Sebelius

Full Life Hospice is a hospice care provider participating in the federal Medicare program. Over a number of years, it provided hospice care services to terminally ill Medicare beneficiaries and sought reim *1014 bursement for these services from the Department of Health and Human Services (HHS). A fiscal intermediary, acting on behalf of HHS, later contested some of these reimbursements and demanded repayment of funds that it claimed were distributed in excess of a spending cap.

Full Life then unsuccessfully challenged HHS intermediary’s determination through an administrative appeal, which was denied as untimely. On appeal to the district court, the court found no basis to excuse Full Life’s untimely challenge. We agree with the district court that it lacked subject matter jurisdiction because of Full Life’s failure to file a timely administrative appeal. Accordingly, exercising jurisdiction under 28 U.S.C. § 1291 , we AFFIRM.

I. Background

A. Statutory and Regulatory Background

Medicare pays hospice care providers a predetermined amount for each day a Medicare beneficiary receives hospice care. See 42 U.S.C. § 1395f(i)(l)(A). This amount is subject to a spending cap. Id. §…