Crestview Clinical Laboratory, LLC v. United States

CourtUnited States Court of Federal Claims
DecidedApril 24, 2026
Docket24-995
StatusPublished

This text of Crestview Clinical Laboratory, LLC v. United States (Crestview Clinical Laboratory, 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
Crestview Clinical Laboratory, LLC v. United States, (uscfc 2026).

Opinion

In the United States Court of Federal Claims

CRESTVIEW CLINICAL LABORATORY, LLC,

Plaintiff, No. 24-cv-0995 (Filed: April 24, 2026) v.

THE UNITED STATES,

Defendant.

Elaine F. Harwell, Procopio Cory Hargreaves & Savitch LLP, San Diego, CA, for Plaintiff.

Galina I. Fomenkova, Commercial Litigation Branch, Civil Division, United States Department of Justice, Washington, D.C., for Defendant. Also on the briefs were Brett A. Shumate, Principal Deputy Assistant Attorney General, Patricia M. McCarthy, Director, and Corinne A. Niosi, Assistant Director.

OPINION AND ORDER

Meriweather, Judge.

In this breach-of-contract action, Plaintiff Crestview Clinical Laboratory, LLC (“Crestview”) seeks damages in the amount of $69 million from the United States for testing services furnished during the COVID-19 pandemic. Crestview alleges, inter alia, that the U.S. Department of Health and Human Services (“HHS”) and the Human Resources and Services Administration (“HRSA”) breached an express or implied-in-fact contract and otherwise acted in bad faith by pausing and reversing reimbursements obligated to Crestview pursuant to the COVID-19 Uninsured Program (“UIP”). The United States filed a Motion to Dismiss, ECF No. 12, contending that Crestview has failed to identify a money-mandating statute or plausibly allege a contract with the United States from which this Court could derive jurisdiction. Having reviewed the pleadings, the parties’ briefing, 1 and the relevant law, and for the reasons explained below, the Court GRANTS IN PART AND DENIES IN PART the United States’ Motion to Dismiss.

1 The following filings are relevant to this Opinion: Compl., ECF No. 1; Def.’s Mot. to Dismiss, ECF No. 12 (“Mot.”); App’x to Def.’s Mot. to Dismiss, ECF No. 12-1 (“App’x”); Pl.’s Opp’n to Def.’s Mot. to Dismiss, ECF No. 15 (“Resp.”); Def.’s Reply in Support, ECF No. 16 (“Reply”). Throughout, page citations to documents in the record refer to the document’s original pagination, unless the page is designated with an asterisk (e.g., *1), in which case the reference is to the pagination assigned by PACER/ECF. BACKGROUND 2

I. Factual Background

A. The COVID-19 Uninsured Program Was Established to Reimburse Healthcare Providers for Eligible Services to Uninsured Individuals.

The COVID-19 pandemic in 2020 placed an unprecedented strain on the global economy and healthcare workers. See Compl. ¶¶ 1–4. To better respond to this complicated health crisis, government officials sought ways to significantly expand COVID-19 testing capacity. See id. ¶ 5. On March 27, 2020, Congress passed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), which appropriated $100 billion in funding and entrusted the Secretary of HHS with “reimburs[ing] through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus.” Pub. L. No. 116-136, 134 Stat. 281, 563 (2020). In conjunction with the CARES Act, Congress approved additional COVID-19 relief funds through the Families First Coronavirus Response Act, Pub. L. No. 116-127, 134 Stat. 178 (2020), the Paycheck Protection Program and Health Care Enhancement Act, Pub. L. No. 116-139, 134 Stat. 620 (2020), and the American Rescue Plan Act, Pub. L. No. 117-2, 135 Stat. 4 (2021) (collectively “UIP Funding Laws”). See Compl. ¶¶ 7– 9. Through the UIP Funding Laws, Congress expressly appropriated $2 billion toward claim reimbursement for testing services provided to uninsured individuals, although HHS later allocated additional general funds for that purpose. See App’x at A2–A3, A6.

Contemporaneously with the CARES Act, HHS established the COVID-19 UIP as a framework to encourage and support testing, treatment, and vaccination services for uninsured individuals. See Compl. ¶ 9. Using the appropriations made available through the UIP Funding Laws, HHS created a fund to reimburse healthcare providers who voluntarily participated in the program. See id. ¶¶ 7–9. HRSA, the operating division within HHS charged with administering the COVID-19 UIP, contracted with UnitedHealth Group (“UnitedHealth”) to process UIP claims. See id. ¶¶ 22, 26; App’x at A3. To submit claims for reimbursement, a healthcare provider had to first enroll through an online portal. See App’x at A18–A19, A26–A27, A42– A50. Once enrolled, a healthcare provider could submit claims for rendered services on a rolling basis, which required a patient roster and attestation that the provider complied with the requisite UIP Terms and Conditions (“T&C”) for every claim submission. See id. at A49, A51–A55. The UIP T&C imposed various record-keeping and other obligations on UIP participants. See

2 As the instant case is at the motion-to-dismiss stage, this Opinion recites and assumes the truth of the factual allegations in the Complaint. See Stephens v. United States, 884 F.3d 1151, 1155 (Fed. Cir. 2018). Courts may also rely on any exhibits attached to a motion to dismiss that are “incorporated by reference or integral to the claim.” Cotter Corp., N.S.L. v. United States, 127 F.4th 1353, 1366 (Fed. Cir. 2025) (quotation omitted). The United States attaches a 137-page Appendix to its Motion consisting of nine exhibits. See Mot. at v (index). Crestview only objects to two exhibits. See Resp. at 10; App’x at A104–A137. Crestview does not ask the Court to exclude the remaining exhibits from consideration—indeed, Crestview cites some of those exhibits multiple times in its opposition. See, e.g., Resp. at 6–7, 13, 27–28. As explained further below, the Court also relies on certain portions of the uncontested Appendix.

2 generally id. at A63–A97. “Non-compliance with any Term or Condition is grounds for the Secretary to recoup some or all of the payments made.” Id. at A76. 3 In exchange for services provided, the UIP T&C state: “The Secretary will reimburse the Recipient generally at 100 percent of Medicare rates.” Id. at A78. After attesting to the UIP T&C and submitting a patient roster, UnitedHealth would analyze the information to verify compliance with the UIP T&C and determine reimbursement eligibility. See Compl. ¶¶ 26, 28; App’x at A35. To assist healthcare providers with the UIP reimbursement processes, HRSA and UnitedHealth provided a “HRSA COVID-19 Claims Reimbursement” training webinar (“HRSA Webinar”), see App’x at A30– A62, as well as supplementary presentations (collectively “UIP Process Training”), see Compl. ¶ 27, while HRSA published “FAQs for COVID-19 Claims Reimbursement” (“UIP FAQs”) on its official website. See Compl. ¶ 49; App’x at A1–A29.

On March 22, 2022 (“Cut-Off Date”), HRSA announced that funding for COVID-19 UIP testing and treatment services had been exhausted and no claims beyond that point would be accepted. Compl. ¶¶ 27, 32. On June 3, 2023, Congress passed the Fiscal Responsibility Act (“FRA”), Pub. L. No. 118-5, 137 Stat. 10 (2023), which rescinded all unobligated balances of certain appropriations under the UIP Funding Laws. See Compl. ¶ 14.

B. Crestview Participated in the COVID-19 UIP for Almost Two Years.

Crestview, a California-based healthcare provider, registered with the COVID-19 UIP on or about September 21, 2020, and provided COVID-19 testing services to uninsured individuals between October of 2020 and March of 2022. See id. ¶¶ 12, 23, 29. Crestview accepted the UIP T&C to receive reimbursements for the provision of COVID-19 testing services. See id. ¶ 23. Crestview alleges that it complied with all UIP T&C provisions, including by “obtaining patient attestations of their insured or uninsured status” and “bill[ing] a patient’s third-party insurance for COVID-19 testing services where available.” Id. ¶ 28. Crestview also “made substantial monetary investments” to meet the COVID-19 UIP requirements. Id.

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