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Board of Trustees of the University of Arkansas v. Secretary of Health & Human Services
District Court, E.D. Arkansas (2005) | 354 F. Supp. 2d 924; 2005 U.S. Dist. LEXIS 13465; 2005 WL 245917
TL;DR: A hospital challenged a Medicare denial for a cancer treatment package. The court reversed the agency, finding its denial of coverage for medically necessary high-dose chemotherapy, which was bundled with a non-covered stem cell transplant, was arbitrary and unsupported by substantial evidence.
Legal Significance: Demonstrates judicial review of agency action, holding that an agency cannot deny coverage for a medically necessary, covered service simply because it is administered in conjunction with a non-covered procedure, especially when the two are severable for billing and medical purposes.