Excel Home Care, Inc. v. United States Department of Health & Human Services

316 B.R. 565, 2004 U.S. Dist. LEXIS 22164, 2004 WL 2441212
District Court, D. Massachusetts·Decided October 29, 2004·No. 1:03-cv-11767·Published·Cited by 3 cases

Opinion

ORDER

O’TOOLE, District Judge.

Order entered Order Adopting Report and Recommendation. No objection having been received, after review the Report and Recommendation is adopted. The motion to dismiss is Granted and the action is Dismissed.

REPORT AND RECOMMENDATION ON DEFENDANT’S MOTION TO DISMISS (#3)

I. INTRODUCTION

COLLINGS, United States Magistrate Judge.

On September 15, 2003, Excel Home Care, Inc. (“Excel” or “plaintiff’) filed a two-count complaint against the United States Department of Health and Human Services (“DHHS” or “defendant”). (# 1) In Count I the plaintiff alleges that by ignoring the terms and provisions of Excel’s confirmed Chapter 11 Plan of Reorganization, DHHS breached its contractual obligations to Excel. (# 1, ¶¶ 16, 17) For the same reason DHHS is alleged to have violated the provisions of Title 11 U.S.C. § 1141(a) in Count II. (# 1, ¶¶ 18,19)

In lieu of answering the complaint, on November 24, 2003, the DHHS filed a motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(1) and 12(b)(6). (# 3) The DHHS argues in its supporting memorandum of law that Title 42 U.S.C. § 405(h), made applicable to Medicare care claims by Title 42 U.S.C. § 1395ii, precludes federal question jurisdiction in this case and second, that even if the Court, in fact, has subject matter jurisdiction, Excel fails to state a claim because the DHHS maintains a right of recoupment. (# 4) On December 9, 2003, Excel submitted a memorandum of law in opposition to the dispositive motion. (# 5) At this juncture, the motion to dismiss is poised for resolution.

II. FACTS

From all that appears, the facts of this case are undisputed. Excel, a Massachusetts corporation, is home health care provider that receives reimbursement for services provided to Medicare beneficiaries from the DHHS under Part A of the Medicare Program. (# 1, ¶ 1; #4 at 1) On November 5, 2001, Excel filed a Chapter 11 bankruptcy petition with the United States Bankruptcy Court for the District of Massachusetts, Case No. 01-46770-JBR. (# 1, ¶ 5) The DHHS, as a creditor in the bankruptcy proceedings, filed a proof of claim. (# 1, ¶ 6) Thereafter the parties reached an agreement to the effect that Excel owed the DHHS a total of $438,236.68 at the time that it filed the bankruptcy petition. (#1, ¶ 7 and Exh. A, 4.3)

On May 29, 2002, Excel filed its First Amended Plan of Reorganization (“Plan”). (#1, ¶ 8 and Exh. A) Approximately nine months later on February 20, 2003, the Bankruptcy Court confirmed the Plan. (# 1, ¶ 9 and Exh. B) As stated within the *567 terms and provisions of its Order, the Court found that the Plan had been accepted by the DHHS. (# 1, Exh. B, ¶ 3(e)) Moreover, the Court ordered that “[furthermore, all Creditors of the Debtor shall be satisfied solely from the payments as defined in the Plan, and may not seek other, further or additional payments, compensation and/or consideration from the Debtor.” (# 1, Exh. B ¶ 6)

According to the terms of the Plan, DHHS’s claims are designated as Class 3 claims. (# 1, ¶ 10 and Exh. A at 5) The Plan provides in section 4.3 that Excel will pay the DHHS in full for the amount owed plus interest over a period not to exceed seven years with payments to be made in monthly installments of $7,000.00. (# 1, ¶ 10 and Exh. A, section 4.3) The plaintiff alleges that the parties “mechanistically” agreed that “the sum of $7,000.00 per month would be withheld by DHHS from its ongoing and continuing payments otherwise to be made to Excel for services rendered to Medicare patients serviced by Excel.” (# 1, ¶ 11)

In May of 2003 after the Bankruptcy Court had confirmed the Plan, the DHHS’s fiscal intermediary calculated that Excel had been underpaid by $127,001.00 for Medicare reimbursement payments during the year 2000. (# 1, ¶ 12 and Exh. C) In a letter dated May 6, 2003, the intermediary informed Excel of the underpayment. (# 1, Exh. C) However, instead of paying Excel the $127,001.00, the DHHS withheld the funds and deducted the amount of the underpayment from the amount Excel otherwise owed the DHHS for past overpayments pursuant to the Plan. (# 1, ¶ 13)

On July 21, 2003, Excel sent the DHHS a letter to advise that, in its view, withholding the underpaid funds violated the confirmed Chapter 11 Plan. (# 1, ¶ 14 and Exh. D) Excel demanded that the total amount due be turned over to it within 14 days of the letter’s issuance. (# 1, ¶ 14 and Exh. D). Having received no response to its demand letter, on September 15, 2003, Excel instituted the present litigation. (# 1, ¶ 15)

III. DISCUSSION

A. Standard Under Rule 12(b)(1)

Pursuant to Rule 12(b)(1), Fed.R.Civ.P., a defendant may move to dismiss an action based on lack of federal subject matter jurisdiction. Because federal courts are considered courts of limited jurisdiction, “federal jurisdiction is -never presumed.” Viqueira v. First Bank, 140 F.3d 12, 16 (1st Cir.1998). Instead, “ ‘the party invoking the jurisdiction of a federal court carries the burden of proving its existence.’ ” Murphy v. United States, 45 F.3d 520, 522 (1st Cir.1995), cert. denied, 515 U.S. 1144, 115 S.Ct. 2581, 132 L.Ed.2d 831 (1995) (quoting Taber Partners, I v. Merit Builders, Inc., 987 F.2d 57, 60 (1 Cir.), cert. denied, 510 U.S. 823, 114 S.Ct. 82, 126 L.Ed.2d 50 (1993)).

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Excel Home Care, Inc. v. United States Department of Health & Human Services, 316 B.R. 565, 2004 U.S. Dist. LEXIS 22164, 2004 WL 2441212 (D. Mass. 2004).

316 B.R. 565 (Excel Home Care, Inc. v. United States Department of Health & Human Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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