Boston Regional Medical Center, Inc. v. Massachusetts Division of Health Care Finance & Policy

365 F.3d 51, 2004 U.S. App. LEXIS 7214, 42 Bankr. Ct. Dec. (CRR) 254, 2004 WL 785337
CourtCourt of Appeals for the First Circuit
DecidedApril 14, 2004
Docket03-1527
StatusPublished
Cited by21 cases

This text of 365 F.3d 51 (Boston Regional Medical Center, Inc. v. Massachusetts Division of Health Care Finance & Policy) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Boston Regional Medical Center, Inc. v. Massachusetts Division of Health Care Finance & Policy, 365 F.3d 51, 2004 U.S. App. LEXIS 7214, 42 Bankr. Ct. Dec. (CRR) 254, 2004 WL 785337 (1st Cir. 2004).

Opinion

LEVIN H. CAMPBELL, Senior Circuit Judge.

At issue in this appeal is whether amounts owing by a debtor hospital under Massachusetts general law, chapter 118G, section 18, to a state fund known as the Commonwealth’s Uncompensated Care Pool are properly considered to be “excise taxes” enjoying priority in bankruptcy under 11 U.S.C. § 507(a)(8)(e).

*54 Appellant, Boston Regional Medical Center, (“BRMC or debtor”) filed a voluntary petition for reorganization under Chapter 11 of the Bankruptcy Code in the United States Bankruptcy Court for the District of Massachusetts. Appellee, the Commonwealth of Massachusetts, by its Division of Health Care Finance and Policy (“HCFP”), filed a proof of claim. After resolving a disagreement oyer the dollar amount, appellee finally asserted a priority of claim for $1,702,714, a sum representing appellant’s unpaid prepetition obligations as an acute hospital under Mass. Gen. Laws ch. 118G, § 18 to the Commonwealth’s Uncompensated Care Pool (the “Pool”). 1 While the debtor agreed to the dollar amount of the claim, it disputed appellee’s contention that the claim was entitled to priority as an “excise tax” under section 507(a)(8)(E) of the Bankruptcy Code. Determining the claim was for an excise tax, the bankruptcy court overruled appellant’s objection and granted priority to the claim. In re Boston Reg’l Med. Ctr., 264 B.R. 222, 229-30 (Bankr.D.Mass.2001) (“BRMC II”). Appellant appealed, and the district court affirméd the bank-ruptey court’s judgment, stating its reasons in the course of an unpublished bench ruling. We affirm the district court.

Facts

The case was submitted on stipulated facts, the substance of which are as follows.

Prior to filing its Chapter 11 bankruptcy petition, appellant, BRMC, owned and operated a 195-bed private, acute hospital in Stoneham, Massachusetts. As an acute hospital 2 within Massachusetts, BRMC was required by Massachusetts law to participate in the Pool (Pool). 3 The Pool, administered by the State’s Division of Health Care Finance and Policy, is a fund from which Massachusetts hospitals are paid or credited for the free health care they furnish to patients whp do not have health insurance or cannot otherwise pay for hospital care. Mass. Gen. Laws. ch. 118G, §§ 18(h) and (k). The Pool’s stated statutory purpose is “to provide access to health care for low income uninsured and underinsured residents of the Commonwealth.” 4 Id. The Massachusetts Supreme *55 Judicial Court has stated, in respect to an earlier version of the Pool law, that the Pool’s purpose is “ ‘to more equitably distribute the burden of uncompensated acute hospital services across all acute hospitals.’ ” Gen. Hosp. Corp. v. Rate Setting Comm’n, 407 Mass. 227, 552 N.E.2d 113, 114 (1990) (quoting Mass. Gen. Laws ch. 6A, § 75).

Pool funding comes both from the mandatory assessments made against each acute hospital based on its “private sector charges,” infra, and from other governmental funds and assessments. The amounts collected by the Pool are segregated for its own purposes and are not used to fund other governmental programs or otherwise to defray the costs of state government.

Section 18 provides for the collection and distribution of Pool funds among the hospitals. According to section 18(e), a hospital’s liability to the Pool is proportional to the amount of otherwise uncompensated care each hospital provides. Liability to the Pool (i.e., the assessment based on its private sector charges) “shall equal the product of (1) the ratio of its private sector charges to all acute hospitals’ private sector charges; and (2) the private sector liability to the uncompensated care Pool as determined by law... .” 5 In order to determine the debtor hospital’s individual liability to the Pool, the HCFP must, therefore, first determine the amount of private sector charges for all hospitals in Massachusetts. “Private sector charges” is defined as a hospital’s gross patient service revenue, less the amount of gross patient service revenue that is attributable to Medicare, Medicaid and other “publicly aided patients, free care and bad debt.” Mass. Gen. Laws ch. 118G, § 1.

In calculating a hospital’s liability to the Pool, certain credits are provided. A hospital’s assessed liability to the Pool is offset against the amount owed by the Pool to the hospital for uncompensated care during the same period, thus resulting in either a net liability to the Pool or a net distribution from the Pool. Mass. Gen. Laws ch. 118G, § 18(d). The Pool, therefore, charges the hospitals’ collective private sector revenue to pay for the hospitals’ collective burden of uncompensated care, resulting, at bottom, in a net transfer of revenue from those hospitals that provide less uncompensated care (as a proportion of the hospital’s total patient service charges) to those that provide more. Mass. Gen. Laws ch. 118G, §§ 18(d) and 18(h). To the extent a hospital receives reimbursement for free care directly from Medicare, Medicaid or another source other than the Pool, the amount owed by all other hospitals is reduced because the amount of funding required from the Pool is reduced.

Furthermore, “disproportionate share hospitals” — which are hospitals that have “a payer mix where a minimum of sixty-three percent of the acute hospital’s gross patient service revenue is attributable to [certain government payments] and free *56 care” — and “non-disproportionate share hospitals” — -which do not have that payer mix — receive different treatment under section 18. Mass. Gen. Laws ch. 118, § 1. In the event that the Pool does not have sufficient funds to reimburse all hospitals for all of the free care provided, the amount paid from the Pool is weighted towards disproportionate share hospitals.

Pursuant to section 18, BRMC owes ap-pellee a total of $1,702,714, representing the total amount due to the Pool for the following fiscal years:

a. 1996 — $1,580,506
b. 1997 — $ 60,639
c. 1998 — $ (77,744) credit
d. 1999 — $ 139,313

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365 F.3d 51, 2004 U.S. App. LEXIS 7214, 42 Bankr. Ct. Dec. (CRR) 254, 2004 WL 785337, Counsel Stack Legal Research, https://law.counselstack.com/opinion/boston-regional-medical-center-inc-v-massachusetts-division-of-health-ca1-2004.