Case Explained: ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON LLC v. ROBERT F. KENNEDY, JR., Secretary of the United States Department of Health and Human Services

Court: United States Court of Appeals for the Fourth Circuit Filed: 2026-06-23 The Fourth Circuit affirmed the district court’s grant of summary judgment to the Secretary of Health and Human Services, upholding the Medicare Appeals Council’s denial of Encompass Health’s claims for inpatient rehabilitation care payments. The court held that the hospital failed to satisfy the specific requirements of 42 C.F.R. § 405.1112(b), which mandates that a request for review must identify with particularity the parts of the administrative law judge’s action with which the party disagrees and explain why it disagrees. The court found Encompass Health’s general assertions regarding coverage criteria and record completeness insufficient to meet this regulatory standard. Additionally, the court rejected the hospital’s claim that the Council acted arbitrarily by treating it differently than other appellants, noting that the cited cases were distinguishable because the Council in those instances either modified decisions or adopted them for reasons consistent with its actions here. The practical consequence is that the administrative denials of payment stand, and Encompass Health receives no judicial relief. Do It For The Case Law is a news reporting service. Nothing in this episode constitutes legal advice.