Case Information
*1 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA )
DCH REGIONAL MEDICAL CENTER, )
)
Plaintiff, )
) v. ) No. 16-cv-0212 (KBJ) )
THOMAS E. PRICE, in his capacity as )
Secretary of the United States )
Department of Health and Human )
Services , )
)
Defendant. )
) MEMORANDUM OPINION
On April 13, 2016, this Court granted Defendant’s uncontested motion to stay the
proceedings in the instant Medicare case pending the D.C. Circuit’s resolution of an
appeal in
Florida Health Sciences Center, Inc. v. Secretary of Health and Human
Services
(“
Florida Health I
”),
For the reasons explained below, this Court concludes that the D.C. Circuit’s reasoning in compels the rejection of the instant challenge to the Secretary’s estimate-generating methodology. ( See Compl. ECF No. 1, at 1.) Consequently, Defendant’s motion to dismiss the complaint must be GRANTED , and this case must be DISMISSED . A separate Order that is consistent with this Memorandum Opinion shall follow.
DISCUSSION
In its complaint, Plaintiff DCH Regional Medical Center (“DCH”) “challenge[s]
the methodology adopted and employed by [former] Defendant Sylvia Burwell, in her
capacity as [former] Secretary of the United States Department of Health and Human
Services[,]” whereby “the calculation [the Secretary] used to determine the
disproportionate share payments owed to qualifying hospitals participating in Medicare
was restricted, in part, to data associated with a single provider number[.]” (Compl.,
ECF No. 1, at 1;
see also id.
(explaining that, when two hospitals merge during the
relevant time period, the challenged methodology results in an understated estimate of
the surviving hospital’s disproportionate share payment);
id.
at 10 (“The problem lies in
her restriction that data (specifically, Medicaid and SSI days) only be collected from a
single hospital’s” provider number (emphasis omitted)).)
[2]
However, this Court discerns
no meaningful difference between the so-called methodological challenge that DCH
raises in this case (
see id.
at 15 (characterizing the Secretary’s methodology as arbitrary
and capricious insofar is it considers “only data associated with a single hospital’s”
provider number and thus does “not use ‘appropriate data’”)), and the data-based
challenge that the D.C. Circuit considered in ,
To the extent that DCH attempts to reframe its challenge as a procedural
objection to the general rule that led to the Secretary’s estimate ( Pl.’s Opp’n to
Def.’s Mot. to Dismiss (“Pl.’s Opp’n”), ECF No. 15, at 13 15), this Court is
unpersuaded. To be sure, “the D.C. Circuit recently stated that, where judicial review
of [an agency’s] decision is barred, judicial review is still appropriate over general rules
leading to that decision.” ( at 13 (citing
Florida Health II
,
Notably, DCH struggles mightily to characterize its complaint as a procedural challenge. To this end, it points to allegations in the complaint that charge the Secretary with failing to “properly consider or respond to comments during the rule - making process regarding the inherent flaw in her methodology[.]” (Compl. at 15; see also Pl.’s Opp’n at 7, 15 n.1.) But, the indisputable gravamen of DCH’s complaint is that the Secretary improperly calculated the amount of uncompensated care for DCH — which merged with Northport Regional Medical Center (“Northport”) on May 1, 2011 ( Compl. at 11)—by basing the agency’s calculation on data associated solely with DCH, rather than data associated with both DCH and Northport. ( See id. (“[U]nder the Secretary’s flawed methodology, [the agency’s] Factor 3 calculation for DCH disregarded seven (7) months of relevant data associated with Northport’s [provider number], resulting in a substantial reduction in DCH’s reimbursement.”).) And one need look no further than DCH’s own request for relief to see clearly that what is at stake in this action is DCH’s requested individualized recalculation of the uncompensated care figure rather than any reformulation of the agency’s general rule; in fact, the complaint seeks neither invalidation of any agency rule nor a remand so that the Secretary may better explain her methodology. ( See id. at 16.) Instead, the *6 complaint requests that this Court “[v]acate the Secretary’s Fiscal Year 2014 Factor 3 calculation for Plaintiff ” and remand the case to the Secretary “with an order compelling her to recalculate the Fiscal Year 2014 disproportionate share adjustment owed to Plaintiff [.]” ( (emphasis added).) Thus, just as in , DCH’s belated contention that the complaint presents an “attack on the general rules leading to [the Secretary’s] estimate” is actually a misguided attempt to “recast[]” the complaint’s core challenge to the methodology that the Secretary used to calculate the estimate, 830 F.3d at 522, and as such, it must be rejected.
Nor can this Court accept DCH’s argument that its legal “claim includes a
challenge to [the Secretary’s]
ultra vires
action[,]” and thus this Court retains
jurisdiction over its complaint. (Pl.’s Opp’n at 17 (citing
COMSAT v. FCC
, 114 F.3d
223, 224 (D.C. Cir. 1997)).) A challenge to agency action on the ground that it is
ultra
vires
requires a plaintiff to establish “a patent violation of agency authority[,]”
Florida
Health II
,
CONCLUSION
It is clear to this Court that DCH’s challenge to the methodology that the
Secretary used to calculate the estimate at issue is “inextricably intertwined with the
Secretary’s estimate of uncompensated care,” ,
DATE: July 6, 2017 KETANJI BROWN JACKSON United States District Judge
Notes
[1] Page-number citations to documents the parties have filed refer to the page numbers that the Court’s electronic filing system assigns.
[2] Thomas Price has been automatically substituted as the Defendant in this action pursuant to Federal Rule of Civil Procedure 25(d).