterans Claims failed to properly apply the benefit-of-the-doubt rule in upholding the denial of benefits.

The U.S. Court of Appeals for the Federal Circuit affirmed in September 2023, holding that the lower court was only required to determine if there was a clear error based on the department’s factual findings.

The Department of Veterans Affairs stands by its decision to deny benefits.

Immigration Cases

On Oct. 15, the Supreme Court will hear Bouarfa v. Mayorkas, which is about whether the federal government can revoke an immigration visa after it determines the immigrant’s marriage to a U.S. citizen is a sham. The petition was granted in November 2023.

The government rescinded a Palestinian man’s visa after it found he previously attempted to pass off another one of his marriages as legitimate in order to obtain a green card. Because he allegedly engaged in fraud before, the current marriage was deemed fraudulent, and his visa, which had been approved, was revoked.

The government says its ruling is “discretionary” and can’t be challenged in the courts. Federal courts of appeal disagree on whether such decisions can reviewed by courts.

The petitioner, Amina Bouarfa, a U.S. citizen, married noncitizen Ala’a Hamayel. They had three children, all of whom are U.S. citizens, according to Ms. Bouarfa’s petition.

Ms. Bouarfa attempted to prove the previous marriage was legitimate but the government said the decision couldn’t be reviewed in court. She appealed to the courts, which sided with the government.

The Supreme Court will hear Velazquez v. Garland on Nov. 12. The petition was granted on July 2.

The court will take a look at how a 60-day deadline works for illegal immigrants who miss the deadline to leave the country after agreeing to self-deportation. The legal issue is whether such a deadline may be extended when it falls on a weekend.

Mexican citizen Hugo Abisai Monsalvo Velazquez came to the United States illegally as a teenager in 2004. He later married a U.S. citizen and they now have two children who are U.S. citizens.

The government put him in removal proceedings and he was given a notice to appear but it didn’t contain the date and time of the removal hearing, saying the hearing would be held “on a date to be set at a time to be set,” he stated in his petition.

After his request to stay in the country was denied, he asked to be able to leave on his own, a process known as voluntary departure or self-deportation. An immigration court allowed him to leave by a certain date, which happened to be a Saturday when the court wasn’t open.

He filed papers seeking to reopen his case the day before the Saturday, but the Board of Immigration Appeals didn’t accept them until Monday, the next business day.

The board should have accepted the papers and allowed the legal process to continue, he argues.

The federal government says the rule about the legal filing deadline in the case was interpreted properly.

This article by Matthew Vadum appeared July 29, 2024, in The Epoch Times.