B & H Medical, LLC v. United States

116 Fed. Cl. 671, 2014 U.S. Claims LEXIS 568, 2014 WL 2854090
CourtUnited States Court of Federal Claims
DecidedJune 23, 2014
Docket1:13-cv-00088
StatusPublished
Cited by5 cases

This text of 116 Fed. Cl. 671 (B & H Medical, LLC v. United States) is published on Counsel Stack Legal Research, covering United States Court of Federal Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
B & H Medical, LLC v. United States, 116 Fed. Cl. 671, 2014 U.S. Claims LEXIS 568, 2014 WL 2854090 (uscfc 2014).

Opinion

OPINION and ORDER

CAMPBELL-SMITH, Chief Judge

Plaintiff has brought suit alleging breach of contract. In Count I of the complaint, plaintiff alleges that the government’s termination of plaintiffs contract to supply diabetic supplies to Medicare recipients effected a breach of contract. Compl. ¶¶ 1-23, ECF No. 1. In Count II of the complaint, plaintiff makes a further claim for breach of contract that arises out of a denial of payment after a routine audit in which defendant disallowed certain sales plaintiff made to Medicare recipients. Id. at ¶¶ 24-44.

The case was transferred to the undersigned on October 29, 2013. ECF No. 18. On October 17, 2013, defendant filed a motion to dismiss pursuant to both Rules 12(b)(1) and 12(b)(6) of the Rules of the United States Court of Federal Claims (RCFC). Def.’s Mot., ECF No. 16. Plaintiff filed its opposition on February 19, 2014. Pl.’s Opp’n, ECF No. 24. Defendant filed a reply on March 4, 2014. Def.’s Reply, ECF No. 25. Oral argument was neither requested by the parties nor deemed necessary by the court. ECF No. 26. Defendant’s motion is ripe for consideration.

For the reasons explained below, defendant’s motion to dismiss is DENIED as to Count I, and GRANTED as to Count II.

I. Count I—Breach of Contract Under Competitive Bidding

The facts pertaining to the contract termination alleged in Count I are identical to those in the matter of Cardiosom, L.L.C. v. United States, 115 Fed.Cl. 761 (2014). In Cardiosom, the government presented the same argument for dismissal that it now offers here. Defendant acknowledges as much in its motion. Def.’s Mot. 7 (stating that “the facts and issues in Cardiosom [v. United States, No. 08-533], are very similar to those in this case, and because the [Federal Circuit decision, Cardiosom, L.L.C. v. United States, 656 F.3d 1322 (Fed.Cir.2011) ] is binding precedent on this Court, we address the decision in some depth here.”). Based on the factual congruity between the Cardiosom case and this one, the court draws heavily from its April 30, 2014 Cardiosom opinion in its analysis here.

The facts of this ease are not in dispute. A detailed recitation of the facts relating to both contract formation and termination was set forth in the previous decisions of both the Federal Circuit and this court. See Cardiosom, 656 F.3d at 1324-25, rev’g 91 Fed.Cl. 659 (2010); Cardiosom, L.L.C. v. United States, 91 Fed.Cl. 659, 660-62 (2010), rev’d, 656 F.3d 1322 (Fed.Cir.2011). Here the court provides an abbreviated summary of the facts particular to this matter.

A. Background

B & H Medical, LLC (plaintiff or B & H) contracted with the Centers for Medicare & Medicaid Services (CMS) of the Department of Health & Human Services (defendant or HHS) to provide diabetic supplies in nine different metropolitan areas. Compl. ¶¶ 4, 6. The contract became effective on July 1, 2008. Id. at ¶ 6.

On July 15, 2008, Congress passed legislation terminating all contracts, including plaintiffs, that had been issued under what was known as Round 1 of HHS’s plan to redefine the way in which it purchased durable medical equipment through the Medicare program. 42 U.S.C. § 1395w-3. Section 1395w-3, which is alternately known as Section 154 of the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) or the 2008 Amendment, included a provision withdrawing the right to administrative or judicial review “with regard to the termi *676 nation.” § 1395w-3(a)(l)(D)(i) (judicial review withholding provision).

HHS then promulgated a regulation in which it established an administrative process through which it would pay specified damages to terminated suppliers. 42 C.F.R. § 414.425. The regulation provided that CMS would make the determination regarding which of the claimed damages were compensable, and provided that CMS’s “determination [would be] final and not subject to administrative or judicial review.” § 414.425(f)(2)(vi). The requisite notice and a public comment period preceded the promulgation of the regulation. See Def.’s Mot. 4 (citing 74 Fed.Reg. 61,738-01 (Nov. 25, 2009)).

B & H submitted a damages claim through the CMS administrative process in February 2010, and at the request of CMS, provided supplemental information in June 2010. Compl. ¶¶ 13, 15. CMS offered B & H partial payment on its claim in April 2012, id. at ¶ 20, which B & H declined to accept on the basis of its inadequacy, PL’s Opp’n 2, ECF No. 24.

In August 2011, the Federal Circuit issued a ruling in the Cardiosom matter, holding that § 1395w-3 “did not withdraw traditional contract jurisdiction under the Tucker Act [and determining that] plaintiff states a claim over which the Court of Federal Claims has jurisdiction.” Cardiosom, 656 F.3d at 1324. The Federal Circuit elaborated:

[a]s we read it, the 2008 Amendment left open the question of the consequences of Congress’s chosen route, and any private remedies arising therefrom. More specifically, the amendment left untrammeled the subject matter jurisdiction of the Court of Federal Claims to hear and decide breach of contract claims resulting from these terminations. Whatever may be the rule regarding nonreviewability of the act of termination, or the absence of challenge to the administrative remedy authorized, the legal consequences of the terminations can still be determined under existing federal law governing contract disputes with the Government.

Cardiosom, 656 F.3d at 1330 (emphasis added).

The Federal Circuit also observed that the meaning of the judicial review withholding provision in § 1395w-3 was susceptible to at least three meanings, any of which was consistent with Congress’s apparent purpose. See id. at 1327-29. First,

Congress could have intended that the statute not be read to provide an ‘independent cause of action or right to administrative or judicial review with regard to the termination,’ with respect to the structure of the administrative compensation mechanism established by the Secretary, or perhaps even to the rewards from the special fund created by the statute.

Id. at 1328. Second, a “somewhat different but equally plausible, interpretation of the judicial review withholding provision is that there is to be no independent judicial review of Congress’s decision to terminate the existing contracts.” Id. at 1329. And third, a

possible reading of the statutory language is that it is intended to prevent judicial or administrative review by third parties.

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Cite This Page — Counsel Stack

Bluebook (online)
116 Fed. Cl. 671, 2014 U.S. Claims LEXIS 568, 2014 WL 2854090, Counsel Stack Legal Research, https://law.counselstack.com/opinion/b-h-medical-llc-v-united-states-uscfc-2014.