Slater Health Center, Inc. v. United States (In Re Slater Health Center, Inc.)

294 B.R. 423, 2003 Bankr. LEXIS 725, 41 Bankr. Ct. Dec. (CRR) 146, 2003 WL 21465161
CourtUnited States Bankruptcy Court, D. Rhode Island
DecidedJune 20, 2003
DocketBankruptcy No. 01-10273. Adversary No. 02-1048
StatusPublished
Cited by4 cases

This text of 294 B.R. 423 (Slater Health Center, Inc. v. United States (In Re Slater Health Center, Inc.)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, D. Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Slater Health Center, Inc. v. United States (In Re Slater Health Center, Inc.), 294 B.R. 423, 2003 Bankr. LEXIS 725, 41 Bankr. Ct. Dec. (CRR) 146, 2003 WL 21465161 (R.I. 2003).

Opinion

ORDER (1) GRANTING DEBTOR’S MOTION TO RECONSIDER, (2) GRANTING DEBTOR’S MOTION TO ASSUME MEDICARE PROVIDER AGREEMENT, AND (3) DENYING THE DEFENDANTS’ MOTION TO DISMISS

ARTHUR N. VOTOLATO, Bankruptcy Judge.

Before the Court are: (1) The Debtor’s Motion to Reconsider Order denying its request for temporary restraining order; (2) The Debtor’s Motion to Assume Medicare Provider Agreement; and (3) The Motions of the United States of America and Blue Cross/Blue Shield to dismiss the above captioned adversary proceeding under Fed.R.Civ.P. 12(b). After hearing, the Motion to Reconsider is GRANTED; the *426 Debtor’s motion to assume the Medicare Agreement is GRANTED; and for the reasons set forth infra, Count II of the Debtor’s adversary Complaint requesting turnover of property of the estate is GRANTED.' The Defendants’ Motion to Dismiss is DENIED.

BACKGROUND/TRAVEL

Slater Health Center (“Slater”) is a 150-bed Medicare approved health care facility providing nursing home care and related services, and is a party to a Medicare Provider Agreement with the United States Department of Health and Human Services (“HHS”) through the Centers for Medicare and Medicaid Services (CMS). Blue Cross Blue Shield of Rhode Island (“Blue Cross”) is the fiscal intermediary for CMS and is responsible for overseeing payments made by Medicare to Slater and for auditing annual cost reports filed by Slater with Blue Cross. Slater derives approximately 14% of its annual revenues from Medicare reimbursements.

On January 26, 2001, Slater filed a petition under Chapter 11. In October 2001, Blue Cross notified Slater that it was reopening its 1997 cost report for analysis, and on December 13, 2001, informed Slater that as a result of the analysis it was determined that Slater had been overpaid by Medicare to the tune of $56,218. On February 15, 2002, Blue Cross notified Slater that its 1998 cost report had also been reopened, revealing that Slater was overpaid $243,888 for that fiscal year, as well. Slater asserts that at various times Blue Cross threatened in writing that it intended to “offset” Slater’s post-petition Medicare billings by these overpayments. In a (probably misguided) move to prevent such an offset, beginning in January 2002, Slater stopped billing Medicare for post-petition services and built up receivables in excess of $720,000.

On June 19, 2002, when it could no longer afford to provide services without Medicare funding, Slater sought “emergency” relief in this Court by filing this adversary proceeding against the Medicare affiliates. That same day, Slater filed a motion for temporary restraining order seeking to prevent the Defendants from:

continuing to threaten to and/or actually reducing, withholding, setting off and/or attempting to recoup against any Medicare monies owing to Slater post-petition, and to otherwise prohibit any such withholding or reduction of such amounts due Slater in the future during the pendency of this Chapter 11 case; and (ii) declining or refusing to forthwith process post-petition Medicare claims of and turning over or otherwise paying to Slater all monies owed to it from such claims from and after Slater’s Chapter 11 filing, without withholding or reduction of such amounts due Slater for any alleged pre-petition claims owed by Slater to such parties.

Slater’s Motion for TRO, A.P. No. 02-1048, Document No. 2, page 2. The stated cause for the exigent circumstances was that if Medicare was allowed to reduce Slater’s post-petition receivables by the overpay-ments, Slater would not have sufficient capital to operate. On August 9, 2002, after an expedited hearing, I denied Slater’s request for a TRO, as Slater had not even filed a Medicare claim to collect the receivable, let alone pursue and exhaust its administrative remedies under 42 U.S.C. § 1395oo 1 before seeking judicial relief. After receiving this Order, Slater apparently filed its $720,000 claim, whereupon *427 Medicare reduced its payment to Slater by $407,600. Of this amount, Slater responds that $87,031 was the result of an accounting error on Slater’s part in the 1997 Medicare cost report, but that the $370,569 retained by Medicare, the alleged “overpayment”, is property of the estate.

Slater disputes Medicare’s use of the term overpayment, arguing that there was no overpayment in the true sense of the word. Rather, Slater argues, independent therapists provided services to the inpatients at Slater, that the patients received the care to which they were entitled, and that Slater billed Medicare for therapy services that were actually performed. To complete the picture, the $370,000 in question generated through services provided by outside professionals whom Slater failed to pay, probably was used in the operation of the business.

The United States argues that under 42 C.F.R. § 413.100(c)(2), Slater is allowed one year to liquidate its short term liabilities, that Slater defaulted as to this, and that therefore Medicare may disallow the reimbursement of the $370,000. Slater complains that allowing such a set off will be a windfall to Medicare and will cause a double hit to Slater — once when it is deprived of funds which directly correlate to what Slater owes the third party therapy providers, and again when it must pay the therapists as creditors in this case.

A Reconsideration

“[T]o succeed on a motion to reconsider, ‘... the moving party [must] show newly discovered evidence or a manifest error of fact or law.’ ” Champagne v. Equitable Credit Union (In re Champagne), 146 B.R. 506, 508 (Bankr.D.R.I.1992) (quoting In re Wedgestone Financial, 142 B.R. 7, 8 (Bankr.D.Mass.1992)); In re Bank of New England Corp., 142 B.R. 584, 587-88 (D.Mass.1992). On reconsideration, Slater argues that it is not required to exhaust its administrative remedies because it does not challenge the validity or the merits of the Medicare overpayment claim, nor is it seeking judicial review of the claim. Rather, it is making arguments under bankruptcy law as to how the claim should be treated in this proceeding. In support, Slater cites In re Healthback, L.L.C., 226 B.R. 464 (Bankr.W.D.Okla.1998), where the Court stated:

... this argument [exhaustion of administrative remedies] is specious, as the foundation of this argument depends upon whether the party is seeking judicial review of the substantive Medicare law. As previously explained, the United States is erroneously attempting to characterize a bankruptcy proceeding as “judicial review”. As this characterization is not accurate and as a bankruptcy proceeding is not making a substantive ruling on Medicare law, the doctrine of exhaustion of administrative remedies would not be applicable.

Id. at 470 n. 5. The Court further found that “the specific language of 42 U.S.C. *428

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
294 B.R. 423, 2003 Bankr. LEXIS 725, 41 Bankr. Ct. Dec. (CRR) 146, 2003 WL 21465161, Counsel Stack Legal Research, https://law.counselstack.com/opinion/slater-health-center-inc-v-united-states-in-re-slater-health-center-rib-2003.