COLLEEN KOLLAR-KOTELLY, United States District Judge.
Plaintiffs are twenty-nine organizations that own or operate hospitals participating in the Medicare program. They have sued the Secretary of the Department of Health and Human Services (the "Secretary"), challenging certain regulatory actions taken by her in the course of administering Medicare's reimbursement scheme.
The relevant statutory and regulatory background underlying Plaintiffs' claims and the lengthy procedural history of this litigation are set out in detail in the Court's prior opinions. See Banner Health v. Sebelius, 797 F.Supp.2d 97 (D.D.C.2011); id., 905 F.Supp.2d 174 (D.D.C.2012); id., 945 F.Supp.2d 1 (D.D.C. 2013). Accordingly, the Court provides herein only a brief summary of the facts and history of this case, as relevant to the present motion.
Plaintiffs are twenty-nine organizations that own or operate hospitals participating in the Medicare program. Am. Compl., ECF No. [16], ¶ 22. On December 23, 2010, Plaintiffs filed their Amended Complaint, which remains the operative iteration of the Complaint in this action. See Am. Compl., ECF No. [16]. As this Court has previously observed, Plaintiffs' Amended Complaint is "sprawling"; it contains over two hundred paragraphs, spans fifty-nine pages, and appends two lengthy exhibits. Plaintiffs challenge the validity of a series of regulations establishing the methodology for calculating outlier payments (the "Outlier Payment Regulations"), 42 C.F.R. §§ 412.80-412.86, as well as the Secretary's annual promulgation of the regulations through which she set the fixed loss threshold for the upcoming fiscal year, for fiscal years 1998 through 2006 (the "Fixed Loss Threshold Regulations").
In enacting a system for Medicare reimbursement, "Congress recognized that health-care providers would inevitably care for some patients whose hospitalization would be extraordinarily costly or lengthy"
As noted, the Secretary "establish[es] the fixed [loss] thresholds beyond which hospitals will qualify for outlier payments" at the start of each fiscal year. Cnty. of Los Angeles, 192 F.3d at 1009. In each of the fiscal years at issue in this action, the Secretary set fixed loss thresholds at a level so that the anticipated total of outlier payments would equal 5.1% of the anticipated total of payments based on DRG prospective payment rates. Similarly, the amount of the outlier payment is "determined by the Secretary" and must "approximate the marginal cost of care" beyond the fixed loss threshold. 42 U.S.C. § 1395ww(d)(5)(A)(iii). During the time period relevant to this action, the implementing regulations generally provided for outlier payments equal to eighty percent of the difference between the hospital's estimated operating and capital costs and the fixed loss threshold. See 42 C.F.R. § 412.84(k).
In this litigation, Plaintiffs claim that the Outlier Payment Regulations, in the form they existed prior to 2003,
Regarding the Fixed Loss Threshold Regulations, Plaintiffs contend that the
Accordingly, Plaintiffs challenge the promulgation and implementation of the following agency actions: three sets of Outlier Payment Regulations promulgated in 1988, 1994, and 2003; and eleven sets of Fixed Loss Threshold Regulations for federal fiscal years 1997 through 2007. In addition, Plaintiffs challenge outlier payment determinations specific to each of the hospital Plaintiffs.
On March 23, 2012, Plaintiffs filed a motion to compel, requesting that the Court order the Secretary to file the "complete administrative record," by supplementing the records she had previously filed with various documents, including certain data files, identified by Plaintiffs and all other documents that were before the agency in connection with its rulemakings, and further order the Secretary to certify to the Court and Plaintiffs the completeness of the administrative record. See Pls.' Renewed Mot. to Compel Def. to File the Complete Admin. Record and to Certify Same, ECF No. [60]. On May 16, 2013, the Court granted-in-part and denied-in-part Plaintiffs' motion to compel, and ordered the Secretary to supplement the administrative record in this matter with several categories of materials. See Banner Health, 945 F.Supp.2d 1; Order (May 16, 2013), ECF No. [82]. Among the materials the Court ordered added to the administrative record was a February 2003 draft interim final rule ("Interim Final Rule"). As discussed at length in the Court's prior Memorandum Opinion, the Interim Final Rule was "exchanged between HHS and [the Office of Management and Budget ("OMB")][
The Court explained the significance of the Interim Final Rule as follows:
Id. at 25-26 (internal citations to the parties' pleadings omitted).
In view of the foregoing, the Court found that Plaintiffs had "made a sufficient showing that `unusual circumstances' warrant supplementation of the administrative record—namely, that the agency deliberately or negligently excluded documents that may have been adverse to its decision.'" Id. at 26 (citing City of Dania Beach v. FAA, 628 F.3d 581, 590 (D.C.Cir. 2010)). On July 30, 2013, the Court denied the Secretary's motion for reconsideration of the decision to require inclusion of the Interim Final Rule in the administrative record. See Order (July 30, 2013), ECF No. [96]. The Secretary filed the administrative record in this action on July 31, 2013.
After the Court resolved issues relating to the completeness of the administrative record, this case moved to the scheduling of summary judgment briefing. Subsequently, however, the Secretary sought leave to file an additional motion to dismiss for lack of subject matter jurisdiction. See Def.'s Mot. for Leave to File Mot. to Dismiss for Lack of Subject Matter Jurisdiction, ECF No. [99]. The Court granted the Secretary's request, but ordered that the Secretary file this motion "simultaneously with, and in the alternative to, Defendant's cross-motion for summary judgment." Order (Aug. 13, 2013), ECF No. [102] at 1. The Court set a deadline of October 25, 2013 for the parties' initial summary judgment briefs and directed the parties to file a joint status report by October 4, 2013 "(a) outlining in bullet-point format the arguments the parties intend to raise in support of or in opposition to summary judgment; and (b) indicating the extent to which there is a need to expand the page limits placed on memoranda of points and authorities by the Local Rules of this Court." Id. at 4. In this subsequently filed Joint Status Report
Under the Federal Rules of Civil Procedure, a party may amend its pleadings once as a matter of course within a prescribed time period. See Fed.R.Civ.P. 15(a)(1). Where, as here, a party seeks to
Foman v. Davis, 371 U.S. 178, 182, 83 S.Ct. 227, 9 L.Ed.2d 222 (1962). "[A] district court has discretion to deny a motion to amend on grounds of futility where the proposed pleading would not survive a motion to dismiss." Nat'l Wrestling Coaches Ass'n v. Dep't of Educ., 366 F.3d 930, 945 (D.C.Cir.2004), cert. denied, 545 U.S. 1104, 125 S.Ct. 2537, 162 L.Ed.2d 274 (2005). Review for futility is practically "identical to review of a Rule 12(b)(6) dismissal based on the allegations in the amended complaint." In re Interbank Funding Corp. Secs. Litig., 629 F.3d 213, 215-16 (D.C.Cir.2010) (quotation marks omitted). Because leave to amend should be liberally granted, the party opposing amendment bears the burden of coming forward with a colorable basis for denying leave to amend. Abdullah v. Washington, 530 F.Supp.2d 112, 115 (D.D.C.2008).
Plaintiffs' proposed motion to amend consists of two components. First, Plaintiffs seek to add claims under 5 U.S.C. § 553 that "the Secretary did not allow for meaningful public comment when she failed to disclose data, analysis and conclusions which had been set forth in the Interim Final Rule, and were adverse to the determinations the Secretary later proposed and finalized in her subsequent published rulemakings relating to the Outlier Payment Regulations and the [Fixed Loss Threshold] Regulations in 2003 through 2007." Pls.' Proposed Amendments at 1. Second, Plaintiffs seek to add factual allegations
Defendant argues that Plaintiffs' motion should be denied because the proposed additional claims under 5 U.S.C. § 553 are futile as contrary to D.C. Circuit precedent. Def.'s Opp'n at 8. The Court agrees that Plaintiffs' claims are not appropriate under § 553, and for this reason, leave to amend the complaint to add these additional claims is denied.
In their proposed Amended Complaint, Plaintiffs state that by failing to disclose data, analysis, and conclusions which had been set forth in the Interim Final Rule which were adverse to the determinations the Secretary later proposed and finalized in her subsequent published rulemakings relating to the Outlier Payment Regulations and the [Fixed Loss Threshold] Regulations in 2003 through 2007, the Secretary violated 5 U.S.C. § 553 by preventing meaningful public comment on these rulemakings. Pls.' Proposed Amendments at 1. The D.C. Circuit has long adhered to the principle that "[i]t is not consonant with the purpose of a rule-making procedure to promulgate rules on the basis of inadequate data, or on data that, [to a] critical degree, is known only to the agency." Portland Cement Ass'n v. Ruckelshaus, 486 F.2d 375, 393 (D.C.Cir.1973). Therefore, "an agency's failure to disclose critical material, on which it relies, deprives commenters of a right under § 553 `to participate in rulemaking.'" Allina Health Svcs. v. Sebelius, 746 F.3d 1102, 1110 (D.C.Cir.2014) (quoting Air Transp. Ass'n of Am. v. F.A.A., 169 F.3d 1, 7 (D.C.Cir.1999)).
The D.C. Circuit's most recent comprehensive discussion of this doctrine came in American Radio Relay League, Inc. v. Federal Communication Commission, 524 F.3d 227 (D.C.Cir.2008), where the panel concluded that the FCC "failed to satisfy the notice and comment requirements of [§ 553] by redacting studies on which it relied in promulgating the rule. . . ." In that case, the FCC placed five technical
Id. at 239. The focal point of this analysis was the Commission's reliance on materials that were undisclosed, or that were disclosed only in part with redactions. Importantly, American Radio Relay League distinguished cases where the agency did not rely on the undisclosed materials, such as EchoStar Satellite LLC v. Federal Communications Commission, 457 F.3d 31, 40 (D.C.Cir.2006), in which "the non-disclosed staff analysis represented `merely... cogitations upon the evidence' that was part of the rulemaking record." Am. Radio Relay League, Inc., 524 F.3d at 238. "By contrast, the challenged orders" in American Radio Relay, "were, according to the Commission, a central source of data for its critical determinations." Id. Moreover, the court concluded that its conclusions were "not inconsistent with the view that `the Portland Cement doctrine should be limited to studies on which the agency actually relies to support its final rule.'" Id. at 240 (quoting 1 RICHARD J. PIERCE, JR., ADMINISTRATIVE LAW TREATISE 437 (4th ed.2002)) (emphasis added in original). See also 1 RICHARD J. PIERCE, JR., ADMINISTRATIVE LAW TREATISE 584 (5th ed. 2010) ("If an agency does not attempt to support its final rule by reference to an undisclosed study, it seems apparent that the agency was not required to make the study available to potential commentators. Thus, the Portland Cement doctrine should be limited to studies on which the agency actually relies to support its final rule.")
Here, according to Plaintiffs' proposed Amended Complaint, the relevant undisclosed material at the time of the rulemakings is the "data, analysis and conclusions which had been set forth in the Interim Final Rule [which] were adverse to the determinations the Secretary later proposed and finalized in her subsequent published rulemakings." Pls.' Proposed Amendments at 1. The parties disagree in their present briefing as to whether the Secretary "relied" on this material in the challenged rulemakings, such that her failure to disclose these materials runs afoul of § 553 under the Portland Cement doctrine. Compare Pls.' Reply at 1-2 with Def.'s Opp'n at 8. As support for the proposition that the Secretary relied on the Interim Final Rule and the supporting materials, Plaintiffs look to this Court's decision to include the Interim Final Rule in the administrative record. Pls.' Mem. at 3; Pls.' Reply at 2. Plaintiffs cite the Court's statement that "there can be little doubt that the Interim Final Rule reflects views adverse to those finally adopted by the Secretary and that the Secretary considered—and indeed proposed to OMB—the
Plaintiffs attempt to bring this case within the ambit of American Radio Relay League by arguing in their Reply brief that the 2003 Proposed Rule reflects portions of the Interim Final Rule favorable to the agency, but excludes unfavorable portions, just as the FCC included favorable portions of studies in American Relay while redacting unfavorable portions. Pls.' Reply at 1-2. Yet Plaintiffs' prior briefing in this case, and the Court's conclusions based on this briefing contradict this newfound argument. As noted in the Court's prior Memorandum Opinion, Plaintiffs themselves have previously pointed out the sharp disconnect between the Interim Final Rule and the Proposed Rule. Indeed, the Court's previous Memorandum Opinion includes the following language: "Plaintiffs observe, however, that the Secretary's proposed rule, issued on February 28, 2003—just over two weeks after HHS submitted the Interim Final Rule to OMB—makes no mention of the data and analysis stated in the Interim Final Rule." Banner Health, 945 F.Supp.2d at 25 (emphasis added). Plaintiffs' instant attempt to argue a contrary position—that the Secretary cherry-picked data and analysis that was utilized in the Interim Final Rule—is unpersuasive.
Accordingly, because the Court concludes that Plaintiffs' have failed to assert proper claims under 5 U.S.C. § 553 based on non-disclosure of the Interim Final Rule and the underlying data and analysis, Plaintiffs' proposed amendment to add these claims is denied as futile.
Although the Court concludes that Plaintiffs' proposed additional claims are futile, this does not doom the entirety of
"Only limited circumstances justify a district court's refusal to grant [] leave to amend: undue delay, bad faith on the part of the moving party, or undue prejudice to the opposing party." Sinclair v. Kleindienst, 645 F.2d 1080, 1085 (D.C.Cir.1981). Moreover, "[t]o warrant denial of leave to amend, any delay in seeking leave must be accompanied by a showing of bad faith or prejudice." Council on American-Islamic Relations Action Network, Inc. v. Gaubatz, 891 F.Supp.2d 13, 33 (D.D.C.2012) (citing Caribbean Broad. Sys., Ltd. v. Cable & Wireless P.L.C., 148 F.3d 1080, 1084 (D.C.Cir.1998)). Defendant, as the party opposing amendment, bears the burden of establishing bad faith or prejudice. City of New York v. Group Health, Inc., 649 F.3d 151, 157 (2d Cir.2011); Abdullah, 530 F.Supp.2d at 115.
Here, the Court finds that Defendant has not met her burden of showing that Plaintiffs' delay in adding these additional allegations is accompanied by bad faith or prejudice. Certainly, Defendant is correct that Plaintiffs have known about the Interim Final Rule since February 2012 and could have moved to add these additional factual allegations to support her claims far sooner. Def.'s Opp'n at 4. But Defendant points to no prejudice from the failure to add these allegations earlier. See Estate of Gaither ex rel. Gaither v. Dist. of Columbia, 272 F.R.D. 248, 252 (D.D.C.2011) ("the mere passage of time does not preclude amendment—the delay must result in some prejudice to the judicial system or the opposing party."). Indeed, the Secretary's entire prejudice argument addresses the harm from allowing Plaintiffs to add new claims—rather than new factual allegations to existing claims—at this stage of the litigation. Def.'s Opp'n at 5-6. Yet the Court has already rejected the proposed additional claims as futile. In the absence of a new claim, Defendant does not provide any reason to believe that she would be prejudiced by allowing the addition of new factual allegations concerning the Interim Final Rule to Plaintiffs' existing claims. Nor can the Court discern any, as leave to add clarifying factual allegations to existing claims is typically freely given. See Council on American-Islamic Relations Action Network, Inc. v. Gaubatz, 793 F.Supp.2d 311, 324 ("Plaintiffs' factual allegations merely fine-tune the basis for the relief Plaintiffs seek in this action. Factual allegations of this kind, which clarify but do not reshape the action, are rarely a bad thing."). See also Harrison v. Rubin, 174 F.3d 249, 253 (D.C.Cir.1999) (stating that technical corrections and clarifications of legal theories without a showing of prejudice are not sufficient grounds for denying a motion). Here, these allegations merely explain the discovery and content of the Interim Final Rule, and provide additional basis for Plaintiffs' arguments that certain actions taken by the Secretary were substantively
The Court is also unpersuaded by Defendant's accusations that Plaintiffs have acted in bad faith. Def.'s Opp'n at 5. Defendant contends that "[t]he most likely explanation for the plaintiffs' motion is that after seeing which of their claims survived the Court's July 2011 and November 2012 rulings and which did not, and then seeing which of their multifarious challenges to the administrative records succeeded and which did not, the plaintiffs decided to shift their bets in hopes of improving their overall chances in this litigation." Id. Again, this accusation goes mainly to Plaintiffs' proposal to add new claims, rather than new factual allegations to existing claims. Accordingly, it does not provide a basis to reject these supplemental allegations.
Therefore, although it denies Plaintiffs leave to add new claims pursuant to 5 U.S.C. § 553, the Court will grant Plaintiffs leave to add factual allegations concerning the Interim Final Rule. Accordingly, Plaintiffs may amend their complaint to include the allegations contained in sub-paragraphs 198.5(a)-(e) of their Proposed Amendments.
For all of the reasons stated herein, the Court