In Re Psychotherapy and Counseling Center, Inc.

195 B.R. 522, 36 Collier Bankr. Cas. 2d 1, 1996 Bankr. LEXIS 513, 1996 WL 262873
CourtDistrict Court, District of Columbia
DecidedMay 15, 1996
DocketBankruptcy 94-0005
StatusPublished
Cited by6 cases

This text of 195 B.R. 522 (In Re Psychotherapy and Counseling Center, Inc.) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Psychotherapy and Counseling Center, Inc., 195 B.R. 522, 36 Collier Bankr. Cas. 2d 1, 1996 Bankr. LEXIS 513, 1996 WL 262873 (D.D.C. 1996).

Opinion

DECISION ON MOTION FOR DECLARATION THAT PROPOSED EXCLUSION IS EXCEPTED FROM AUTOMATIC STAY OR, ALTERNATIVELY, FOR RELIEF FROM STAY

S. MARTIN TEEL, Jr., Bankruptcy Judge.

Under the court’s consideration is a motion in the alternative filed by the United States Department of Health and Human Services (“HHS”) seeking a declaration that the automatic stay does not bar it from excluding the debtor, Psychotherapy and Counseling Center, Inc., from participating in Medicare and the state health care programs based on the debtor’s default under a settlement agreement with HHS. Alternatively, HHS requests rehef from the automatic stay so it can proceed to exclude the debtor from participation in the programs.

This case arises out of HHS’s investigation of the debtor for aUeged violations of the False Claims Act in connection with the Medicare and Medicaid provider reimbursement program. HHS and the debtor agreed to settle the matter before trial pursuant to a settlement agreement whereby HHS agreed to drop all claims against the debtor in return for the debtor’s agreement, without admitting any fault, to pay HHS $145,000 over three years. The debtor defaulted on the agreement after the first year and filed for bankruptcy. HHS now seeks to exclude the debtor from the program, which is the sole remedy provided in the default provision of the agreement. HHS argues that if it is unable to enforce the exclusion remedy, HHS’s ability to settle cases wiU be undermined because violators can simply escape the responsibility under the settlement by filing bankruptcy after settling the claims. For reasons explained below, HHS’s motions wifi be denied.

BACKGROUND FACTS

The debtor is a mental health center that participates in the Medicare and Medicaid provider reimbursement program pursuant to Medicare and Medicaid Provider Agreements with HHS. On January 16, 1992, HHS and the debtor 1 entered into a settlement agreement to resolve the debtor’s potential liability for the aEeged submission of false claims to the Medicare and Medicaid programs from January 1988 to January 1992 in violation of the civil False Claims Act 2 and certain other civil common laws. *525 Under the terms of the settlement HHS gave up its right to pursue the debtor for any cause of action arising from the alleged false claims. In return, without admitting any fault or wrong-doing, the debtor agreed to pay HHS a total of $145,000, together with 6.5% annual interest. The debtor’s payment was to be made pursuant to a promissory note incorporated into the agreement, which provided for an initial up-front payment of $20,000 to HHS to be followed by four yearly installments of $36,250, beginning on December 1,1992. 3

In the event of default, Article VI of the agreement provided that:

the United States of America through the Department of Health and Human Services may at any time and at its option exclude the ... Parties from participation in the Title XVIII (Medicare) program and applicable State health care programs pursuant to 42 U.S.C. 1320a-7a(a) and 42 U.S.C. § 1320a-7(h) until such time as the ... Parties have fully cured the default. The ... Parties agree not to contest such exclusion either administratively or in any State or Federal court.

The debtor complied with the initial $20,-000 payment immediately due 'under the note but was late on the first $36,250 payment due on December 1, 1992, making this payment in two installments on January 21 and February 19,1993. Thereafter, the debtor made no further payments and filed for bankruptcy under chapter 11 on January 5, 1994, shortly after the second annual payment was due. Following the debtor’s petition, HHS sent two letters notifying the debtor of its default under the agreement and indicating an intent to enforce the exclusion remedy provided in the agreement. Specifically, on February 16, 1994, the United States Department of Justice (“DOJ”) as counsel for HHS sent a letter to the debtor which read, in relevant part:

We have not received the above payment. If we do not receive full payment on or before March 16, 1994, thirty days from today’s date, we will be forced to proceed with the legal remedies provided in the Agreement for the collection of this debt.

See Debtor’s Supp.Mem. in Opp. at Attach. 1.

Similarly, on August 12, 1994, HHS sent a letter to the debtor providing:

In accordance with Article VI of the Agreement, we now intend to exclude you from participation in the Medicare and all State health care programs because of your default....
Unless you repay all amounts now due within 30 days of your receipt of this letter, we will take the exclusion action and notify the public as well as all other appropriate parties.

See id. at Attach. 2.

On April 24, 1995, the debtor filed its Amended Plan of Reorganization which provided under Article V that the Medicare and Medicaid Provider Agreements with HHS would be assumed as part of the plan. Additionally, under Article III of the plan HHS’s claim for amounts due under the settlement agreement was classified as a general unsecured claim designated to receive a pro rata distribution of assets valued at approximately $30,000 to $40,000.

On May 18, 1995, HHS filed this motion seeking permission to exclude the debtor from the health care program. Specifically, HHS seeks a declaration that its proposed exclusion of the debtor is excepted from the automatic stay under 11 U.S.C. § 362(b)(4) as an enforcement of regulatory power. HHS insists that this exercise of regulatory authority is not motivated by the desire to collect the debt owed under the agreement, conceding that a desire to protect its pecuniary advantage would be an improper motivation, citing United States ex rel. Marcus v. NBI, Inc., 142 B.R. 1, 3 (D.D.C.1992). Rather, HHS contends that it is seeking to exclude the debtor because the debtor is untrustworthy as demonstrated by its default under the settlement agreement. HHS supports this conclusion with the affidavit of William M. Libercci, the HHS Director of *526 Health Care Administrative Sanctions, in which he states that:

An exclusion from participation in the Medicare and State health care programs is not an action to collect a debt. Rather, it is a determination that a particular individual or entity is no longer eligible to participate in the Medicare and State health care programs because that individual or entity has demonstrated by past conduct they are untrustworthy.

See HHS Mot. at Ex 2.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
195 B.R. 522, 36 Collier Bankr. Cas. 2d 1, 1996 Bankr. LEXIS 513, 1996 WL 262873, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-psychotherapy-and-counseling-center-inc-dcd-1996.