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HAYS v. SEBELIUS

No. 08-5508.

589 F.3d 1279 (2009)

Ilene HAYS, Appellee v. Kathleen SEBELIUS, Secretary of the United States Department of Health and Human Services, et al., Appellants.

United States Court of Appeals, District of Columbia Circuit.

Decided December 22, 2009.

Attorney(s) appearing for the Case

Samantha L. Chaifetz, Attorney, U.S. Department of Justice, argued the cause for appellants. On the briefs were Mark B. Stern and Christopher C. Fonzone, Attorneys.

Stuart M. Gerson argued the cause for appellee. With him on the brief was Robert E. Wanerman.

Peter D. Keisler and Patrick Morrisey were on the brief for amicus curiae Sepracor Inc. in support of appellee.

Concurring opinion filed by Senior Circuit Judge RANDOLPH.

TATEL, Circuit Judge:

Appellee, a Medicare Part B beneficiary, challenges a decision by a regional Medicare contractor to reimburse for a particular drug only up to the price of its least costly alternative. The district court held that the Medicare Act unambiguously forecloses that determination and requires instead that Medicare pay for covered items or services at a statutorily prescribed rate. Agreeing with the district court, we affirm.

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