WESTERN MEDICAL ENTERPRISES, INC., Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant-Appellee

This appeal involves a decision of the Medicare system’s Provider Reimbursement Review Board (Board) that there was no good cause shown by Western Medical Enterprises (Western) for an extension of the 180-day period to appeal a final reimbursement determination. Western sought judicial review of that decision but the district court found it had no jurisdiction to review the Board’s decision and dismissed the action. The court also held that, even if it had jurisdiction, it would uphold the Board’s findings. We find that the Board’s decision is reviewable and we affirm the district court on the ground that the Board did not abuse its discretion.

I. FACTS

Western operates either directly or through wholly owned subsidiaries thirty-nine health care facilities that provide Medicare services. Title XVIII of the Social Security Act establishes a Medicare program which provides health insurance benefits to eligible aged and disabled persons. 42 U.S.C. § 1395 (1982). Western is a “provider” of Medicare services entitled to certain payments under the act. Providers are reimbursed by the government, usually through insurance companies that act as “fiscal intermediaries” under contract…