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A federal appeals court on Tuesday threw out a district court’s injunction won by a Nevada doctor won against a Medicaid contractor he had accused of repeatedly denying his claims on the same incorrect basis, finding that the doctor was required to present each disputed claim to the Department of Health and Human Services.
The unanimous 9th U.S. Circuit Court of Appeals panel found that, although U.S. District Judge Richard Boulware in Nevada had found it would be impractical for the doctor, Robert Odell, to administratively appeal each individual claim when the contractor had shown a pattern of denying them improperly, the federal Medicare statute did not give courts jurisdiction to review claims that had not gone through administrative appeal.