917 F. Supp. 2d 1
D.D.C.2012Background
- Hospitals sue HHS Secretary Sebelius over DSH payment calculations for low-income patients.
- Dispute centers on inclusion of Medicare Part C patient days in the Medicaid fraction before Oct. 1, 2004.
- Northeast Hospital Corp. v. Sebelius held retroactive exclusion violated rule against retroactive rulemaking.
- Court remands for recalculation of reimbursements consistent with Northeast Hospital; seeks possible relief.
- Plaintiffs request interest on any additional amounts and other remedial terms.
- Court vacates Secretary’s final decisions and remands; dismisses actions without prejudice.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Part C patient days may be counted in the Medicaid fraction pre-2004 | Alegent argues inclusion violates Northeast Hospital and retroactive rulemaking. | Sebelius contends proper treatment per existing framework and remand possible. | Remand to recalculate consistent with Northeast Hospital. |
| Whether to require interest on any amounts due on remand | Interest should be awarded under 42 U.S.C. § 1395oo(f)(2). | Agency remand not yet determined; interest arguable but procedural. | Remand order should award interest on amounts due upon remand. |
| Whether the remand order should include agency instructions to recalculate | Court should direct prompt recalculation and progress. | Court should not micromanage agency remand. | Court declines detailed remedial instructions and jurisdiction retention. |
| Whether the court should retain jurisdiction during remand | Retain jurisdiction to monitor progress. | No jurisdiction retention unless extraordinary circumstances. | No jurisdiction retention; remand without ongoing oversight. |
| What is the ultimate remedy on remand | Remand for recalculation with appropriate relief. | Remand for recalculation; no further directives. | Final decisions vacated; remanded for recalculation consistent with Northeast Hospital. |
Key Cases Cited
- Northeast Hospital Corp. v. Sebelius, 657 F.3d 1 (D.C. Cir. 2011) (retroactivity rule; include Part C days in Medicaid fraction limits pre-2004)
- Tucson Med. Ctr. v. Sullivan, 947 F.2d 971 (D.C. Cir. 1991) (two-part prevailing party test for § 1395oo(f)(2))
- PPG Indus. Inc. v. United States, 52 F.3d 363 (D.C. Cir. 1995) (agency remedial action standards on remand)
- Baystate Med. Ctr. v. Leavitt, 587 F. Supp. 2d 37 (D.D.C. 2008) (norms reremand without retained jurisdiction in ordinary cases)