Trauma Service Group, Ltd. v. United States

33 Fed. Cl. 426, 1995 U.S. Claims LEXIS 89, 1995 WL 259971
CourtUnited States Court of Federal Claims
DecidedMay 5, 1995
DocketNo. 94-547C
StatusPublished
Cited by27 cases

This text of 33 Fed. Cl. 426 (Trauma Service Group, Ltd. 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
Trauma Service Group, Ltd. v. United States, 33 Fed. Cl. 426, 1995 U.S. Claims LEXIS 89, 1995 WL 259971 (uscfc 1995).

Opinion

ORDER

WEINSTEIN, Judge.

Defendant has moved to dismiss the complaint for lack of subject-matter jurisdiction, under RCFC 12(b)(1), or for failure to state a claim, RCFC 12(b)(4). In the alternative, defendant moves for summary judgment.

The grounds alleged for allowing each of defendant’s motions are essentially the same — that the Department of Defense’s partnership agreement with plaintiff Trauma Service Group, Ltd. (TSG), pursuant to 10 U.S.C. § 1096, was not, as plaintiff claims, a binding contract to pay the salary of an x-ray technician employed by plaintiff.

For purposes of deciding the motions to dismiss, the court has deemed to be true, and viewed in their most positive light, all of the facts pleaded by plaintiff as relevant to the establishment of an oral or implied-in-fact contract within the jurisdiction of the court. See Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct. 1683, 1686, 40 L.Ed.2d 90 (1974); see also Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 101-02, 2 L.Ed.2d 80 (1957) (dismissal inappropriate “unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief’). However, the facts here are not really in dispute. Defendant’s motion to dismiss, with prejudice, for failure to state a claim is granted.

Background

In 1956, Congress established a health plan for dependents of active and certain retired members of the uniformed services, to allow for the provision of uniform medical care by civilian medical facilities for those who could not be cared for in military medical facilities. See Dependents’ Medical Care Act, Pub.L. 84-569, 70 Stat. 250 (1956) (now codified as amended at 10 U.S.C. §§ 1071-1106) (Act). The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) executes the Dependents’ Medical Care Act, as amended. See 10 U.S.C. § 1072(4).

Under the Act, all hospital charges in excess of twenty-five dollars, including surgeons’ and physicians’ fees and all preoperative and postoperative charges for care, including x-ray and laboratory costs incurred during those periods, are paid directly by CHAMPUS. 10 U.S.C. §§ 1077, 1079. Civilian outpatient care was approved in 1966. See Military Medical Benefits Amendments of 1966, Pub.L. 89-614, § 2(4), 80 Stat. 862, 864 (codified at 10 U.S.C. § 1079(b)(2)).

Military treatment facility commanders are authorized to enter into “agreements for the sharing of resources” between “facilities of the uniformed services” and civilian health [428]*428care providers, when such an arrangement “result[s] in the delivery of health care to which covered beneficiaries are entitled under this chapter in a more effective, efficient, or economical manner.” 10 U.S.C. § 1096(a). These “partnership agreements” authorized by § 1096 “allow[] the military treatment facility to achieve maximum use of available facility space, [and] ... result in savings to the Government by using civilian medical specialists to provide inpatient care in Government-owned facilities, thereby avoiding the civilian facility charges which would have otherwise been billed CHAMPUS.” 32 C.F.R. § 199.1(p)(1)(ii). See generally United States v. Custodio, 39 F.3d 1121, 1122 (10th Cir.1994).

The Secretary of Defense separately contracts with CHAMPUS providers, under other provisions of the Act, see §§ 1079, 1086, 1097, to compensate them directly for medical care provided to certain beneficiaries. These provisions differ from § 1096 in that they authorize “contract[s]” with the providers (§ 1096 refers to “agreement[s]”), and because they expressly authorize the Secretary to make payments to the providers for services rendered to CHAMPUS beneficiaries. See 10 U.S.C. §§ 1079(h)(1), 1086(h)(1).1

On August 20, 1990, plaintiff and Winn Army Community Hospital (the hospital), the military treatment “facility,” entered into an “agreement[] for the sharing of resources,” labelled a Memorandum of Agreement (MOA). The stated purpose of the MOA was “to integrate specific Winn Army Community Hospital and CHAMPUS program resources to provide Primary Care/Pediatric services for CHAMPUS beneficiaries in Winn Army Community Hospital.” App. 1.

Under the MOA, plaintiff was required, inter alia, to “[m]onitor overall outpatient services that are directly related to the care of patients referred as a part of this agreement except that portion of care rendered by or at the direction of Department of the Army health care providers,” App. 3; obtain professional liability insurance; abide by Department of Defense, Department of the Army, and CHAMPUS regulations; and provide a specific number of personnel at all times.2 Plaintiff agreed to charge patients in that hospital no more than sixty-nine percent of the CHAMPUS prevailing rate. The hospital commander agreed, among other things, to review and approve plaintiffs chosen doctors, and give thein access to the hospital and its facilities.

The MOA also provided that neither party could assign its rights under the agreement without the other’s written consent, and stated: “Termination of this agreement shall be predicated upon satisfactory written notice to the other party not less than 60 days before the proposed termination date. However, the 60-day notice may be waived by mutual consent of the parties to the agreement or unilaterally for the convenience of government.” App. 4.

Plaintiff contends that defendant breached the MOA by making improper use of plaintiffs x-ray technician, specifically, by requiring the technician to work full time on nonCHAMPUS-related inpatient services, and therefore is obligated to pay that employee’s full salary. (Plaintiff does not, however, allege that any particular government official expressly contracted in writing or verbally with plaintiff to reimburse TSG for this employee’s salary.)

Defendant argues that the MOA is not a binding contract to pay this salary, because: it contains no statement that it is binding; it sets out neither the consequences of a breach nor any method for resolving disputes, including the dispute here over how much of an [429]*429employee’s time may be utilized by defendant; and it does not contain any agreement to directly and separately reimburse TSG for the salary of one of its employees, nor any undertaking authorized by §§ 1079(h)(1) or 1086(h)(1), which provide only for payment for direct services to CHAMPUS beneficiaries.

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Cite This Page — Counsel Stack

Bluebook (online)
33 Fed. Cl. 426, 1995 U.S. Claims LEXIS 89, 1995 WL 259971, Counsel Stack Legal Research, https://law.counselstack.com/opinion/trauma-service-group-ltd-v-united-states-uscfc-1995.