Florida Home Medical Supply, Inc. v. United States

131 Fed. Cl. 170, 2017 U.S. Claims LEXIS 244, 2017 WL 1154952
CourtUnited States Court of Federal Claims
DecidedMarch 28, 2017
Docket14-596 C (Lead) Con. 13-88, 14-590, 14-594, 14-599, 14-600, 14-610, 14-612
StatusPublished
Cited by3 cases

This text of 131 Fed. Cl. 170 (Florida Home Medical Supply, Inc. 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
Florida Home Medical Supply, Inc. v. United States, 131 Fed. Cl. 170, 2017 U.S. Claims LEXIS 244, 2017 WL 1154952 (uscfc 2017).

Opinion

Motion to Dismiss for Lack of Subject Matter Jurisdiction under RCFC 12(b)(1); Medicare Prescription Drug, Improvement, and Modernization Act; 42 U.S.C. § 1395w-3 (2012); Administrative Review Permissive, not Mandatory.

OPINION

CAMPBELL-SMITH, Judge

This case arises from defendant’s termination of contracts for the provision of medical supplies to Medicare beneficiaries. Fourteen of the parties with whom defendant entered such contracts have filed eight separate lawsuits. The fourteen parties are now seeking compensation under breach of contract and takings theories. The cases have been consolidated for purposes of determining liability and this case has been designated as the lead case. See ECF No. 35. 1 The consolidated member cases include: B&H Medical, LLC v. United States, Case No. 13-88; Advacare Home Services, Inc., et al. v. United States, Case No. 14-590; All-States Medical Supply, Inc. v. United States, Case No. 14-594; American Home Health Care, Inc. v. United States, Case No. 14-599; Plus Medical, LLC v. United States, Case No. 14-600; Discount Diabetic, LLC v. United States, Case No. 14-610; and DPS Holdings, Inc. v. United States, Case No. 14-612. See id. 2

Now before the court is defendant’s motion to dismiss plaintiffs breach of contract claims for lack of jurisdiction, pursuant to Rule 12(b)(1) of the Rules of the United States Court of Federal Claims (RCFC) and for failure to state a claim, RCFC 12(b)(6), on which relief may be granted. See ECF No. 13. The motion to dismiss was initially filed in response to Florida Home Medical Supply, Inc.’s complaint. See ECF No. 13. In the order consolidating the eases, however, the court determined that its decision on the motion to dismiss would be binding on plaintiffs in seven of the eight member cases, and directed plaintiffs in those cases to file responses to defendant’s motion. See ECF No. 35 at 2. Plaintiff in B&H Medical, LLC v. United States, Case No. 13-88, is not bound by the court’s decision on this motion to dismiss be'eause its complaint previously survived a motion to dismiss. See B&H Medical, LLC v. United States, 116 Fed.Cl. 671 (2014).

For the following reasons, defendant’s motion to dismiss is DENIED.

I. Background

Medicare benefits, which are administered by the Center for Medicare & Medicaid Services (CMS), include, in part, outpatient services, durable medical equipment, and certain prescription medications. See 42 U.S.C. § 1395m(a) (2012). “Durable medical equipment” includes items such as hospital beds, wheelchairs, and diabetes testing equipment. See 42 U.S.C. § 1395x(n) (2012); 42 C.F.R. § 414.202 (2012). These benefits are part of what is known as “Medicare Part B.” See 42 U.S.C. §§ 1395j-1395w-6 (2012).

From 1989 to 2003, Medicare Part B paid the covered portion of durable medical equipment on the basis of a fee schedule. See 42 U.S.C. § 1395m(a) (2012). In 2003, Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA), which established a competitive bidding program to replace the fee schedules. See 42 U.S.C. § 1395w-3 (2012). Under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Acquisition Program (DMEPOS CAP), suppliers, such as plaintiffs in this litigation, compete to win contracts under which they would provide certain equipment in specific geographic areas at fixed prices. See 42 U.S.C. § 1395w-3(b)(5) (2012).

*174 In June 2008, CMS entered into an initial round of DMEPOS CAP contracts with approximately 300 suppliers. See ECF No. 13 at 11. Plaintiffs in the consolidated cases were among the awardees. Each plaintiff submitted one or more successful bids under the DMEPOS CAP, and effective July 1, 2008, each plaintiff contracted with CMS to provide specified durable medical equipment in one or more geographic areas for a period of three years. See Florida Home Med. Supply, Case No. 14-596, ECF No. 1 at 3-4; Advacare Home Servs. et al, Case No. 14-690, ECF No. 7 at 6; All-States Med. Sup-⅛ Case No. 14-594, ECF No. 1 at 3-4; Am. Home Health Care, Case No. 14-599, ECF No. 1 at 3-4; Plus Med., Case No. 14-600, ECF No. 1 at 3-5; Discount Diabetic, Case No. 14-610, ECF No. 5 at 3-4; and DDS Holdings, Case No. 14-612, ECF No. 10 at 3-5.

The following month, on July 15, 2008, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Pub. L. No. 110-275, 122 Stat. 2494 (codified at 42 U.S.C. § 1395w-3). The MIPPA terminated all DMEPOS CAP contracts executed by CMS in the initial round of contracting to begin the competitive bidding procedures. See 42 U.S.C. § 1395w-3(a)(l)(D)(i). That provision reads, in relevant part, as follows:

(D) Changes in competitive acquisition programs
(i) Round 1 of competitive acquisition program
Notwithstanding subparagraph (B)(i)(I) and in implementing the first round of the competitive acquisition programs under this section—
(I) the contracts awarded under this section before July 15, 2008, are terminated, no payment shall be made under this subchapter on or after July 15, 2008, based on such a contract, and, to the extent that any damages may be applicable as a result of the termination of such contracts, such damages shall be payable from the Federal Supplementary Medical Insurance Trust Fund under section 1395t of this title;
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Nothing in subclause (I) shall be construed to provide an independent cause of action or right to administrative or judicial review with regal’d to the termination provided under such subclause.

42 U.S.C. § 1395w-3(a)(l)(D)(i) (2012).

Pursuant to this statutory language, CMS created an administrative claims process for suppliers whose contracts were terminated. See ECF No. 13 at 12. The rule relating to the claims process appears as a regulation at 42 C.F.R. § 414.425 (2012).

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Bluebook (online)
131 Fed. Cl. 170, 2017 U.S. Claims LEXIS 244, 2017 WL 1154952, Counsel Stack Legal Research, https://law.counselstack.com/opinion/florida-home-medical-supply-inc-v-united-states-uscfc-2017.