Aquavella v. Richardson

In Aquavella v. Richardson, 437 F.2d 397 (2d Cir. 1971), the Court held that a provider could obtain judicial review of the Secretary's decision to suspend reimbursement payments, although the Medicare Act did not expressly provide for judicial review of that category of decision,<#fn6> by recourse to "nonstatutory" review under the APA. Id. at 402. Subject matter jurisdiction to entertain this claim, we found, properly rested on general federal question jurisdiction, 28 U.S.C. Sec. 1331, provided, of course, the amount in controversy exceeded $10,000. Id. at 400 n. 9. In so holding, the Court necessarily met and resolved the contention urged by the Secretary that section 405(h)<#fn7> of the Social Security Act, incorporated into the Medicare Act by section 1395ii, expressly precluded judicial review of any decision by the Secretary unless such review was provided by the Medicare Act itself. After a thorough examination of the relevant legislative history as well as a prior interpretation of section 405(h) by this Court in Cappadora v. Celebrezze, 356 F.2d 1 (2d Cir. 1966), the Court construed the limitations of section 405(h) to apply only where a litigant sought to by-pass the judicial review procedures provided by the Medicare Act. The Court clearly noted: Where the Medicare Act establishes procedures for review of the Secretary's decision, a court may not review that decision by any other means. However, where the Act does not provide such procedures, section 405(h) does not preclude review. (Aquavella, supra, 437 F.2d at 402.)