Tulsa County Public Health Nursing Service, Inc. v. Tulsa City-County Health Department

475 F. Supp. 152, 1979 U.S. Dist. LEXIS 10115
CourtDistrict Court, N.D. Oklahoma
DecidedAugust 30, 1979
DocketNo. 79-C-530-C
StatusPublished

This text of 475 F. Supp. 152 (Tulsa County Public Health Nursing Service, Inc. v. Tulsa City-County Health Department) is published on Counsel Stack Legal Research, covering District Court, N.D. Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Tulsa County Public Health Nursing Service, Inc. v. Tulsa City-County Health Department, 475 F. Supp. 152, 1979 U.S. Dist. LEXIS 10115 (N.D. Okla. 1979).

Opinion

MEMORANDUM OPINION AND ORDER OF DISMISSAL

BRIMMER, District Judge.

Plaintiff, Tulsa County Public Health Nursing Service, Inc., is a non-profit Oklahoma corporation which has brought suit against the Tulsa City-County Health Department, both the City and County of Tulsa, and the Tulsa County Treasurer, as defendants, claiming jurisdiction under 28 U.S.C. § 1331 relating to questions arising under the Constitution and laws of the United States. Plaintiff seeks the declaration of this Court that it is a “provider” of services under the Medicare Act, 42 U.S.C. §§ 1395c-1395qq, entitled to $225,000 which was paid by the U.S. Department of Health, Education and Welfare to the Plaintiff and turned over to the Defendant and now held by the Defendant Treasurer, and to possession of medical and fiscal records now held by the Defendant Health Department. Plaintiff sought a preliminary injunction. At the hearing upon Plaintiff’s motion for a preliminary injunction, Defendants filed a Motion to Dismiss on grounds of lack of jurisdiction, but informed the Court that except for their desire to be heard on the jurisdictional question, Defendants had no objection to consolidation of the hearing on the preliminary injunction with a hearing on the merits of this case. At the end of the first day’s hearing on Plaintiff’s Amended Complaint the Court granted Plaintiff’s Motion to Consolidate under Rule 65, F.R.C.P., required Defendants to file their Answer which they have done, but the Court reserved ruling on the Motion to Dismiss. The Defendants have re-asserted their Motion to Dismiss at the close of the Plaintiff’s evidence in this case, and the Court then heard arguments of the parties on the jurisdictional issue.

Plaintiff has sought declaratory relief, based on federal question jurisdiction, but also has claimed that Defendants have violated Sections 1 and 2 of the Sherman Act, Title 15, U.S.C.

Plaintiff was incorporated in 1960 and in 1964 contracted with the Defendant Health Department to provide home nursing services in Tulsa County jointly with it. Their written agreement provided for a joint or cooperative enterprise under the direction of the Medical Director of the Defendant Health Department. The services provided are home-care nursing and therapy to patients of Tulsa County, Oklahoma and a few fringe areas of its adjoining counties. The service has grown and in the last year Plaintiff provided more than 26,000 home [154]*154nursing visits compared to 225 visits made by its only competitor in Tulsa County. The Plaintiff has interstate contacts, receiving supplies and payments from out-of-state, and using interstate facilities like highways and telephones, but essentially its activities are local in character and limited to provision of its services in the immediate area of Tulsa County.

Initially, the parties agreed each to pay a half of the personnel salaries, but in 1969 the visiting nurses were placed on the payroll of Tulsa County so that they could have the benefit of the County payroll schedule and also its fringe benefits. By 1978 all of the salaries of Plaintiff’s employees were being paid by Tulsa County.

From its inception the Plaintiff and its personnel have occupied, rent-free, space provided on premises owned by the Defendant city and county, and has received from the Defendants without charge furniture, lights, heat, janitorial services, computer services, some office supplies and typewriters and some vehicles. The Plaintiff is a member of Tulsa’s United Way and receives $160,000 a year, paid in monthly increments, which it keeps in a separate account from its other funds, which come to it from a minor amount of payments from insurance companies, patients and from payments made by Oklahoma Blue Cross-Blue Shield as the contractual fiscal intermediary of H.E.W.

The Medicare Act provides for funds, and encourages nursing care services of the type rendered by the program of the parties. The Plaintiff has submitted to Blue Cross as such fiscal intermediary its monthly billings for direct costs, such as salaries and mileage expense, as well as indirect costs, such as the value of the space and services provided to Plaintiff without charge by the Defendants. Blue Cross has approved and paid such statements after being satisfied that the joint entity created by the parties was a “provider of services”, as that term is defined by 42 U.S.C. § 1395x(u). To become a provider of services application was made to the Oklahoma State Department of Health, which was contractually designated as its certification agent by H.E.W. It received the application, checked for qualifications and made its recommendations to H.E.W. At first, according to H.E.W. records, the “parent” of the Tulsa County home nursing operations was the Oklahoma State Board of Health but in September 1966 it was split off from the State Board. Application was then made in 1966 by the Defendant Health Department, designated therein as the “parent” organization, and the State department thereafter found the joint entity composed of the Plaintiff and Defendant Health Department to be qualified as a provider and issued number “37-7001” to that entity. Each year a renewal application had to be made and the provider certification renewed, without which Blue Cross would not make its payments on the billings. 42 U.S.C. § 1395f. In those applications the entity providing the Tulsa County nursing services was referred to as a “Combination Government and Voluntary Agency.” The Oklahoma State Department of Public Health and the Dallas Regional Office of H.E.W. each regarded Plaintiff and Defendant Health Department as a combination agency. Together they had the necessary qualifications for “provider” certification, such as the medical advisory board of Plaintiff, maintenance of clinical records by Defendant, a medical director or administrator provided by Defendant, registered nurses, and occupational, physical and speech therapists of Plaintiff. H.E.W. has recognized that it has been dealing with a combined agency as its “provider”, and that it was one voluntary entity formed by this 1966 written agreement, which has never been amended or rescinded. Although the name of the provider was changed in 1971 (Plaintiff’s Exhibit 42) from that of the Defendant Health Department to that of the Plaintiff, H.E.W. believed that it was still dealing with the same combined entity.

The fiscal intermediary, Blue Cross-Blue Shield, has paid its billings for direct and indirect home nursing costs in Tulsa County to “Tulsa City-County HHA, # 37-7001.” The letters “HHA” were meant to refer to “home health agency” as used in the Medi[155]*155care Act. The Plaintiff has received these moneys over the years and because of the payment to it of the indirect costs for which it billed Medicare, in the last three years, there has accumulated the surplus sum of $225,000. Defendant Treasurer holds that $225,000 sum which was turned over to the Defendant Health Department by an attorney for Plaintiff. In recent months personnel of the Defendants have asserted claims to this sum, claiming it under an Oklahoma statute and because the money was paid by H.E.W. for indirect costs which Defendants have furnished without charge.

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Bluebook (online)
475 F. Supp. 152, 1979 U.S. Dist. LEXIS 10115, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tulsa-county-public-health-nursing-service-inc-v-tulsa-city-county-oknd-1979.