Himmler v. Califano

ENGEL, Circuit Judge.

In this appeal we are called upon to decide whether the Social Security Act and the Due Process Clause of the Fifth Amendment require the Secretary of Health, Education and Welfare to provide notice and an opportunity for a hearing before medical expenses already incurred by eligible Medicare recipients can be initially rejected by a fiscal intermediary for Medicare payment as not “medically necessary” when such services were previously certified as necessary by the beneficiary’s physician and by a utilization review committee. We hold that the regulatory *139scheme at issue…