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From Health Law Daily, October 2, 2018

Temporary restraining order denied for home health care provider during appeal

By Brian Craig, J.D.

The federal district court in Orlando, Florida has denied a request for a temporary restraining order enjoining HHS from recouping more than $800,000 from a home health provider during the pendency of an administrative appeal. The court concluded that the home health provider, with approximately 20 employees and 35 patients, failed to show irreparable injury to warrant a temporary restraining order over the billing dispute. The court found that the provider failed to show that it had been forced to lay off employees or face similar immediate financial impacts for actual and imminent injury (Alpha Home Health Solutions, LLC v. HHS, September 27, 2018, Byron, P.).

Alpha Home Health Solutions, LLC is a home health care service provider with approximately 20 employees providing medical services to approximately 35 patients in their homes, at assisted living facilities, and in retirement communities. On December 29, 2016, a Medicare Administrative Contractor (MAC) requested that the provider repay $1,418,503. On April 30, 2018, the provider received a "partially favorable" reconsideration decision, resulting in a reduced overpayment amount of $707,981. As of July 27, 2018, $101,767 of interest had accrued, thus the provider owes a total of $809,748.

The provider requested a hearing before an administrative law judge (ALJ) and also applied for a five-year repayment plan. The provider alleged that it would need to wait between three and five years for an ALJ hearing due to a current backlog of cases. The provider contended enforcement of the alleged debt would effectively bankrupt the company causing it to shut down, resulting in employees losing their jobs and patients losing their home health care provider. The provider sought a temporary restraining order (TRO) to enjoin HHS from enforcing the alleged debt during the pendency of an administrative appeal.

The court found that the potential injuries inflicted to employees and patients are not considered under the irreparable injury prong of the TRO test. Rather, those injuries are considered under the public interest factor. The provider failed to show that it had been forced to lay off employees or faced similar immediate financial impacts. The court also found that the provider’s allegations that it will be forced to close absent a TRO are too speculative. The court distinguished other cases where courts found irreparable injury where movants had been forced to terminate employees. While going out of business can be sufficient evidence of irreparable injury, the court found that the provider failed to show sufficient evidence of an actual and imminent threat. Therefore, the court denied the request for an ex parte TRO.

The case is No. 6:18-cv-01577-PGB-TBS.

Attorneys: Jonathan Seth Robbins (Fowler White Burnett, P.A.) for Alpha Home Health Solutions, LLC.

Companies: Alpha Home Health Solutions, LLC

MainStory: TopStory CaseDecisions CMSNews BillingNews HomeNews MedicareContractorNews PaymentNews FloridaNews

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