Paramount Health Systems, Inc. v. Wright’s Empirical Analysis

Citation profile

5 federal appellate · 1 district · 4 state decisions

Most-quoted passages

The sentences later courts lift from this opinion, ranked by how many decisions quote each — the parts of the opinion doing the work. These counts are smaller than the citation total above because most of the 16 citing decisions cite the case generally; a passage count includes only decisions quoting that exact language verbatim.

1. “constrained by Loving to give some weight to Congress’s declaration in the Balanced Budget Act that providers of services to [QMBs] are not entitled to reimbursement at full Medicare rates. Although we don’t know how much weight to give it — probably rather little in the circumstances — it is enough to tip the balance in favor of Chevron deference. The Act is a hopeless muddle so far as [QMB] reimbursement is concerned, and while it seems to us that [the health care providers have] the better interpretation, there is sufficient ambiguity to require us to defer to the government.”

   2 later decisions quote this exact passage · from the majority
   e.g. 1 F. Supp. 2d 32 - McCreary v. Offner · 323 N.J. Super. 434 - Blecker v. State

2. “There is an air of unreality in treating section 4714(a) as an attempted clarification of original statutory meaning, although it is captioned “Clarification Regarding State Liability for Medicare Cost-Sharing.” The disputed [QMB] provisions date from 1986 . ..■ — eleven years before the Balanced Budget Act was passed. The membership of Congress had largely turned over during the interim and surely few member of the 105th Congress who had been members of Congress back in 1986 remembered what the membership’s intentions had been regarding the esoteric issue of the reimbursement rate for providers of medical services to [QMBs]. In any event, Congress is not an interpretive body and has no felt duty to maintain continuity with the past. “The views of a subsequent Congress form a hazardous basis for inferring the intent of an earlier one.” The location of the 1997 amendments in a statute labeled the “Balanced Budget Act” and concerned primarily with cutting the federal deficit hardly creates confidence that Congress was, court-like, interpreting the 1986 statute. It is far more realistic to regard the 1997 [QMB] provisions as designed to change the original statute in order to reduce the cost of Medicaid to the federal government. Nothing in the provisions themselves suggests a process of interpretation; they merely declare that the states are not required to reimburse [QMB] providers at the Medicare rate.”

   1 later decision quote this exact passage · from the majority
   e.g. 1 F. Supp. 2d 32 - McCreary v. Offner

3. “Suppose that for the same service the Medicare-approved rate is $100 and the Medicaid-approved rate only $70. [The health care provider] claims that when it renders the service to a [QMB], it is entitled to be reimbursed $80 by the federal government (which is conceded) and (what is contested) $20 by the state (of which the actual cost to the state would be at most $10, since the federal government pays at least half). Otherwise [the health care provider] will be rendering for only $80 a service to a Medicare beneficiary for which Medicare entitles it to $100. The government counters that the proper payment is $70, the Medicaid rate, and that since Health and Human Services is reimbursing the provider $80, the state need give the provider nothing; the provider is already being overpaid, since $80 is larger than $70.”

   1 later decision quote this exact passage · from the majority
   e.g. 1 F. Supp. 2d 32 - McCreary v. Offner