Baylor County Hospital Dist v. Thomas Price

EDITH H. JONES, Circuit Judge:

In 1997, Congress created a favorable Medicare reimbursement schedule for rural facilities designated as “critical access hospitals.” 42 U.S.C. §§ 1395i-4, 1395f. A critical access hospital is defined in part by the type of roads that connect the facility to the next nearest hospital. Congress used the term “secondary roads” in the definition, but it neither defined that term nor contrasted it with “primary roads.” To fill that gap, an agency within the Department of Health and Human Services (DHHS) issued a manual that defines “primary roads” as, inter alia,…