COA reverses in favor of FSSA in provider payment dispute

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The Indiana Court of Appeals held that a trial court erred in ruling in favor of health care providers regarding payments from the state’s Residential Care Assistance Program.

In Michael A. Gargano, in his official capacity as Secretary of the Indiana Family and Social Services Administration, et al. v. Lee Alan Bryant Health Care Facilities, Inc., et al., No. 49A02-1105-PL-449, the appellants contended that the trial court violated separation of powers when it found that the Family and Social Services Administration and Division of Aging had acted unlawfully in refusing to accept RCAP applications after Dec. 1, 2009.

The FSSA had notified providers that relied on RCAP funds in October 2009 that due to budgetary constraints affecting all state agencies, the RCAP would not be accepting new applications effective Dec. 1, 2009. Following that date, a number of applications for the RCAP submitted by individuals admitted to providers’ facilities were denied.

The COA declined to hold that FSSA and the DOA may not exercise or perform conventional administrative and executive steps of directing or redirecting allotted funds in order to meet the directives of the State Budget Agency, and therefore reversed the trial court’s award of damages to providers.

The appellants also claimed that the court erred in ordering them to recalculate reimbursement rates paid to RCAP providers. The trial court had ordered the state agencies in 2011 to recalculate reimbursement amounts from 2003 to 2009.

Citing Indiana Code 12-10-6-2.1, subsection (g), the COA held that “a prenegotiated payment rate is predicated on a reasonable cost related basis with a growth of profit factor in accordance with generally accepted accounting principles and methods and written standards and criteria as established by the division.” RCAP providers had been paid the upper rate limit and therefore were not entitled to additional reimbursement, nor were the reimbursement rates unlawful, the COA held.

The Court of Appeals remanded for proceedings consistent with its opinion.



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  1. Joe, you might want to do some reading on the fate of Hoosier whistleblowers before you get your expectations raised up.

  2. I had a hospital and dcs caseworker falsify reports that my child was born with drugs in her system. I filed a complaint with the Indiana department of health....and they found that the hospital falsified drug screens in their investigation. Then I filed a complaint with human health services in Washington DC...dcs drug Testing is unregulated and is indicating false positives...they are currently being investigated by human health services. Then I located an attorney and signed contracts one month ago to sue dcs and Anderson community hospital. Once the suit is filed I am taking out a loan against the suit and paying a law firm to file a writ of mandamus challenging the courts jurisdiction to invoke chins case against me. I also forwarded evidence to a u.s. senator who contacted hhs to push an investigation faster. Once the lawsuit is filed local news stations will be running coverage on the situation. Easy day....people will be losing their jobs soon...and judge pancol...who has attempted to cover up what has happened will also be in trouble. The drug testing is a kids for cash and federal funding situation.

  3. (A)ll (C)riminals (L)ove (U)s is up to their old, "If it's honorable and pro-American, we're against it," nonsense. I'm not a big Pence fan but at least he's showing his patriotism which is something the left won't do.

  4. While if true this auto dealer should be held liable, where was the BMV in all of this? How is it that the dealer was able to get "clean" titles to these vehicles in order to sell them to unsuspecting consumers?

  5. He has refused his Assent to Laws, the most wholesome and necessary for the public good. He has forbidden his Governors to pass Laws of immediate and pressing importance, He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance. He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation: For imposing Taxes on us without our Consent: He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.. He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless [ ] Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions. GOD BLESS THE GOVERNORS RESISTING! Count on the gutless judiciary to tie our children down and facilitate the swords being drawn across their throats. Wake Up America ...