February 27, 2015
by Sue Tuck Richmond
As previously reported here and here (copy of complaint) the Alabama Pain Clinic sued the Center for Medicare and Medicaid Services (CMS) over billing changes for compounded drugs. The clinic claims the CMS cannot retroactively change reimbursement policies. Today, as expected, the CMS filed a motion to dismiss based on a lack of subject matter jurisdiction. The CMS argues that the complaint should be dismissed because, "under the Medicare statute, and pursuant to clear precedent from the Supreme Court and the Court of Appeals for the Eleventh Circuit, a court has jurisdiction over a Medicare dispute only after the plaintiff has presented its grievance to the Secretary, channeled its challenge through the Medicare administrative appeals process, exhausted its administrative remedies, and received a final decision of the Secretary[]" and in this case the plaintiffs have failed to do so. The district court entered an order today giving plaintiff's until March 10, 2015 to respond to the motion to dismiss. CMS will then have until March 13, 2015 to reply once the Clinic files its response.
Stay tuned to see how this case turns out.
by Sue Tuck Richmond
As previously reported here and here (copy of complaint) the Alabama Pain Clinic sued the Center for Medicare and Medicaid Services (CMS) over billing changes for compounded drugs. The clinic claims the CMS cannot retroactively change reimbursement policies. Today, as expected, the CMS filed a motion to dismiss based on a lack of subject matter jurisdiction. The CMS argues that the complaint should be dismissed because, "under the Medicare statute, and pursuant to clear precedent from the Supreme Court and the Court of Appeals for the Eleventh Circuit, a court has jurisdiction over a Medicare dispute only after the plaintiff has presented its grievance to the Secretary, channeled its challenge through the Medicare administrative appeals process, exhausted its administrative remedies, and received a final decision of the Secretary[]" and in this case the plaintiffs have failed to do so. The district court entered an order today giving plaintiff's until March 10, 2015 to respond to the motion to dismiss. CMS will then have until March 13, 2015 to reply once the Clinic files its response.
Stay tuned to see how this case turns out.
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