SOUTHWEST PHARMACY SOLUTIONS v. CTRS. FOR MEDICARE

No. 12-40097.

718 F.3d 436 (2013)

SOUTHWEST PHARMACY SOLUTIONS, INCORPORATED, doing business as American Pharmacies, Plaintiff-Appellant, v. CENTERS FOR MEDICARE AND MEDICAID SERVICES; Donald M. Berwick, solely in his official capacity as Administrator of The Centers for Medicare and Medicaid Services; Kathleen Sebelius, Secretary of the United States Department of Health and Human Services, solely in her official capacity; United States Department of Health and Human Services, Defendants-Appellees.

United States Court of Appeals, Fifth Circuit.

May 1, 2013.


Attorney(s) appearing for the Case

Miguel Sergio Rodriguez (argued), Isabelle Maria Antongiorgi , Attorney, Donald Ray Taylor , Attorney, Taylor Dunham , L.L.P., Austin, TX, for Plaintiff-Appellant, Southwest Pharmacy Solutions, Incorporated, doing business as American Pharmacies.

Dana Lydia Kaersvang, Esq. , (argued), Michael S. Raab , Caroline Lewis Wolverton , U.S. Department of Justice, Washington, DC, John Albert Smith, III , Assistant U.S. Attorney, U.S. Attorney's Office, Corpus Christi, TX, for Defendants-Appellees, Centers for Medicare and Medicaid Services, Donald M. Berwick, solely in his official capacity as Administrator of the Centers for Medicare and Medicaid Services, Kathleen Sebelius, Secretary of the United States Department of Health and Human Services, solely in her official capacity, United States Department of Health and Human Services.

Before WIENER, CLEMENT, and PRADO, Circuit Judges.


EDITH BROWN CLEMENT, Circuit Judge:

The sole issue on appeal is whether the district court properly dismissed Southwest Pharmacy Solutions's claim for lack of subject matter jurisdiction. While 42 U.S.C. § 405(h) clearly requires a plaintiff to exhaust administrative remedies before filing a claim in federal court, the Supreme Court has provided a narrow exception to this rule in Shalala v. Illinois Council on Long...

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