Henderson hospital sues feds for Medicare funds

Grace Leong

Monday, April 14, 2003 | 11:27 a.m.

St. Rose Dominican Hospital-Siena Campus sued the administrator of the federal Medicare program to recover $360,000 in payments for emergency services provided in mid-2000 to Medicare patients when it had not yet been certified as a Medicare-participating hospital.

The Siena Campus St. Rose hospital in Henderson, which opened in July 2000, sued the Secretary of the Department of Health and Human Services in U.S. District Court last week, alleging the hospital was entitled, under federal Medicare laws, to be paid for services it provided to 164 patients with emergency medical conditions from July 17-Aug. 24, 2000.

"As a licensed hospital with an emergency department, St. Rose was not permitted to turn away or refuse to treat patients with emergency medical conditions or transfer them to other hospitals if we have the capability to treat them," said John Bailey, St. Rose's attorney.

St. Rose, owned by Catholic Healthcare West, said the defendant had denied its requests to be reimbursed for emergency services provided from July 17-Aug. 24, 2000 because the hospital wasn't Medicare-certified until Sept. 6, 2000.

But St. Rose appealed that decision, saying its delayed certification was due to the defendant's delay in performing a certification survey of the Siena Campus.

The defendant later revised the certification date to Aug. 24, 2000, which allowed St. Rose to be reimbursed for emergency services provided between Aug. 24-Sept. 6, 2000.

"But since we provided emergency services to our Medicare patients since July 17, 2000, we are now seeking to recover payments from July 17-Aug. 24, 2000," Bailey said.

Another St. Rose attorney, Patric Hooper, said the purpose of the lawsuit was not to get Medicare certification before Aug. 24, 2000, but to recover payments for emergency services it provided when it wasn't a Medicare participating hospital.

The defendant declined comment on St. Rose's allegations.