Carter Healthcare Inc v. Sebelius

Filing 24

MEMORANDUM OPINION and JUDGMENT, granting 17 Defendant HHS Secretary's Motion to Remand Case to the Agency in Light of Tenth Circuit Decision.. Signed by Honorable Robin J. Cauthron on 3/15/12. (lg, )

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
CARTER HEALTHCARE, INC.,
d/b/a CARTER HEALTHCARE AND
HOSPICE,
Plaintiff,
vs.
KATHLEEN SEBELIUS, Secretary,
U.S. Department of Health and Human
Services,
Defendant.

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Civil Action No. CIV-10-1081-C

MEMORANDUM OPINION AND JUDGMENT
Plaintiff brought the present action challenging a regulation employed by Defendant
in calculating payments due to it. In particular, Plaintiff challenged Defendant’s reliance on
42 C.F.R. § 418.309(b). The undersigned has previously determined two other challenges
to the relevant regulation, both times determining the regulation was invalid. The Tenth
Circuit has also recognized that Defendant has now disavowed any further reliance on the
regulation and is either in the process of, or has completed, its revision of the regulation.
Following the Circuit’s ruling in Hospice of N.M., LLC v. Sebelius, 435 F. App’x 749
(10th Cir. 2011), Defendant filed the present motion seeking remand of the matter to the
Agency for calculation under the revised regulation. Plaintiff objects to the remand, arguing
that in the first instance the Court must enter a judgment on its request for relief before
remand is proper.

After consideration of the parties’ briefs, the Court finds that Plaintiff’s arguments are
well-taken. A judgment is appropriate in this matter. Therefore, for the reasons set forth by
the Court in Prairie View Hospice, LLC v. Kathleen Sebelius, Case No. CIV-09-1234-C, and
Compassionate Care Hospice v. Kathleen Sebelius, Case No. CIV-09-28-C, the Court finds
that the regulation set forth at 42 C.F.R. § 418.309(b) is invalid. In reaching this decision,
the Court also relies upon the Circuit’s opinion in Hospice of N.M., LLC.
Accordingly, judgment is entered in favor of Plaintiff on its request for relief from the
regulation. This matter is remanded to the Provider Resources Review Board for further
consideration of Plaintiff’s challenge to Defendant’s determination of overpayment.
IT IS SO ORDERED this 15th day of March, 2012.

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