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Supreme Court Nixes "Equitable Tolling" for Hospitals Seeking to File Late Appeals of Medicare Underpayments

Client Alert | 1 min read | 01.24.13

In Sebelius v. Auburn Regional Medical Center, the Supreme Court on January 22nd, 2013 rejected hospital arguments and found that equitable tolling did not extend the deadline for hospitals to appeal within HHS a government decision on their reimbursement under the Medicare program. The Court also found, though, that the underlying statute setting a 180 day limit for filing appeals was not "jurisdictional" in nature so that the Secretary of HHS had acted lawfully in adopting by regulation a "good cause" exception permitting an appeal within 3 years.  In this case, appeals were filed only after 10 years or more, but the hospitals claimed that the Secretary had prevented a timely appeal by suppressing the information the hospitals would have needed in order to know they had a basis for appeal. The Court noted that the parties involved were "'sophisticated' institutional providers" who are "repeat players" in the Medicare system, while noting that equitable tolling may well be appropriate in other contexts involving government programs. The Court's ruling was 9-0 to reverse a lower court ruling in the hospitals' favor. The decision appears to confirm a general administrative law principle that, where consistent with congressional intent, courts should grant deference to an agency rule extending an agency filing deadline to a non-arbitrary time certain, and should not then undermine the agency rule by judicially imposing equitable tolling that might better fit a court's sense of reasonableness.


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Client Alert | 3 min read | 11.21.25

A Sign of What’s to Come? Court Dismisses FCA Retaliation Complaint Based on Alleged Discriminatory Use of Federal Funding

On November 7, 2025, in Thornton v. National Academy of Sciences, No. 25-cv-2155, 2025 WL 3123732 (D.D.C. Nov. 7, 2025), the District Court for the District of Columbia dismissed a False Claims Act (FCA) retaliation complaint on the basis that the plaintiff’s allegations that he was fired after blowing the whistle on purported illegally discriminatory use of federal funding was not sufficient to support his FCA claim. This case appears to be one of the first filed, and subsequently dismissed, following Deputy Attorney General Todd Blanche’s announcement of the creation of the Civil Rights Fraud Initiative on May 19, 2025, which “strongly encourages” private individuals to file lawsuits under the FCA relating to purportedly discriminatory and illegal use of federal funding for diversity, equity, and inclusion (DEI) initiatives in violation of Executive Order 14173, Ending Illegal Discrimination and Restoring Merit-Based Opportunity (Jan. 21, 2025). In this case, the court dismissed the FCA retaliation claim and rejected the argument that an organization could violate the FCA merely by “engaging in discriminatory conduct while conducting a federally funded study.” The analysis in Thornton could be a sign of how forthcoming arguments of retaliation based on reporting allegedly fraudulent DEI activity will be analyzed in the future....