⚖ Oral Arguments, with Context

Health benefit funds for retired coal miners and their dependents challenge reductions in their Medicare reimbursement. The plaintiffs are trustees of four United Mine Workers of America plans. This is not a lawsuit over one patient's treatment. It concerns how the federal government reimburses these plans for medical services. Under a longstanding Medicare Part B arrangement, the funds pay physicians for covered care and receive reimbursement from the Centers for Medicare and Medicaid Services, or CMS, based on reasonable costs. Advance payments are reconciled through an annual cost report. That payment chain matters because the funds and the government disagree about where a federal budget cut belongs. The first dispute concerns the two-percent Medicare reduction that began in 2013. You will hear it called sequestration: an automatic reduction in federal spending. The funds reduced their payments to physicians by two percent. CMS then applied a two-percent reduction when calculating the funds' reimbursement. The trustees say that imposes a second cut for the same services and shifts Medicare costs onto money intended for miners' benefits. The government sees two different transactions. It will argue that paying physicians less lowers the funds' actual costs, while the law still requires a reduction in the federal reimbursement calculated from those costs. The judges will examine whether the unusual structure of these plans changes that result. There is also a separate dispute over audits of the funds' 2012 and 2013 cost reports. Contractors found payment errors in samples of claims and extrapolated: they used the samples to estimate overpayments across a larger group. The trustees contend that the statutory conditions for using that method were not met. That is a challenge to the audit method, not a finding that the funds committed fraud. After administrative review, the federal district court upheld the government's treatment of both issues. The trustees now seek reversal in the D.C. Circuit. Ron Connelly will present their appeal.

Micheal Buckner v. Robert Kennedy, Jr. (No. 25-5343) — U.S. Court of Appeals for the D.C. Circuit, argued October 19, 2026.