Maine Med sues fed over $3M in claims
Maine Medical Center has filed a lawsuit against U.S. Department of Health and Human Services Secretary Kathleen Sebelius, saying the federal government owes the hospital nearly $3 million in claims for patients with government health insurance.
The Bangor Daily News reported the suit stands apart from the hospital's effort to recover its portion of $484 million in unpaid Medicaid reimbursements from the state and federal government.
The lawsuit alleges that the federal government is on the hook for care the hospital provided to patients who qualified for both the state-level MaineCare and the federal Medicaid and Medicare programs.
The state stopped making payments for those patients through MaineCare in 1999, and gave providers documentation that showed it was no longer paying those claims. Hospitals could then seek payments from the federal government.
In its lawsuit, the hospital alleges that an "anomaly of unknown origin" prevented the state from processing those claims between November 2001 and August 2003, leaving the hospital without that documentation and unable to seek reimbursement from Medicare.
Last November, the paper reported, the hospital won a favorable decision from an independent Medicare review board but it was denied reimbursement by the Centers for Medicare and Medicaid Services.
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