Hospital Services Ass'n v. United States

78 Fed. Cl. 434, 100 A.F.T.R.2d (RIA) 6028, 2007 U.S. Claims LEXIS 301, 2007 WL 2768861
CourtUnited States Court of Federal Claims
DecidedSeptember 14, 2007
DocketNo. 05-503T
StatusPublished
Cited by1 cases

This text of 78 Fed. Cl. 434 (Hospital Services Ass'n 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.

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Hospital Services Ass'n v. United States, 78 Fed. Cl. 434, 100 A.F.T.R.2d (RIA) 6028, 2007 U.S. Claims LEXIS 301, 2007 WL 2768861 (uscfc 2007).

Opinion

OPINION AND ORDER

WHEELER, Judge.

This tax case is before the Court on Defendant’s February 28, 2007 Motion for Summary Judgment, and Plaintiffs April 30, 2007 Cross-Motion for Partial Summary Judgment. Plaintiff, Hospital Services Association of Northeastern Pennsylvania (“HSA”), filed this action to recover federal income taxes alleged to have been erroneously overpaid for the years 1991 through 1997.1 HSA is a Blue Cross/Blue Shield (“BC/BS”) organization that was exempt from federal income tax until the Tax Reform Act of 1986 (the “Tax Reform Act”) took effect on January 1, 1987. Pub.L. No. 99-514, § 1012, 100 Stat. 2085, 2390 (1986). Section 1012 of the Tax Reform Act contained provisions designed to transition BC/BS organizations into taxation, including one known as the “Fresh Start Basis Rule.” This rule provided that “for purposes of determining gain or loss, the adjusted basis of any asset held [by a BC/BS organization] on [January 1, 1987] shall be treated as equal to its fair market value as of such day.” Id. § 1012(e)(3)(A)(ii).

The question before the Court is whether the Fresh Start Basis Rule and Internal Revenue Code (“I.R.C.”) § 1652 apply to loss deductions that HSA claims for the termination or cancellation of its healthcare coverage contracts. Four other federal courts, including most recently this Court, have answered this question in favor of the taxpaying BC/BS entity. Trigon Ins. Co. v. United States, 215 F.Supp.2d 687 (E.D.Va.2002); Capital Blue Cross v. Comm’r, 122 T.C. 224, 2004 WL 473263 (2004) (“Capital I”); Capital Blue Cross v. Comm’r, 431 F.3d 117 (3d Cir.2005) (“Capital II”); Highmark, Inc. v. United States, 78 Fed.Cl. 146 (2007). For the reasons explained below, the Court agrees with the analysis from the other four [436]*436decisions, and finds that the Fresh Start Basis Rule and I.R.C. § 165 do apply to the loss deductions arising from the termination or cancellation of HSA’s healthcare coverage contracts. Accordingly, Plaintiffs Cross-Motion for Partial Summary Judgment is GRANTED, and Defendant’s Motion for Summary Judgment is DENIED. The case will be set for further proceedings to determine the amount of HSA’s loss deductions.

Factual Background3

Plaintiff HSA is a Pennsylvania nonprofit corporation doing business as an independent licensee of the BC/BS organization. HSA is a provider of health insurance, and is a party to healthcare coverage contracts with individual and group subscribers. HSA’s healthcare coverage contracts obligate HSA to pay the healthcare costs of the individual or group members in exchange for the subscriber’s payment of an insurance premium. HSA incurs various business expenses to induce potential customers to enter into contracts. These costs include advertising, salaries, travel, actuarial fees to compute premiums, and overhead. Over the life of each healthcare coverage contract, HSA incurs additional expenses to maintain the policy.

Historically, HSA and other BC/BS organizations were not subject to federal income taxes. In 1986, Congress became concerned that the tax-exempt status of BC/BS organizations gave them an unfair competitive advantage over other healthcare insurers, and eliminated the tax exemption as of January 1, 1987. See H.R.Rep. No. 99-841, pt. 2, at 350 (1986) (Conf.Rep.), as reprinted in 1986 U.S.S.C.A.N. 4075, 4437-38. When BC/BS entities became taxable, they needed a method to determine the tax basis of their assets. Congress therefore provided that BC/BS entities could take a stepped-up basis in their assets, so that the tax basis of each asset would be its fair market value on January 1, 1987. Tax Reform Act, § 1012(c)(3)(A)(ii). This allowance of a stepped-up basis is known as the Fresh Start Basis Rule.

The purpose of the Fresh Start Basis Rule was to prevent any unrealized gain or loss that had accrued while a BC/BS organization was tax exempt from being considered in determining tax liability once the entity became a taxpayer. See H.R.Rep. No. 99-841, supra. By requiring the basis of each asset held on January 1, 1987 to be adjusted to its fair market value on that date, the Fresh Start Basis Rule ensures that the taxable income or loss of a BC/BS entity would be based solely on income and loss that accrue after the entity became subject to federal income tax. See Trigon, 215 F.Supp.2d at 691-92.

For purposes of its financial accounting, both before and after January 1, 1987, HSA treated its business expenses of selling and maintaining health insurance contracts as current expenses, and not as capital items. For tax accounting purposes after January 1, 1987, HSA also treated these expenses as ordinary expenses, both as to the posH986 expenses incurred to maintain pre-1987 contracts, and as to posW986 expenses incurred to solicit and maintain post-1986 contracts.

HSA did not claim any loss deductions for terminated contracts on its originally filed income tax returns for 1987 through 1995. HSA first claimed loss deductions for terminated contracts in September 1996 on its amended returns for 1991 and 1992. After filing its amended returns for 1991 and 1992, HSA filed refund claims for the 1993, 1994, and 1995 tax years, seeking deductions for terminated healthcare coverage contracts. HSA also claimed deductions for terminated contracts on its original 1996 and 1997 tax returns. HSA did not request or secure the consent of the Internal Revenue Service (“IRS”) to change its method of accounting for the termination or cancellation of healthcare coverage contracts, believing that it had not changed its method of accounting.

The amount of HSA’s loss deductions will be determined in further proceedings, but one document attached to HSA’s April 27, 2005 Complaint, Exhibit D, indicates that the value ascribed to HSA’s healthcare coverage [437]*437contracts on January 1,1987 was $32,485,000. The IRS disagreed with this value, setting the amount instead at $22,396,000. At the July 27, 2007 oral argument, Defendant’s counsel stated that the claimed deductions were in the range of “tens of millions of dollars.” Summ. J. Hr’g Tr. 5, July 27, 2007.

Also at the oral argument, the Court inquired why HSA had waited until 1996 to assert loss deduction claims stemming from a 1987 valuation process. Hr’g Tr. 46. HSA’s counsel explained that the BC/BS entities had little prior familiarity with the federal tax code, and were awaiting instruction from the IRS while also acquiring knowledge and expertise on their own. Hr’g Tr. 45-46. The IRS issued Technical Advice Memorandum 9533003 in 1995 indicating that the stepped-up basis in assets as of January 1, 1987 could apply to self-created assets such as software. Hr’g Tr. 46-47. The healthcare coverage contracts at issue also are regarded as self-created assets. See infra.

HSA filed administrative claims for refund with the IRS for the 1991 through 1997 tax years, which the IRS denied in their entirety in notices of claim disallowance dated April 27, 2001. Following agreements with the IRS extending the time for HSA to file suit, HSA commenced this action on April 27, 2005.

Positions of the Parties

Plaintiff HSA contends that the language of the Fresh Start Basis Rule and I.R.C.

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78 Fed. Cl. 434, 100 A.F.T.R.2d (RIA) 6028, 2007 U.S. Claims LEXIS 301, 2007 WL 2768861, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hospital-services-assn-v-united-states-uscfc-2007.