Rio Hondo Memorial Hospital v. United States

689 F.2d 1025, 231 Ct. Cl. 657, 1982 U.S. Ct. Cl. LEXIS 477
CourtUnited States Court of Claims
DecidedSeptember 22, 1982
DocketNo. 75-80C
StatusPublished
Cited by11 cases

This text of 689 F.2d 1025 (Rio Hondo Memorial Hospital v. United States) is published on Counsel Stack Legal Research, covering United States Court of Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rio Hondo Memorial Hospital v. United States, 689 F.2d 1025, 231 Ct. Cl. 657, 1982 U.S. Ct. Cl. LEXIS 477 (cc 1982).

Opinion

KASHIWA, Judge,

delivered the opinion of the court:

This case, before us on cross motions for summary judgment, requires the court to determine the appropriate treatment under Medicare of sales transactions between related parties that were completed before the effective date of the Medicare Act. Specifically, plaintiff, the provider, seeks to deduct the interest expense incurred by its owner in purchasing plaintiffs assets from a related party as a reasonable cost of providing care. Secondly, plaintiffs owner seeks to increase the valuation of plaintiffs assets as a result of the sale in order to claim a stepped-up basis for depreciation.

On the effective date of the Medicare Act,1 July 1, 1966, Rio Hondo Associates (hereinafter "Associates”) owned and controlled the land, building, and equipment used in operating the Rio Hondo Memorial Hospital (hereinafter "Hospital”). The Associates purchased all the assets and stock in one transaction from the Orangewood Realty Holding Company (hereinafter "Orangewood”) on April 6, 1966, in an agreement that was effective January 1, 1966. Orangewood had leased these assets to the Hospital before the sale and Associates continued to do so after the sale. Associates is a partnership of 50 individuals comprised of all 30 partners of Orangewood and an additional 20 new investors.

[659]*659The Associates gave Orangewood notes for $940,000 to cover the purchase of the assets. Notes in the amount of $700,000 covered the purchase of the stock. Interest at the rate of 6 percent a year was charged on each note. As a result of the sale, the value of the assets was increased approximately $780,000. The Hospital sought reimbursement from Medicare for the interest expense and depreciation costs incurred by Associates for the years ending October 31, 1966, and October 31, 1967. The Hospital claimed those costs arguing, for purposes of reimbursement under the Medicare Act, that Associates and Hospital should be treated as "one entity.”

The Hospital filed its Medicare reports for the years ending October 31, 1966, and October 31, 1967, with its designated fiscal intermediary, Blue Cross Association of Southern California (hereinafter "BCSC”). The Hospital claimed the interest expense and depreciation costs which arose from the sale of the assets of the hospital to Associates. BCSC denied reimbursement for those costs reasoning that the sale of stock and assets from Orange-wood to Associates was between related organizations and hence not a bona fide sale for Medicare reimbursement purposes. BCSC disallowed the interest expense and reduced the depreciation allowable to Orangewood’s basis rather than the stepped-up basis claimed by Associates.

An appeal to the Provider Appeals Committee was unsuccessful. That appeal exhausted Hospital’s administrative remedies and the Committee’s decision became the final decision of the Secretary. See 42 U.S.C. § 1395oo.

On November 15, 1974, Hospital filed suit in the United States District Court for the Central District of California. Cross motions for summary judgment were filed and the court in 1975 granted Hospital’s motion and denied the Secretary’s motion for summary judgment. The Secretary appealed to the United States Court of Appeals for the Ninth Circuit. The Ninth Circuit held that the district court lacked subject matter jurisdiction and remanded the case to the district court for transfer to the Court of Claims.

We deal with three issues in this case. First, whether Hospital may claim costs incurred by Associates as reim[660]*660bursable costs under the Medicare Act. Secondly, whether the interest expense is allowable as a "reasonable cost” incurred by the provider. Finally, whether the depreciation costs were "reasonable costs” subject to reimbursement under the Medicare Act.

Jurisdiction for this appeal can be found in 28 U.S.C. § 1491 (the "Tucker Act”) "both because of plaintiffs contract with the Government and also because the Medicare legislation, fairly read, mandates appropriate payment to providers.” Whitecliff v. United States, 210 Ct. Cl. 53, 536 F. 2d 347 (1976), cert. denied, 430 U. S. 969 (1977). Defendant contended at oral argument that this court lacks jurisdiction over Part A Medicare cases.2 Defendant cited United States v. Erika, Inc., 456 U.S. 201 (1982) as support. That case, however, dealt only with Part B Medicare cases and does not affect our jurisdiction over this Part A Medicare case. We hold that Hospital is entitled to be reimbursed for all interest expenses incurred by reason of the purchase of the hospital. The buyer’s basis for depreciation, however, shall be the historical cost of the seller.

I

The first issue we decide is whether Hospital may claim costs incurred by Associates as reimbursable costs under the Medicare Act.

Defendant contends that the Hospital may not claim reimbursement for either the interest expense or depreciation costs since they were incurred by the Associates. Defendant argues that the Hospital, not the Associates, was the provider of services and only the provider may be reimbursed for those expenses.3 Plaintiff argues that, for [661]*661purposes of Medicare reimbursement, the Hospital and Associates should be considered a "single entity” since the Associates completely own the facilities and stock of the Hospital. The applicable Medicare regulations, the Secretary’s interpretation of these regulations, and defendant’s prior stipulation support plaintiffs position.

20 C.F.R. § 405.427 provides in pertinent part:

§ 405.427 Cost to related organizations.
(a) Principle. Costs applicable to services, facilities, and supplies furnished to the provider by organizations related to the provider by common ownership or control are includable in the allowable cost of the provider at the cost to the related organization. However, such cost must not exceed the price of comparable services, facilities, or supplies that could be purchased elsewhere. [Emphasis supplied.]
***♦>}!
(c)(2) Where the provider obtains items of services, facilities, or supplies from an organization, even though it is a separate legal entity, and the organization is owned or controlled by the owner(s) of the provider, in effect the items are obtained from itself. An example would be a corporation building a hospital or a nursing home and then leasing it to another corporation controlled by the owner. Therefore, reimbursable cost should include the costs for these items at the cost to the supplying organization. However, if the price in the open market for comparable services, facilities, or supplies is lower than the cost to the supplier, the allowable cost to the provider shall not exceed the market price. [Emphasis supplied.]

Associates qualifies as an "organization related to the provider by common ownership” by virtue of owning 100 percent of Hospital’s stock and facilities.

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Bluebook (online)
689 F.2d 1025, 231 Ct. Cl. 657, 1982 U.S. Ct. Cl. LEXIS 477, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rio-hondo-memorial-hospital-v-united-states-cc-1982.