Maple Manor Rehab Center LLC v. Department of Treasury

CourtMichigan Court of Appeals
DecidedJuly 23, 2020
Docket349168
StatusPublished

This text of Maple Manor Rehab Center LLC v. Department of Treasury (Maple Manor Rehab Center LLC v. Department of Treasury) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Maple Manor Rehab Center LLC v. Department of Treasury, (Mich. Ct. App. 2020).

Opinion

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports.

STATE OF MICHIGAN

COURT OF APPEALS

MAPLE MANOR REHAB CENTER, LLC, and FOR PUBLICATION MAPLE MANOR REHAB CENTER OF NOVI, July 23, 2020 INC., 9:00 a.m.

Plaintiffs-Appellants,

v No. 349168 Court of Claims DEPARTMENT OF TREASURY, LC No. 18-000271-MT

Defendant-Appellee and

DEPARTMENT OF HEALTH AND HUMAN SERVICES,

Defendant.

Before: FORT HOOD, P.J., and JANSEN and TUKEL, JJ.

PER CURIAM.

In this case involving the alleged overpayment of the Medicaid Long-Term Care Quality Assurance Assessment (QAA) tax under Michigan’s Medicare program, MCL 333.20161, plaintiffs Maple Manor Rehab Center, LLC (the Wayne facility) and Maple Manor Rehab Center of Novi, Inc. (the Novi facility) appeal as of right the Court of Claims’ opinion and order granting summary disposition in favor of defendant, Department of Treasury (Treasury), under MCR 2.116(C)(4) and (C)(8) on the basis that the Treasury lacks authority to hear and decide plaintiffs’ refund petition for the alleged QAA overpayment. On appeal, this Court is asked to decide whether the procedures for processing a petition for refund under the Revenue Act, MCL 205.01 et seq., are applicable to a request for a refund for overpayment of the QAA tax. We affirm.

I. FACTUAL AND PROCEDURAL BACKGROUND

Plaintiffs are post-acute care facilities that partake in Michigan’s Medicare program and therefore are subject to the QAA. The QAA is collected in order to secure matching federal funds:

-1- MCL 333.20161 and 42 CFR 433.68 provide that the QAA and matching federal funds are to “be used to finance Medicaid nursing home reimbursement payments.” MCL 333.20161(11)(a). Collection of the QAA, along with matching federal funds, allows for greater Medicaid reimbursements to nursing homes through the Qualified Assurance Supplement (QAS) Medicaid payment. MCL 333.20161(11)(a). The QAA is assessed on the basis of the total number of days of patient care a nursing home or hospital long-term unit gives to non-Medicare patients. MCL 333.20161(11)(b). The QAA excludes from assessment days of care given to residents in assisted living beds and days of care for Medicare beneficiaries. See MCL 333.20161(11)(b). To determine the amount due, providers submit annual Medicare cost reports to the Michigan Department of Health and Human Services (the DHHS), which then calculates the facilities’ QAA liability. For the years at issue, 2015, 2016, and 2017, plaintiffs timely remitted monthly QAA payments to the DHHS.

MCL 333.20161 vests authority in the DHHS to implement and administer the QAA. Specifically, the DHHS has the authority to implement policies and procedures and impose penalties for nonpayment. MCL 333.20171; MCL 333.20172; MCL 333.20161(11)(f). Additionally, the DHHS must administer the QAA in accordance with federal law and regulations, and is required to seek annual approval from the Centers for Medicare and Medicaid Services (CMS), a federal agency within the United States Department of Health and Human Services. MCL 333.20161(11)(c); MCL 333.20161(11)(e); 42 CFR 433.68(e).

As aptly explained by the Court of Claims:

The QAA rates charged to all providers under MCL 333.20161 are dependent upon information provided in each individual provider’s cost reports. As averred by John Donaldson, a director of the Long-Term Care Reimbursement and Audit Division within [the] DHHS, “any changes to an individual provider’s cost reports would impact the tax rates for all providers in the state of Michigan to ensure adequate funding for the QAS program. . . .” [The] DHHS sends written notice to each provider of the provider’s upcoming QAA tax. The rates are based on information contained in the prior year’s cost reports. According to the notices issued by [the] DHHS in the instant case, an entity has “10 calendar days from the date of this notice to notify [the DHHS] in writing of a disagreement with the total number of non-Medicare days of care rendered indicated above. Failure to respond within this 10[-]day time period will result in any changes being made on a prospective basis only.”

In the Court of Claims, the DHHS submitted documentary evidence to explain that the 10-day time period is rooted in the fact that the amount of federal money received is dependent on state-wide QAA information. Any change to an individual provider’s QAA amounts affects the rates for all providers in Michigan. Additionally, the DHHS is required to obtain an annual waiver from CMS to impose the QAA, and the DHHS must have final and accurate information at the time it seeks that waiver. Accordingly, in administering the QAA, the DHHS only gives prospective effect to late QAA challenges.

Turning to the instant matter, in October 2017, plaintiffs discovered a clerical error in their annual reporting of QAAs to the DHHS: they had overpaid. Specifically, the Wayne facility

-2- included days of care for residents in assisted living and Medicare patients in 2015, 2016, and 2017, resulting in an overpayment of $227,419. The Novi facility made the same mistake in 2016 and 2017, resulting in an overpayment of $237,438. In December 2017, plaintiffs’ counsel sent a letter to the DHHS explaining the errors in the cost reports for the years at issue and asking the DHHS to correct the non-Medicare days erroneously reported.

In a January 2018 letter, the DHHS acknowledged the mistake and corrected it on a prospective basis, but did not refund any of the overpayments. The DHHS reasoned that the error was reported outside of the audit period, and therefore only a prospective adjustment could be made. Plaintiffs did not seek judicial review of the denial of the relief requested from the DHHS. Rather, in September 2018, plaintiffs filed a petition with the Treasury seeking a refund of their QAA overpayments per MCL 205.30 for fiscal years 2015, 2016, and 2017. In their petition, plaintiffs correctly noted that the Treasury holds the QAA funds under MCL 333.20161(11)(g), and that the DHHS had not disputed plaintiffs’ mistakes and resultant overpayments of QAAs. In a letter dated October 19, 2018, the Treasury denied plaintiffs’ request, explaining:

Please be advised that the Department of Treasury has no jurisdiction in this matter and will not process or take action to review Maple Manor’s petition. The Quality Assurance Assessment which is the subject of Maple Manor’s Petition is not administered under the Revenue Act, and MCL 205.30 does not apply.

Following the Treasury’s refusal to issue a refund, plaintiffs filed a complaint in the Court of Claims alleging that Treasury had violated MCL 205.30 by refusing to process plaintiffs’ petition for a refund.1 In lieu of an answer, the Treasury moved for summary disposition arguing that it did not have authority to issue plaintiffs a refund for overpayment of their QAAs for the relevant tax years. It explained that the Revenue Act only applies to the Treasury’s decisions that result from its administration of laws that it has the authority to administer. Where Treasury does not administer the QAA, and relief from a wrongly assessed QAA is a decision of the DHHS, Treasury argued that it made no decision appealable under the Revenue Act. Further, Treasury noted that it was merely a custodian of the funds and that plaintiffs’ claim was an improper collateral attack on the DHHS’ prior decision.

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Bluebook (online)
Maple Manor Rehab Center LLC v. Department of Treasury, Counsel Stack Legal Research, https://law.counselstack.com/opinion/maple-manor-rehab-center-llc-v-department-of-treasury-michctapp-2020.