Pines Residential Treatment Center, Inc. v. United States

64 Fed. Cl. 307, 2005 U.S. Claims LEXIS 47, 2005 WL 428479
CourtUnited States Court of Federal Claims
DecidedFebruary 24, 2005
DocketNo. 03-794 C
StatusPublished
Cited by4 cases

This text of 64 Fed. Cl. 307 (Pines Residential Treatment Center, 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
Pines Residential Treatment Center, Inc. v. United States, 64 Fed. Cl. 307, 2005 U.S. Claims LEXIS 47, 2005 WL 428479 (uscfc 2005).

Opinion

OPINION AND ORDER

HEWITT, Judge.

Before the court is plaintiff’s Complaint, filed April 18, 2003, and Defendant’s Motion to Dismiss, filed August 21, 2003, and the responsive briefing thereto.1 Upon plaintiff’s motion, see Motion for Oral Argument on Defendant’s Motion to Dismiss (Pl.’s Mot.) at 1, oral argument was held on January 31, 2005, see generally Transcript of Oral Argument (Tr.). For the following reasons, the court GRANTS Defendant’s Motion to Dismiss.

I. Background

Plaintiff, Pines Residential Treatment Center, Inc. (Pines), “owned and operated a mental health treatment facility” in Massachusetts which “was an approved provider of medical services to patients who qualified for assistance under the Medicare Act.” Complaint (Compl.) 11112-3. Plaintiff’s complaint alleges that it sustained “a loss of $630,243” [308]*308reimbursable under Medicare when it sold all its assets to a non-profit state hospital in May of 1996. Id. ¶3. Plaintiff claims that, “[f]or the fiscal year ending [FYE] ... May 31, 1996, [it] submitted Cost Reports [to the Medicare Intermediary for Massachusetts (Intermediary)2] claiming entitlement to reimbursement of [the] loss of $630,243 resulting from the sale of its assets.” Id. ¶¶ 3-4. The Intermediary denied plaintiff’s claim, id. ¶ 4, and plaintiff timely appealed to the Provider Reimbursement Review Board (PRRB or Board) of the Department of Health and Human Services (HHS) under the provisions of 42 U.S.C. § 1395oo (2000), id. ¶ 5.

Plaintiffs complaint asserts that the PRRB appeal process resulted in the Intermediary’s “issuing] Notices of Revised Settlement Determinations on July 19, 2002, notifying [plaintiff] that ... [it] was entitled to reimbursement of $548,104 for the loss on sale of its assets.” Id. 116, Exs. A, B (Notices of Revised Settlement of Determination (Notices) issued to plaintiffs Director of Reimbursement dated 7/19/02). The Notices advised plaintiff that checks “[would] be issu[ed]” for the amounts “due to [its] facility,” Id., Exs. A at 2, B at 1; “[h]owever,” the Notices continued, “you should be aware that th[ese] check[s] will be applied against any previous outstanding liability that has been liquidated for which you do not have an approved repayment schedule,” id. Plaintiff claims that the Notices “obligated the United States to pay [plaintiff] Medicare reimbursement in the amount of $548,104 ... [but that,] [notwithstanding [this obligation,] ... the United States has failed to pay ... the $548,104 which is due.” Id. ¶¶ 7-8.

In April of 2003, plaintiff filed its complaint in this court, stating:

This case involves a claim against the United States for payment of Medicare reimbursement as required by the Social Security Act, 42 U.S.C. § 1395 et seq. This Court has jurisdiction pursuant to 28 U.S.C. § 1491.
[Plaintiff] respectfully requests that this Court enter judgment ... in the ... amount of $548,104 [due pursuant to the Notices issued July 19, 2002 by the Intermediary].
Id. ¶1; id. at 2.

Defendant moved, pursuant to Rule 12(b)(1) of the Rules of the Court of Federal Claims, to dismiss the complaint for lack of subject matter jurisdiction. Defendant’s Motion to Dismiss (Def.’s Mot.) at 1. This court’s jurisdiction to hear contract disputes against the federal government is preempted, defendant asserts, where the statute under which the dispute arises provides a comprehensive scheme for review in another forum. Id. at 14-15 (“The United States Supreme Court and the United States Court of Appeals for the Federal Circuit have consistently found preemption of Tucker Act jurisdiction where Congress has enacted a ‘precisely drawn, comprehensive and detailed scheme of review in another forum.’”) (quoting St. Vincent’s Med. Ctr. v. United States, 32 F.3d 548, 550 (Fed.Cir.1994)) (citing United States v. Fausto, 484 U.S. 439, 454-55, 108 S.Ct. 668, 98 L.Ed.2d 830 (1988)). Because “[t]he Federal Circuit has held that the Medicare Act, which is the basis for [plaintiffs claim], contains ... a ‘comprehensive administrative and judicial review scheme,’ ” defendant argues that this court’s Tucker Act jurisdiction is preempted. Id. at 15 (quoting St. Vincent’s, 32 F.3d at 549-50). “Rather, jurisdiction to consider the claim rests exclusively in Federal district [court] once Pines has exhausted its administrative remedies.” Id. at 14 (citing 42 U.S.C. § 1395oo(f)(1)).

In its motion to dismiss, defendant produced evidence which added context to the Medicare reimbursement dispute forming the basis of plaintiffs complaint, see Def.’s Mot. at v (indexing ten exhibits attached to defendant’s motion to dismiss), and plaintiff produced additional evidence in its responsive briefing, see Plaintiffs Brief in Opposition to Defendant’s Motion to Dismiss (PL’s Opp’n) at iii (indexing three exhibits attached to plaintiffs response). See also Tr. at 4:14-16 (statement of defendant’s counsel) (“[T]here [309]*309is more to this story than that the government owes the [p]laintiff money.”). While the additional evidence produced by the parties amplifies the court’s understanding of the case, the evidence does not, as plaintiff asserted at oral argument, see id. at 23:21-22, 24:12, 32:1-10, preclude application of the Federal Circuit’s holding that this court lacks jurisdiction over Medicare claims. See St. Vincent’s, 32 F.3d at 549-50 (“Because the Medicare Act contains its own comprehensive administrative and judicial review scheme, there is no Tucker Act jurisdiction over Medicare reimbursement claims.”); id. at 551 (“[U]nder the plain terms of [the Medicare Act], the Court of Federal Claims lack[s] jurisdiction to review ... Medicare reimbursement elaim[s].”). To the contrary, the evidence produced by the parties reinforces the court’s view that it cannot hear such disputes. See n. 3 infra. In the interest of clarifying its jurisdiction, the court summarizes the events that both parties allege preceded plaintiffs complaint.

A. Plaintiff Assumed the Medicare Provider Numbers of its Predecessor Corporation

Defendant asserts and plaintiff confirms that, on November 23,1994, plaintiffs parent corporation acquired the assets of Heritage Hospital (Heritage), “an inpatient hospital facility ... [which had] participated in the Medicare program ... under Medicare provider numbers 22-0068 and 22-[S]068”.3 Def.’s Mot. at 8-9 (citing Ex. C (“Disclosure of Ownership and Control Interest Statement” form for Heritage filed with HHS dated 11/23/94), at 2 (showing “a change in ownership” dated 11/23/94 and referencing Medicare provider numbers “220068” and “225068 [sic]”));

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

Related

Cunningham v. United States
108 Fed. Cl. 208 (Federal Claims, 2012)
Tucker v. Astrue
738 F. Supp. 2d 835 (N.D. Illinois, 2010)
Berry v. United States
86 Fed. Cl. 750 (Federal Claims, 2009)

Cite This Page — Counsel Stack

Bluebook (online)
64 Fed. Cl. 307, 2005 U.S. Claims LEXIS 47, 2005 WL 428479, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pines-residential-treatment-center-inc-v-united-states-uscfc-2005.