Prosser v. Becerra

Dist. Ct. did not err in dismissing for lack of standing plaintiff-patient’s action that challenged defendant’s denial of Medicare coverage during January to April 2018 period for plaintiff’s TTF treatment for her glioblastoma multiforme condition. Record showed that plaintiff had received therapy for coverage period and owed nothing out of pocket, since she had not signed advance beneficiary notice. As such, manufacturer of durable medical equipment used in plaintiff’s treatment is responsible for its own costs in supplying plaintiff’s treatment during relevant coverage period. Accordingly, because plaintiff faces no financial liability for instant treatment period, Dist. Ct. could properly find that she lacks standing to bring instant lawsuit, where any future financial risk to plaintiff is too attenuated from instant denial of coverage. Moreover, record reflected that plaintiff’s TTF therapy is now being deemed reasonable and necessary, such that there are no facts indicating that she is at imminent risk of being denied coverage, and if plaintiff is denied coverage in future, she will be able to avail herself of appeals process and seek judicial review.