MM Curator summary
FL is suing CMS over supplemental payments the feds denied.
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The dispute stems from a decision by the HHS “disallowing” Medicaid reimbursements from July 1, 2006 to June 30, 2013, according to the lawsuit filed in federal court in South Florida.
The Florida Agency for Health Care Administration has filed a lawsuit against the federal government in a dispute about $97.57 million in Medicaid payments, primarily involving Jackson Memorial Hospital in Miami.
The lawsuit, filed Tuesday in federal court in South Florida, stems from a decision by the U.S. Department of Health and Human Services “disallowing” Medicaid reimbursements from July 1, 2006 to June 30, 2013, according to the lawsuit.
The dispute involves supplemental Medicaid payments through what is known as the Low Income Pool, or LIP, program. That program is designed primarily to help hospitals such as Jackson that treat large numbers of poor and uninsured patients.
The federal Centers for Medicare & Medicaid Services, which is part of the Department of Health and Human Services, disallowed $146.1 million in costs in September 2016 and later revised the amount to $97.57 million.
The lawsuit said more than $92 million of the disallowed amount involved LIP payments to Jackson in 2012 and 2013.
A Department of Health and Human Services appeals board on Feb. 25 upheld the disallowance, which was based on a dispute about calculations.