Home health agency sues to stop HHS from collecting $1.8M in Medicare over-payments

Michelle Keahey, East Texas Bureau Feb. 11, 2013, 9:03pm

LUFKIN - A home health agency has filed a lawsuit against the U.S. Department of Health and Human Services in order to obtain an extended repayment plan for $1.8 million that it owes to Medicare. 

Texas Medical Enterprise filed suit against HHS on Feb. 4 in the Eastern District of Texas, Lufkin Division.

In July 2011, Texas Medical Enterprise was notified of a $3,555,446 Medicare overpayment.  It filed an administrative appeal and the overpayment was reduced almost in half to $1,846,433.

The plaintiff submitted a request for a five-year repayment in December 2012, but it was denied.  According to the lawsuit, HHS informed Texas Medical Enterprise that it will impose recoupment on Feb. 6t and begin collecting all Medicare payments due the provider to liquidate the overpayment.

Texas Medical Enterprise states this will deprive it of essential operating funds and it will be forced to shut down and be unable to repay any of the alleged overpayment. Further, Texas Medical argues that it will not be able to proceed to a hearing before a federal administrative law judge where it has the best opportunity to set aside an “erroneously imposed overpayment.” The plaintiff states that actual overpayment liability based upon the claims reviewed would be no more than $50,000.

The plaintiff is asking the court to compel the defendant to make available to plaintiff a feasible repayment plan due to the extreme hardship posed in repaying the alleged Medicare overpayment and for an award of damages for attorney’s fees and court costs.

Texas Medical Enterprise is represented by Ryan W. Gertz of Gertz Adair Law Firm in Beaumont and Dallas attorneys Mark S. Kennedy and Joanna H. Martin.

U.S. District Judge Ron Clark is assigned to the case.

Case No. 9:13-cv-00027

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