Maine’s Lawsuit Challenging Termination of Riverview’s Medicare Program Participation Dismissed

Contact: Andrew K. Lizotte
Assistant United States Attorney
Tel: (207) 780-3257

Portland, Maine:  United States Attorney Thomas E. Delahanty II announced that yesterday U.S. District Judge John D. Levy dismissed a lawsuit brought against the federal government by the State of Maine on behalf of Riverview Psychiatric Center (“Riverview”), a psychiatric hospital operated by the Maine Department of Health and Human Services.

On October 3, 2014, Maine filed its lawsuit in U.S. District Court asking the court to review the June 4, 2013 decision by the Centers for Medicare and Medicaid Services (“CMS”) terminating Riverview’s Medicare provider agreement effective September 2, 2013.  The termination was due to a number of significant deficiencies related to Riverview’s compliance with health, safety and administrative requirements.  Riverview submitted three plans of correction, two of which were determined to be unacceptable by the Maine Department of Health and Human Services and CMS.  However, Riverview failed to properly challenge the termination decision, even when provided with additional time, until January 3, 2014, to do so.  The federal government moved to dismiss the lawsuit claiming that the State had failed to properly and timely challenge CMS’s termination decision.

Judge Levy agreed that Riverview had failed to properly and timely challenge the termination decision under the Medicare statute and regulations and that CMS had repeatedly reminded Riverview that the submission of plans of correction would not change the termination.  In dismissing the lawsuit, Judge Levy concluded that the State’s arguments stretched the facts of the case, and the relevant statutory and regulatory language, beyond their limits; were “semantic only;” or were unsupported by the Medicare regulations and the administrative record.  “[R]ead in their entirety,” Judge Levy concluded that Medicare’s “regulations offer no support for the proposition that a provider can avoid the effects of an unchallenged termination decision by engaging in a corrective process with CMS.  Here, the State had ample opportunity to challenge the June 4 decision but failed to do so. The consequences flowing from that failure may be harsh, but they are not, in the end, surprising given the regulatory scheme set out in the regulations.”
                    
The federal government was represented by the U.S. Attorney’s Office and the Office of General Counsel, U.S. Department of Health & Human Services.