MEMORANDUM **

The California counties of Santa Cruz, Sonoma, San Diego, Marin, Santa Barbara, San Luis Obispo, and Monterey, as well as Theodore M. Mazer and Wolbers & Poree Medical Corp., (collectively “Plaintiffs”), brought this action against the Secretary of the Department of Health and Human Services (“the Secretary”). Plaintiffs claim that the Secretary’s failure to revise the “fee schedule areas,” which determine the fees paid to the Plaintiffs for providing Medicare services, violated Plaintiffs’ equal protection rights, and that 42 U.S.C. § 1395w-4(j)(2) (the “Fee Schedule” statute) and the regulation implementing this statute, 42 C.F.R. § 414.4, are unconstitutional as applied to Plaintiffs because the Fee Schedule statute and the related regulation deprived Plaintiffs of equal protection.

The district court granted the Secretary’s motion to dismiss for failure to state a claim for relief or, in the alternative, for summary judgment. We AFFIRM. Under our “highly deferential” rational basis review of such government classification under the equal protection component of the Due Process Clause, Kahawaiolaa v. Norton, 386 F.3d 1271, 1279-80 (9th Cir. 2004), the Secretary’s decision to maintain the status quo in the fee schedule areas structure can be supported on the basis of minimizing administrative cost and burden. See Armour v. City of Indianapolis, — U.S. -, 132 S.Ct. 2073, 2083, 182 L.Ed.2d 998 (2012).

AFFIRMED.