Stanley L. Drennan, M.D. v. Patricia Harris (Successor to F. David Mathews), Secretary of Health, Education and Welfare and Blue Shield of California

Appellant, a physician, seeks judicial review of the determination of the Department of Health, Education and Welfare (HEW) and Blue Shield of California to recoup alleged overpayments made to appellant for medical services rendered by him to elderly patients under the Medicare Program. We find that the district court lacked jurisdiction to consider the appellant’s claim and remand this case to the district court with directions to transfer the cause to the United States Court of Claims.

BACKGROUND

The Medicare Program, 42 U.S.C. § 1395 et seq., consists of two basic parts: Part A, which provides for insurance for hospital services, 42 U.S.C. § 1395c-1395i-2, and Part B, which provides for supplemental medical services, primarily physicians’ services, 42 U.S.C. § 1395j-1395w. Individuals covered under Part B can either request reimbursement for payments themselves or assign the right to reimbursement to the physician, § 1395u(b)(3)(B)(ii). Part B is administered through private intermediaries such as Blue Shield, called “carriers,” who are authorized to set rates, review claims and make payments on behalf of HEW. 42 U.S.C. § 1395u.

Appellant, Dr. Stanley Drennan, is a medical…