Encompass Health Rehabilitation Hospital of Charleston, LLC v. ROBERT F. KENNEDY, JR., Secretary of the United States Department of Health

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 25-1170
ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON,
LLC,
Plaintiff - Appellant,
v.
ROBERT F. KENNEDY, JR., Secretary of the United States Department of Health
and Human Services,
Defendant - Appellee.
Appeal from the United States District Court for the District of South Carolina, at
Charleston. David C. Norton, District Judge. (2:22-cv-04171-DCN)
Submitted: April 29, 2026 Decided: June 23, 2026
Before NIEMEYER and QUATTLEBAUM, Circuit Judges, and FLOYD, Senior Circuit
Judge.
Affirmed by unpublished per curiam opinion.
ON BRIEF: Adam L. Bird, CALHOUN BHELLA & SECHREST LLP, Washington,
D.C., for Appellant. Yaakov M. Roth, Acting Assistant Attorney General, Michael S. Raab,
Ashley C. Honold, Civil Division, UNITED STATES DEPARTMENT OF JUSTICE,
Washington, D.C.; Bryan P. Stirling, United States Attorney, OFFICE OF THE UNITED
STATES ATTORNEY, Charleston, South Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit.

-- 1 of 4 --

2
PER CURIAM:
Denied payment four times through successive levels of administrative review for
inpatient rehabilitation care it furnished to two Medicare beneficiaries, Encompass Health
Rehabilitation Hospital of Charleston, LLC, requested the Medicare Appeals Council
review two decisions issued by administrative law judges denying its claims. Finding
Encompass Health insufficiently identified and explained its challenges to these decisions,
the Council adopted the administrative law judges’ decisions after determining there were
no clear legal errors. Encompass Health then sought judicial review in district court, and
the district court granted summary judgment to the Secretary of Health and Human
Services. For the reasons set out below, we affirm.
Encompass Health makes two arguments on appeal.∗ First, it contends the district
court erred in finding its requests for review before the Council didn’t satisfy the
requirements of 42 C.F.R. § 405.1112(b). Section 405.1112(b) specifies a “request for
review must identify the parts of the ALJ’s . . . action with which the party requesting
review disagrees and explain why he or she disagrees with the ALJ’s . . . decision.” 42
C.F.R. § 405.1112(b) (2020). According to Encompass Health, it was enough to say only
that the beneficiaries met coverage criteria, that the administrative law judges didn’t
account for all information in the record and that it reserved the right to file supplemental
briefing. The Secretary responds that it wasn’t.
∗ We review de novo the district court’s summary-judgment decision. Pleasant
Valley Hosp., Inc. v. Shalala, 32 F.3d 67, 69 (4th Cir. 1994). “The Secretary’s decision
should be affirmed where supported by substantial evidence and not arbitrary, capricious,
or otherwise contrary to law.” Id. at 70 (citation modified).

-- 2 of 4 --

3
We agree with the Secretary. The regulation requires parties to describe with
particularity the aspects of the administrative law judge’s decision with which they
disagree, and the explanations they give for their challenges must be similarly specific. See
§ 405.1112(b); Medicare Program: Changes to the Medicare Claims Appeal Procedures,
67 Fed. Reg. 69312, 69335–36 (Nov. 15, 2002); accord Rehab. Hosp. of Phenix City, LLC
v. Sec’y, U.S. Dep’t of Health & Hum. Servs., No. 25-10017, 2025 WL 2216616, at *1–2
(11th Cir. Aug. 5, 2025) (per curiam). Encompass Health’s requests for review don’t come
close to meeting § 1112(b)’s standard. See § 405.1112(b) (providing, “[f]or example, if the
party requesting review believes that the ALJ’s . . . action is inconsistent with a statute,
regulation, CMS Ruling, or other authority, the request for review should explain why the
appellant believes the action is inconsistent with that authority”).
Second, Encompass Health argues the Council acted arbitrarily and capriciously by
treating it differently than the Council did other appellants who violated § 405.1112(b).
The Secretary responds that Encompass Health waived this claim by not asserting it in its
complaint and that, alternatively, the Council did not engage in differential treatment.
Even assuming Encompass Health didn’t waive this claim, its argument collapses
on the merits. The two decisions Encompass Health says show an unexplained
inconsistency in the Council’s decision-making are distinguishable. It’s true that in In re
Jefferson Surgical Clinic, Inc., No. M-11-1480, 2012 WL 4760802 (H.H.S. Sep. 4, 2012),
the Council modified the administrative law judge’s decision after finding the appellant’s
request for review deficient. Id. at *2–4, *2 n.3. But here, the Council didn’t perceive a
need to modify either decision. And in In re All Care Home Health, No. M-11-2187, 2013

-- 3 of 4 --

4
WL 7872031 (H.H.S. Apr. 16, 2013), the Council did just what it did here. See generally
id. (pointing out problems in appellants’ requests for review, describing background of
each claim and adopting administrative law judges’ decisions without further comment).
Accord Rehab. Hosp., 2025 WL 2216616, at *3.
Accordingly, we see no error in the district court’s decision. We dispense with oral
argument because the facts and legal contentions are adequately presented in the materials
before us and argument would not aid the decisional process.
AFFIRMED

-- 4 of 4 --