San Bernardino Mountains Community Hospital District v. Secretary of Health & Human Services

This appeal arises from the district court’s grant of summary judgment in favor of the Secretary of the Department of Health and Human Services upholding the validity of its regulation governing “sole community hospital” status under the Medicare Act, 42 C.F.R. § 412.92 (a) (1994). The San Bernardino Mountains Community Hospital District (“the District”) operates Mountains Community Hospital, which is located in Lake Arrowhead, California, within the County of San Bernardino. Lake Arrowhead is a mountainous region in the San Bernardino National Forest. Mountains Community Hospital is a general care hospital with fewer than fifty beds. The two nearest like-facilities to the hospital are located between twenty-five and thirty miles away. The District contends that, due to its location, weather and travel conditions, and the absence of other like hospitals nearby, the hospital is the sole source of hospital services reasonably available to individuals in and around Lake Arrowhead. The hospital seeks to be classified as a sole community hospital to be exempted from cost limits established under the Medicare program and thereby increase the amount it is reimbursed for treating Medicare…