`

Fort Wayne hospital loses Medicaid payment appeal

July 14, 2015

Parkview Hospital in Fort Wayne was not wrongly denied $27 million in Medicaid payments it sought from the state when it failed to properly and timely document the claims, the Indiana Court of Appeals affirmed Tuesday.

The Family and Social Services Administration denied Parkview’s request for disproportionate share hospital payments it sought for 2010 and 2011, a decision affirmed by Allen Superior Judge Nancy Eshcoff Boyer.

In Parkview Hospital, Inc. v. John J. Wernert, in his official capacity as Secretary of the Indiana Family and Social Services Administration, and The Methodist Hospitals, Inc., 02A03-1408-PL-296, Judge Elaine Brown wrote a 45-page order for the Court of Appeals panel that affirmed the trial court. She wrote that the hospital has received more than $70 million in DSH payments and safety-net programs since 2004 and claims a continuous shortfall of more than $198 million since then from serving Medicaid and uninsured patients.

Nevertheless, the panel rejected the hospital’s argument that denial of the DSH benefits for 2010 and 2011 was an unduly harsh sanction and that Parkview had a contract with FSSA and it suffered a disproportionate forfeiture.

“Based upon the record, the decision of the Secretary of FSSA was not arbitrary, capricious, or unsupported by substantial evidence. In addition, there was no contract or agreement of material terms and conditions regarding DSH payments supporting a forfeiture claim,” Brown wrote.

“For the foregoing reasons, we affirm the July 25, 2014 judgment of the trial court affirming the decision of the Secretary of FSSA.”

ADVERTISEMENT

Recent Articles by Dave Stafford