Ronald Fournier v. Kathleen Sebelius

Appellants Delores Berg and Thomas DiCecco are Medicare beneficiaries who suffer from medical conditions that caused significant dental problems, and they received dental services to correct those problems. But the Secretary of the Department of Health and Human Services (HHS) denied coverage for those services. Appellants contend that this denial was premised on the Secretary’s unreasonable interpretation of the Medicare Act, which contravenes the intent of Congress and violates Appellants’ right to equal protection under the Fifth Amendment. We affirm the district court, holding (1) that the statute under which the Secretary denied coverage is ambiguous on the question Appellants raise; (2) that Chevron deference applies; (3) that the Secretary’s interpretation of the statute is reasonable; and (4) that the denial does not violate Appellants’ Fifth Amendment rights.

I

Berg is a Medicare Advantage beneficiary. She suffers from Sjogren’s Syndrome, which has left her unable to produce saliva. As a result, she lost teeth, her gums deteriorated, and her bite collapsed. Berg’s lack of saliva made her prone to gum infections, which put her at risk of a life-threatening heart…