Fourth Circuit Weighs In ON Circuit Split Re: Meaning of "Reimbursement"

Per A.T. Massey Coal Company v. Holland, 472 F.3d 148 (4th Cir. Dec. 21, 2006):

The parties commenced these actions--the most recent skirmishes in a long-running fight--to resolve whether "reimbursements" as used in the formula includes the total payments that Medicare made to the 1950 and 1974 Benefit Plans for the base year ($182.3 million) or only the amount that the 1950 and 1974 Funds actually paid out in Medicare benefits to beneficiaries for the base year ($156.3 million). Interpreting Medicare "reimbursements" to be the $182.3-million figure results in lower premiums for the coal operators; interpreting "reimbursements" to be the $156.3-million figure results in higher premiums.The district court ruled that "reimbursements" unambiguously refers to the total payments ($182.3 million) that Medicare made to the 1950 and 1974 Benefit Plans in the base year, and it declined to defer under Chevron to the contrary interpretation put forth by the Commissioner of Social Security. See A.T. Massey Coal Co. v. Barnhart, 381 F.Supp.2d 469 (D.Md.2005).

Agreeing with the district court, we conclude that "reimbursements" is an unambiguous historical term of art used by Congress to refer to the total reimbursements that Medicare actually made, using a capitation method, to the 1950 and 1974 Benefit Plans during the base year. [FN2] We also conclude that because Congress did not delegate interpretative authority to the Commissioner to construe "reimbursements," her interpretation of "reimbursements" is not entitled to deference under Chevron. See United States v. Mead Corp., 533 U.S. 218 (2001). Accordingly, we affirm.

FN2. In reaching this conclusion, we join the Eleventh Circuit's holding in National Coal Ass'n v. Chater, 81 F.3d 1077 (11th Cir.1996), and depart from the D.C. Circuit's holding in Holland v. National Mining Ass'n, 309 F.3d 808 (D.C.Cir.2002), which had created a split between the circuits.


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