Medicare Billing Kickup Booted From D.C. Court

     (CN) – Dismissing a challenge of time limits surrounding the billing of certain Medicare claims, a federal judge in Washington, D.C., found jurisdiction lacking.
     American Hospital Association, Missouri Baptist Sullivan Hospital, Munson Medical Center, Lancaster General Hospital, Trinity Health Corporation and Dignity Health sued Secretary of Health and Human Services Sylvia Matthews Burwell in 2012, alleging that time limits on certain Medicare claims were “arbitrary and capricious in violation of the Administrative Procedure Act.”
     They also challenged application of “the timely filing limit to certain new Medicare Part B claims,” and said the one-year time limit of the Medicare Act is equitably tolled.
     Burwell moved to dismiss the complaint for lack of jurisdiction, and U.S. District Judge Colleen Kollar-Kotelly did just that Wednesday.
     The challenge shifted throughout the course of litigation in reaction to interim rulings issued by the Centers for Medicare and Medicaid Services (CMS), the court found.
     The rulings came after the plaintiffs’ challenge to “what they call CMS’s ‘Payment Denial Policy,'” prohibiting Part B reimbursement for items originally billed under Part A, and seeking payment for service previously provided, according to the ruling.
     “Meanwhile, CMS issued a final rule, superseding both the interim ruling and the proposed rule,” Kollar-Kotelly wrote. “In response to the court’s request for clarification in light of those events, plaintiffs explained that they are challenging ‘a policy that has been in place since before [the rulings] and remains in place after the final rule.”
     In the end, the plaintiffs’ amended challenges fail to show jurisdiction.
     “Ultimately, the court considered the plaintiffs’ challenge as they have reframed it, in light of intervening events, challenging a general policy neither promulgated in CMS’s (Centers for Medicare and Medicaid Services) recent rulemaking nor in the now-superseded interim ruling,” she said. “The court has no jurisdiction over this challenge.”

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