Frazier

Frazier v. Johnson

Good Law
312 F. App'x 879
United States Court of Appeals for the Ninth CircuitFebruary 20, 2009No. 06-56652California929 words

Opinion

Lead Opinion

MEMORANDUM **

Robert E. Frazier, an enrollee in a qualified Medicare plan, appeals pro se the district court’s summary judgment uphold *881 ing the Secretary’s denial of reimbursement for the cost of surgery performed by a doctor outside of the plan. Although our review is de novo, we will not reverse the Secretary’s decision unless it is “arbitrary, capricious, an abuse of discretion, not in accordance with the law, or unsupported by substantial evidence on the record taken as a whole.” Wilmot Psychiatric/Medi-center Tucson v. Shalala, 11 F.3d 1505 , 1506 (9th Cir.1993) (internal quotation marks omitted). Applying that standard, we affirm.

DISCUSSION

Frazier contends his out-of-plan surgery was medically necessary and superior to what his plan offered. The record indicates, however, that his Medicare health provider, Kaiser Foundation Health Plan (Kaiser), offered similar, if not essentially the same, treatment that Frazier ultimately received from the out-of-plan physician. Indeed, an independent review board, the Center for Health Dispute Resolution (CHDR), rejected Frazier’s request for the out-of-plan surgery, reasoning that Kaiser offered “a medically appropriate…

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