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D.C. Circuit: Federal Courts Have Jurisdiction Over APA Challenges to Denial of Coverage—El Rio Santa Cruz Neighborhood Health Center, Inc. v. HHS

Published online by Cambridge University Press:  06 January 2021

Wendy Chan
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Type
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Information
American Journal of Law & Medicine , Volume 31 , Issue 1 , March 2005 , pp. 131 - 134
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2005

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References

1 No. 04-5089, 2005 U.S. App. LEXIS 1966 (D.C. Cir. Feb. 8, 2005) [hereinafter El Rio].

2 5 U.S.C. §§ 701-706 (2005).

3 28 U.S.C. § 1346 (2005).

4 El Rio, 2005 U.S. App. LEXIS 1966, at 3.

5 Id.

6 Id.

7 Id. The FSHCAA was enacted by Congress to relieve publicly funded health centers of the burden of malpractice insurance costs. See El Rio, 2005 U.S. App. LEXIS 1966, at 4-5 (citing H.R. Rep. No. 104-398, at 5-6 (1995), reprinted in 1995 U.S.C.C.A.N. 767, 769; H.R. Rep. No. 102- 823(II), at 5-6 (1992)). To be considered for FTCA coverage, the health center must submit an application to the HHS Secretary verifying that the health center and the individual seeking coverage meet FSHCAA requirements. 42 U.S.C. § 233(g)(1)(D) (2005); see also §§ 233(g)(1)(B)-(C), (h). The Secretary must reply within thirty days with a determination. § 233(g)(1)(E). If the HHS Secretary approves an application for coverage, the individual is deemed an employee of the Public Health Service. § 233(g)(1)(F). The Attorney General is then required to defend the individual against subsequent malpractice actions. § 233(b), (d).

8 El Rio, 2005 U.S. App. LEXIS 1966, at 2.

9 Id. at 7.

10 Id.

11 Id.

12 Id. at 8.

13 Id. The Arizona state court stayed the physicians’ medical malpractice case pending resolution of their APA claim. Id.

14 Id. at 9-10.

15 Id. at 9.

16 Id.

17 Id.

18 Id. at 10.

19 5 U.S.C. § 704 (2005).

20 El Rio, 2005 U.S. App. LEXIS 1966, at 10-11.

21 Id. at 10-13.

22 Id. at 15. The plain text of the statute speaks only to the final and binding nature of the Secretary's affirmative coverage determinations. The removal remedy is mentioned only in connection with the Attorney General's appearance to certify that a defendant was acting in the scope of his employment, which assumes a positive coverage determination has already been made. The statute remains silent as to a remedy for negative coverage determinations. The legislative history of the FSHCAA shows that Congress intended the removal section to apply only where the defendant has already been found to be covered by the FTCA. Id.

23 Id.

24 Id. at 20-22.

25 Id. at 22.

26 Id. at 23.

27 Id.

28 Id.

29 Id.

30 Id.

31 Id. at 24.

32 Id. at 20.

33 Id. at 31.

34 Id. at 28-29 (citing Gray v. Poole, 275 F.3d 1113, 1119 (D.C. Cir. 2002)).

35 Id. at 29.

36 Id. at 30.

37 Id. at 30-31.

38 Id. at 31; 5 U.S.C. § 706(2)(A) (2005).

39 El Rio, 2005 U.S. App. LEXIS 1966, at 32.

40 Id. at 35.

41 Id. at 38-39.