County of Los Angeles v. Leavitt

Opinion by Judge RYMER; Dissent by Judge REINHARDT.

RYMER, Circuit Judge:

This appeal, which involves Medicare reimbursement of indirect medical education expenses (IME) incurred by a public teaching hospital with an approved intern and resident program, presents two questions: first, whether it was arbitrary and capricious for the Secretary of Health and Human Services to interpret the Medicare statute and regulations providing for IME payment on the basis of “available beds” as presumptively meaning physical beds, when the hospital’s fiscal intermediary had previously accepted a calculation…