With Holland & Knight's help, a large public hospital in Atlanta finally obtains $1.8 million in reimbursements.
Charles Johnson, Sarah Leopold and Josh Bosin (all ATL) recently received an appellate win on behalf of Grady Health Systems. The case stems from an action by the Georgia Department of Community Health (DCH) to under-reimburse Hughes Spalding Children's Hospital for services rendered to Medicaid patients from 1999-2002.
Hughes Spalding was owned and operated by the Fulton-DeKalb Hospital Authority (d/b/a Grady Health System). The DCH based its reimbursement decision on a retroactive application of its hospital services manual, despite the existence of a contract between the parties expressly prohibiting such retroactive action. The action by the DCH resulted in a $1.8 million loss to Grady.
Grady's in-house counsel first challenged the action in administrative proceedings and lost before an administrative law judge who affirmed DCH's reimbursement decision. Holland & Knight came in as appellate counsel and successfully appealed the action to the Superior Court of Fulton County. The superior court reversed the administrative law judge and awarded Grady $1.8 million.
On DCH's discretionary appeal to the Georgia Court of Appeals, the court reversed the superior court, adopting the position of the administrative law judge and finding in favor of DCH. Holland and Knight filed a motion for reconsideration arguing that the court ignored the binding authority of the contract between the parties. On Nov. 7, the same appellate panel reversed itself, vacated its original opinion and found in the client's favor based on the arguments advanced in the motion for reconsideration. Click here to view a copy of the opinion.
"Getting rehearing granted like this is an extremely rare occurrence," said Laurie Webb Daniel (ATL), chair of Holland & Knight's appellate team. "This win will provide Grady with a much-needed $1.8 million in reimbursements."
11/25/2008
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