United States District Court for the District of Columbia
August 3, 2004.
HEARTLAND HOSPITAL, Plaintiff,
TOMMY G. THOMPSON, Secretary of Health and Human Services, Defendant.
The opinion of the court was delivered by: RICARDO URBINA, District Judge
DENYING THE PLAINTIFF'S MOTION TO ENFORCE JUDGMENT
This matter comes before the court upon the plaintiff's motion
to enforce the court's judgment of June 15, 1998 ("the
judgment"). Issued by the late Judge Harold L. Greene, the
judgment in question, Heartland Hospital v. Shalala, No.
95-951, slip op. (D.D.C. Jun. 15, 1998) ("Heartland I")
addressed challenges that the plaintiff ("Heartland") brought
against the Department of Health and Human Services ("HHS") for
its adoption of a regulation preventing Heartland from receiving
Medicare reimbursements. The court held that the regulation was
invalid and remanded the action to HHS for action consistent with
the court's opinion. Claiming that HHS' subsequent action has
been inconsistent with the court's judgment, the plaintiff now
seeks Medicare reimbursements and interest payments. The
defendant, styling its opposition to Heartland's motion to
enforce judgment as a motion to dismiss pursuant to Federal Rule
of Civil Procedure 12(b)(6), maintains that the plaintiff is
misinterpreting Heartland I and that HHS is under no obligation to reimburse or provide interest payments to
the plaintiff. For the reasons stated below, the court denies the
plaintiff's motion to enforce the judgment.
A. Factual History
Medicare reimburses certain hospitals for medical care provided
to eligible elderly and disabled persons. 42 U.S.C. § 1395 et
seq. Medicare places certain cost limits on participating
hospitals, but a "sole community hospital" ("SCH") is exempt from
such limits. Heartland I at 3. To qualify for SCH status, a
hospital must meet requirements promulgated by the Secretary of
HHS. Id. During all times relevant to this case, a hospital
could receive SCH status if it was located in a rural area and
met other criteria. Id. at 7. A hospital in an urban area could
qualify as an SCH if it was more than 35 miles away from the
nearest like hospital. Id. at 5. The Secretary defined "urban"
as any area located within a "Metropolitan Statistical Area"
("MSA"), as determined by the Office of Management and
Budget.*fn1 Id. at 5-6. "Rural" meant any area not within
an MSA. Id.
At the time of the judgment, the plaintiff was a hospital
located in an urban area and less than 35 miles from the nearest
like hospital. Id. at 2. Therefore, the Health Care Financing
Administration ("HCFA") an agency within HHS denied the
plaintiff SCH status in 1993. Id. at 1-2. The plaintiff
subsequently appealed the denial of SCH status to the Provider
Reimbursement Review Board ("the Board"). Id. at 2. After the
Board determined that it lacked jurisdiction, it granted the plaintiff's request for expedited
judicial review of its denial of SCH status. Id.
B. Procedural History
In 1995, the plaintiff filed suit in this court seeking
reimbursement based on SCH status from 1992, plus interest. Pl.'s
Mot. to Enforce J. ("Pl.'s Mot.") at 1-2. The plaintiff then
moved for summary judgment, alleging that the rural requirement
was arbitrary and capricious and, therefore, invalid under the
Administrative Procedure Act ("APA"). Specifically, the plaintiff
claimed that (1) the rural requirement was manifestly contrary to
the Medicare statute; (2) the Secretary failed to provide an
adequate basis or reasoned analysis for the regulation; and (3)
the Secretary failed to consider reasonable alternatives when
adopting the MSA as the relevant measure of an urban area.
Heartland I at 2.
In a 1998 opinion, Judge Greene rejected the first two
arguments, holding (1) that the regulation was "well within the
realm of permissible interpretations of" the Medicare statute and
(2) that "the Secretary established, and has maintained, a
rational basis for the rural location requirement." Id. at 15,
On the third argument, however, the court held for the
plaintiff, stating that "[t]he failure of the Secretary to
respond to the reasonable alternative[s] suggested during the
comment period renders the adoption of the regulations arbitrary
and capricious and, consequently, invalid." Id. at 23-24. In
reaching this conclusion, the court noted that the Secretary had
"at least three alternatives to MSAs as a method of identifying
an urban area." Id. at 20. The principal alternative was the
elimination of the rural requirement altogether. Id. at 21. The
court also indicated that the determination of the urban/rural
distinction could be made (1) by using the Census Bureau definition of "urbanized areas" and (2) by using
health facility planning areas. Id. at 20. While HHS had
"considered and rejected the principal alternative," the court
held that "[r]esponding to only one alternative . . . is not
enough to satisfy the APA." Id. at 21. Instead, the defendant
"should have responded to [the other alternatives] and explained
why they were not adopted." Id. at 22. Judge Greene granted the
plaintiff's motion for summary judgment and remanded to HHS for
"action consistent with the foregoing opinion." Order of Jun. 10,
Upon remand, HHS issued "a final rule specifically explaining
its adoption of an MSAbased definition of urban areas and
rejecting the use of either Census Bureau urbanized areas or
health facility planning areas for that purpose." Def.'s Opp'n at
5. HCFA interpreted Judge Greene's judgment to mean that the
rural requirement was not vacated and that explanation of the
MSA-based definition's superiority to its alternatives was
sufficient to satisfy the judgment. Id. Consequently, HCFA
issued its final decision on the Heartland matter in September
2000, again applying the rural requirement based on the MSA based
definition of urban areas, and again denying Heartland SCH
status. Id. at 5-6.
After the case was reassigned to this judge, the plaintiff
moved to enforce the judgment in November 2000, again seeking
Medicare reimbursement consistent with SCH status starting in
1992. Pl.'s Mot. at 1-2. The defendant claims that the
plaintiff's motion to enforce judgment is essentially "a request
for judicial review of the Secretary's decision on remand," and
responds with a motion to dismiss. Def.'s Opp'n at 15. After the
plaintiff and defendant filed their motions, the court granted
the parties' request to stay the case pending settlement
negotiations. The parties, however, were unable to resolve the
The plaintiff has filed a separate action seeking judicial
review of HHS' September 2000 decision on remand Heartland Hosp. v. Thompson, No. 00-2802
(D.D.C. November 20, 2000). This Court's order stayed the
plaintiff's action seeking judicial review until disposition of
the motion currently under consideration. Order dated April 18,
2001. Accordingly, the court will not presently engage in
judicial review of the Secretary's decision on remand The court
will consider only the plaintiff's Motion to Enforce Judgment.
A. Legal Standard for Motion to Enforce Judgment
A motion to enforce judgment is the usual method for requesting
a court to interpret its own judgment. Sec. & Exch. Comm'n v.
Hermil, Inc., 838 F.2d 1151, 1153 (11th Cir. 1988). "Such a
motion should be utilized to compel compliance with a prior
decision, especially in cases of willful or deliberate violation
of a court order." Natural Res. Def. Council, Inc. v. Texaco
Ref. & Mktg., Inc., 20 F. Supp.2d 700, 707 (D. Del. 1998);
Gregis v. Edberg, 645 F. Supp. 1153, 1156 (W.D. Penn. 1986),
aff'd, 826 F.2d 1054 (3d Cir. 1987).
Courts grant motions to enforce judgments when a prevailing
plaintiff demonstrates that a defendant has not complied with a
judgment entered against it, even if the noncompliance was due to
misinterpretation of the judgment. E.g., Pub. Citizen, Inc. v.
Dep't. of Educ., 292 F. Supp.2d 1 (D.D.C. 2003) (granting a
motion to enforce judgment ordering the Department of Energy's
compliance with the plaintiff's Freedom of Information Act
request when the Department could not demonstrate that its search
for information was adequate to satisfy the judgment); Cent. of
Ga. R.R. Co. v. United States, 410 F. Supp. 354 (D.D.C. 1976)
(granting a motion to enforce judgment against the Interstate
Commerce Commission when the Commission's misinterpretation of the prior judgment caused it to reopen
barred administrative proceedings).
If the plaintiff has received all relief required by that prior
judgment, the motion to enforce is denied. See, e.g., Watkins v.
Washington, 511 F.2d 404, 406 (D.C. Cir. 1975). In cases of
judicial review of administrative agency decisions where the case
is remanded to the agency for explanation of its challenged rule,
the court will deny a motion to enforce judgment against the
agency if the agency adequately explains its reasons for adopting
the rule. E.g., Int'l Union v. Occupational Safety & Health
Admin., 37 F.3d 665 (D.C. Cir 1994) (denying a motion to enforce
judgment where the Occupational Safety & Health Administration
adequately explained its reasons for adopting a challenged
regulation). Within a court's power to administer its decrees is
the power to construe and interpret the language of the judgment.
Hermil, 838 F.2d at 1153.
B. The Court Denies the Plaintiff's Motion Because the Defendant
Has Complied With the Judgment
In the instant case, the parties disagree as to what is
required of the Secretary to comply with the judgment in
Heartland I. While the plaintiff contends that the judgment
entitles it to reimbursement and interest, the defendant argues
that the judgment merely remands the case to the Secretary to
better articulate the "rationale for using MSAs, as opposed to
the alternatives that had been proposed by public commenters, to
differentiate between urban and rural areas." Pl.'s Mot. at
16-17; Def.'s Opp'n at 3. The order, however, merely grants
judgment for the plaintiff and remands to HHS for "action
consistent with the foregoing opinion." Order dated June 15,
The plaintiff alleges that the judgment controls rather than
the opinion. Pl.'s Reply at 2. In contrast to the ambiguity of the order in the instant case,
however, the cases cited by the plaintiff involve a direct
conflict of a clearly-written order with an opinion or with a
clerk's docket entry. E.g., Eakin v. Cont'l Ill. Nat'l Bank &
Trust Co., 875 F.2d 114, 118 (7th Cir. 1989) (direct conflict
between opinion and order); O'Brien v. Harrington, 233 F.2d 17,
20 (D.C. Cir 1956) (direct conflict between order and clerk's
docket entry); United States v. Hark, 320 U.S. 531, 534 (1944)
(direct conflict between opinion and order). Another case cited
by the plaintiff merely holds that the holding of the prior
judgment, rather than dicta in the opinion, controls. State of
Oklahoma v. State of Texas, 272 U.S. 21, 42-43 (1926). In the
instant case, the order is ambiguous; it does not directly
contradict the opinion. Further, Judge Greene's reasoning for
finding the rural requirement arbitrary and capricious is not
merely dicta, it is the meat of the opinion.
Finally, the plaintiff argues that Great Northern Railway Co.
v. General Railway Signal Co. also supports the proposition that
the judgment controls rather than the opinion. Pl.'s Reply at 2
(citing Great Northern Railway Co. v. General Railway Signal
Co., 57 F.2d 457 (8th Cir. 1932). But Great Northern supports
the exact opposite conclusion. Great Northern deals with the
authority of a trial court to interpret an appellate opinion in
applying its mandate on remand Id. at 458. The Eighth Circuit
held that an appellate opinion is part of its mandate and "should
be consulted [by the trial court] to ascertain what was intended
by the mandate." Id. at 459. The case before this court
presents a similar situation here the court attempts to
interpret the judgment of another district judge. Thus, Great
Northern suggests that the court should consult Judge Greene's
opinion to interpret his judgment. Id. Because the parties
present conflicting interpretations of the judgment and the
judgment itself is ambiguous, the court concludes that it must interpret the opinion accompanying the judgment to resolve
the ambiguity. Hermil, 838 F.2d at 1153.
1. Awarding Reimbursement and Interest Would Contradict the
Reasoning and Holding of the Opinion
The plaintiff insists that the court "could not have made it
more clear that it was invalidating the rural location
requirement in total," not only the "use of MSAs in making the
urban rural distinction." Pl.'s Reply at 7. The plaintiff
misstates Judge Greene's holding. One needs to look at the reason
why Judge Greene invalidated the Secretary's rural location
requirement to understand the nature of that invalidation. As
stated in the opinion, "the regulation is invalid because the
Secretary failed to consider or respond to reasonable
alternatives to the use of [MSAs] as the relevant measure of an
urban area." Heartland I at 24. The court found nothing wrong
with the regulation itself. In fact, the court found that the
regulation was both consistent with the governing statute and had
a rational basis. Id. at 15, 19. Rather, it stated that HHS'
failure to consider alternatives "render[ed] the adoption of
the regulations arbitrary and capricious." Id. at 23-24
The Secretary's failure to consider alternatives does not
automatically entitle the plaintiff to reimbursement and
interest. A procedural flaw in the adoption of a rule does not
automatically make the opposite of that rule the proper outcome.
Often courts will remand to the agency for reconsideration
without technically vacating the regulation when the challenged
rule fails for lack of reasoned decision-making. E.g., Engine
Mfrs. Assoc. v. Envtl. Prot. Agency, 20 F.3d 1177, 1184 (D.C.
Cir. 1994); Mass. v. U.S. Nuclear Regulatory Comm'n,
924 F.2d 311, 336 (D.C. Cir. 1991); United Mine Workers of America v.
Mine Safety & Health Admin., 920 F.2d 960, 966-67 (D.C. Cir. 1990).
The plaintiff argues that in the each of the aforementioned
cases where a court remanded for reconsideration without
vacating, "the court expressly stated that it was not vacating
the agency action." Pl.'s Reply at 10 (emphasis in original). Be
that as it may, that argument is irrelevant to the issue of
whether it is appropriate to remand for reconsideration in this
case. Indeed, the plaintiff itself cites "lack of reasoned
decision-making" due to inadequate consideration or unclear
analysis of relevant issues as a reason to remand for
reconsideration without vacating the rule. Id. at 11. The
argument that Judge Greene did not explicitly remand for
elaboration of the agency's reasoning is unpersuasive. Id. at
11-12. Nor did he explicitly remand for automatic grant of SCH
status, reimbursement and interest. Order of June 10, 1998.
Nothing in Heartland I foreclosed the possibility that the
rural requirement might eventually pass scrutiny; after properly
considering alternatives to MSAs to determine SCH status, HHS was
still permitted to utilize MSAs. E.g., Int's Union, 37 F.3d at
667 (denying the plaintiffs' motion to enforce judgment when,
after remand, the agency explained its reasons for re-adopting
the challenged regulation). Consideration of the alternatives was
the decisive factor in Heartland I, and the Secretary's lack of
consideration, not a fundamental flaw in the rural requirement
itself, ultimately caused the court to invalidate the rural
requirement. Heartland I at 24. The Court will not grant the
plaintiff SCH status, reimbursement and interest purely on the
grounds that there was a procedural flaw in adoption of the rural
requirement. 2. The Relief that The Plaintiff Seeks Is Inappropriate
Finally, an award to the plaintiff of its requested relief
SCH status and reimbursement plus interest would be
inappropriate under an uncontroverted line of binding cases.
See, e.g., Fed. Power Comm'n v. Idaho Power Co., 344 U.S. 17,
20 (1952); Nat'l Labor Relations Bd. v. Food Store Employees
Union, Local 347, 417 U.S. 1, 9 (1974); Parkview Med. Assocs.
v. Shalala, No. 94-1941 (RMU), slip op. (D.D.C. Aug. 13, 1997).
Idaho Power and its progeny suggest that a judicial court
should not substitute its judgment for that of an administrative
agency on matters of administrative policy, even when it finds
legal errors with agency actions. Idaho Power, 344 U.S. at 20.
Rather, "the guiding principle . . . is that the function of the
reviewing court ends when an error of law is laid bare. At that
point the matter once more goes to the [agency] for
reconsideration." Id. The "guiding principle of administrative
law, long recognized by [the Supreme] Court, is that `an
administrative determination in which is imbedded a legal
question open to judicial review does not impliedly foreclose the
administrative agency, after its error has been corrected, from
enforcing the legislative policy committed to its charge.'" Food
Store Employees, 417 U.S. at 9 (quoting Federal Communications
Comm'n v. Pottsville Broad. Co., 309 U.S. 134, 145 (1940)).
In Idaho Power, the Supreme Court struck down a district
court's order modifying a license granted by the Commission to
the plaintiff power company. Idaho Power, 344 U.S. at 20. The
Court warned district courts reviewing agency action that they do
not have the "power to exercise an essentially administrative
function." Id. at 21. Here, the plaintiff wishes this Court to
interpret Judge Greene's opinion as having made an essentially
administrative decision to grant Heartland SCH status.
42 U.S.C. § 1395ww(d)(5)(D)(iii)(I). The plaintiff attempts to distinguish its case from the Idaho
Power line by noting that the right to judicial review in its
case is based on the Administrative Procedure Act (APA), rather
than the Federal Power Act (FPA), as in Idaho Power. Pl.'s
Reply at 4. Citing no caselaw, the plaintiff asserts that the APA
provides courts with greater discretion to take and order
remedial action. Id. But the language of the FPA allowed
reviewing courts "to affirm, modify, or set aside" an order of
the FPC. Idaho Power, 344 U.S. at 21 (emphasis added). Yet the
Supreme Court decided it was nonetheless inappropriate for the
reviewing court to modify the FPC's order. Id. at 20.
Like in Idaho Power, the Supreme Court in Food Store
Employees struck down a court order modifying an agency action
even though the controlling statute allowed great judicial
discretion. 417 U.S. at 3. The National Labor Relations Act
granted authority to courts to "make and enter a decree . . .
modifying, and enforcing as so modified" NLRB action. Id. But
the Supreme Court refused to allow the reviewing court to enlarge
a remedy set by the NLRB, citing "the integrity of the
administrative process" and the "discretionary judgment which
Congress has entrusted to [the NLRB]." Id. at 8-9.
The language of the APA, on the other hand, allows courts only
to "hold unlawful and set aside" illegal agency action.
5 U.S.C. § 706(2). The plain language of the APA seems to afford less
discretion to reviewing courts to make administrative decisions
than the FPA. Moreover, the Court in a case involving APA-based
judicial review of an administrative action stated that "if the
agency has not considered all relevant factors . . . the proper
course, except in rare circumstances, is to remand to the agency
for additional investigation or explanation." Fla. Power & Light
Co. v. Lorion, 470 U.S. 729, 744 (1985). The judicial practice
of deferring to agency discretion theoretically should be universal and applied
not only to certain agency actions under certain
statutes.*fn2 Bridge v. U.S. Parole Comm'n, 981 F.2d 97,
105 (3d Cir. 1992) (stating that "[t]he Supreme Court's decisions
in Food Store Employees and Idaho Power are equally
applicable to all administrative agencies").
When a reviewing court concludes that an agency invested with
broad discretion has apparently abused that discretion, remand to
the agency for reconsideration is ordinarily the reviewing
court's proper course. Food Store Employees, 417 U.S. at 10.
Such a solution "best respects the congressional scheme investing
the [agency] with broad powers" to shape policy and "affords the
[agency] the opportunity . . . to reframe and better effectuate
that policy." Id.
Accordingly, the Court rules that Judge Greene did not intend
to grant the plaintiff SCH status, reimbursement and interest.
Upon remand, the defendant has reconsidered the alternatives to
the MSA and has concluded that they are inferior. This conclusion
is all that was required by the prior judgment. Thus, the court
denies the plaintiff's motion to enforce judgment. Watkins, 511
F.2d at 406. IV. CONCLUSION
For the foregoing reasons, the Court denies the plaintiff's
motion to enforce judgment. An order directing the parties in a
manner consistent with the Memorandum Opinion is separately and
contemporaneously issued this 3rd day of August, 2004.