Grijalva v. Shalala

WIGGINS, Circuit Judge:

Medicare beneficiaries enrolled in health maintenance organizations (“HMOs”) in Arizona sued the Secretary of Health and Human Services (“Secretary”). Their suit alleged a failure to enforce due process requirements and a failure to monitor HMO denials of medical services to enrolled Medicare beneficiaries. The district court granted Plaintiffs summary judgment, holding that HMO denials of medical services to Medicare beneficiaries constitute state action and that the regulations issued by the Secretary fail to provide due process. The district court issued an…