Shalala

At issue in this case is Foothill Presbyterian Hospital’s reimbursement from Medicare for inpatient hospital services for fiscal year 1983. The Hospital argues that the district court erred in holding that its 1992 request for an exception to its 1983 target rate limit under 42 U.S.C. § 1395ww(b)(4)(A) and 42 C.F.R. § 413.40 (e) was untimely. Although the Hospital’s target rate limit was revised in the second revised notice of program reimbursement (“NPR”) in 1991, the revision was based solely on malpractice insurance costs and wholly unrelated to the Hospital’s request for an exception due to atypical services. We hold that the atypical services issue had to have been raised vwthin 180 days of the initial NPR, in 1985. Thus, the exception request in 1992 was untimely.

I. Background

A. Statutory and Regulatory Framework

Under the Medicare statute, 42 U.S.C. §§ 1395 to 1395cce (1988), the Secretary of Health and Human Services reimburses health care providers for services provided to Medicare patients. Foothill Presbyterian Hospital is a provider of hospital services under the Medicare program. During the period of time relevant in this case, the Medicare statute authorized…