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Justices affirm ruling in dispute between health care facility and FSSA

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The Indiana Supreme Court has affirmed the outcome of a case between Family and Social Services Administration and a decertified intermediate care facility, in which the net result was a wash for both sides.

In Randall L. Woodruff, Trustee, U.S. Bankruptcy Court, on Behalf of Legacy Healthcare, Inc.d/b/a New Horizon Develop. Center v. In. Family & Social Serv. Admin., Office of Medicaid Policy & Planning, No. 29S02-1110-PL-598, New Horizon Development Center was certified to receive Medicaid reimbursement from the state. However, an inspection found deplorable conditions and its certification was revoked. The facility operated without receiving federal or state funding for nine months, when the state then appointed a receiver. At issue in the case is whether Legacy Healthcare, which ran the center, is entitled to funding for the care of the patients, after it was decertified, until all the patients could be transferred to other facilities.

The trial court denied restitution for the unpaid months under a theory of quantum meruit, afforded relief under related breach of contract claims, but offset that judgment by the amount the state paid for its receiver. The parties received no net gain. The justices affirmed.

New Horizon couldn’t have reasonably foreseen payment from FSSA for its Medicaid-eligible patients after it was decertified, and the evidence clearly shows that it was aware that decertification would not result in immediate transfer of those patients to other facilities by the state. New Horizon then, can’t succeed as a matter of law in its claim for quantum meruit because it can’t show that it expected payment for any services it might have provided, wrote Chief Justice Randall T. Shepard.

Because FSSA did not have any contractual or equitable obligation to pay the health care costs of the Medicaid-eligible patients at New Horizon during the post-decertification period, there is no bar to the state’s counterclaim for a set-off pursuant to the receivership statutes, wrote Shepard.

The justices did reverse the trial court with respect to its findings on the issue of exhaustion, noting that the facility appealed its decertification through administrative channels and had sought relief in court.

 

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  1. Good riddance to this dangerous activist judge

  2. What is the one thing the Hoosier legal status quo hates more than a whistleblower? A lawyer whistleblower taking on the system man to man. That must never be rewarded, must always, always, always be punished, lest the whole rotten tree be felled.

  3. I want to post this to keep this tread alive and hope more of David's former clients might come forward. In my case, this coward of a man represented me from June 2014 for a couple of months before I fired him. I knew something was wrong when he blatantly lied about what he had advised me in my contentious and unfortunate divorce trial. His impact on the proceedings cast a very long shadow and continues to impact me after a lengthy 19 month divorce. I would join a class action suit.

  4. The dispute in LB Indiana regarding lake front property rights is typical of most beach communities along our Great Lakes. Simply put, communication to non owners when visiting the lakefront would be beneficial. The Great Lakes are designated navigational waters (including shorelines). The high-water mark signifies the area one is able to navigate. This means you can walk, run, skip, etc. along the shores. You can't however loiter, camp, sunbath in front of someones property. Informational signs may be helpful to owners and visitors. Our Great Lakes are a treasure that should be enjoyed by all. PS We should all be concerned that the Long Beach, Indiana community is on septic systems.

  5. Dear Fan, let me help you correct the title to your post. "ACLU is [Left] most of the time" will render it accurate. Just google it if you doubt that I am, err, "right" about this: "By the mid-1930s, Roger Nash Baldwin had carved out a well-established reputation as America’s foremost civil libertarian. He was, at the same time, one of the nation’s leading figures in left-of-center circles. Founder and long time director of the American Civil Liberties Union, Baldwin was a firm Popular Fronter who believed that forces on the left side of the political spectrum should unite to ward off the threat posed by right-wing aggressors and to advance progressive causes. Baldwin’s expansive civil liberties perspective, coupled with his determined belief in the need for sweeping socioeconomic change, sometimes resulted in contradictory and controversial pronouncements. That made him something of a lightning rod for those who painted the ACLU with a red brush." http://www.harvardsquarelibrary.org/biographies/roger-baldwin-2/ "[George Soros underwrites the ACLU' which It supports open borders, has rushed to the defense of suspected terrorists and their abettors, and appointed former New Left terrorist Bernardine Dohrn to its Advisory Board." http://www.discoverthenetworks.org/viewSubCategory.asp?id=1237 "The creation of non-profit law firms ushered in an era of progressive public interest firms modeled after already established like the National Association for the Advancement of Colored People ("NAACP") and the American Civil Liberties Union ("ACLU") to advance progressive causes from the environmental protection to consumer advocacy." https://en.wikipedia.org/wiki/Cause_lawyering

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