Oral arg. – Miss.S.Ct. – Tues., Dec. 16, 2014

At 10:30 the Court will hear an interlocutory appeal concerning the procedure by which medical providers may appeal the Department of Medicaid’s decisions with regard to reimbursement rates.  It is Mississippi Department of Medicaid v. Crossgates River Oaks. It involves 12 hospitals.

In Oct. of 2010, Medicaid announced that it was retroactively adjusting downward the hospitals’ outpatient rates for fiscal year 2001.  The hospitals requested and were granted hearings in which they argued that the downward adjustment (totaling $86,420.49) was unfair and that rates should be adjusted upward (by a total of $2,164,292.58). The Hospitals appealed to the Hinds County Chancery Court.  “Because there is no statutory method for appealing decisions made by the [Director of Medicaid] after hearing in a provider administrative appeal, the issue is whether the Chancery Court has jurisdiction to review the decision of the DOM, or whether the providers must utilize the writ of certiorari procedure in Circuit Court pursuant to Miss. Code Ann. Sections 11-51-93 and 11-51-95.”  Medicaid’s brief at p. 2.  In other situations where there is no statutory mechanism for appeal, the Miss.S.Ct. has held that the proper procedure was via writ of cert. in the Circuit Court because those seeking review  were provided a quasi judicial proceeding by the agency itself.  Crossgates points out that Medicaid did not raise this jurisdictional issue until a year after Crossgates filed its initial complaint in Chancery Court. Crossgates’ brief at p. 5.  An, indeed, that Medicaid has participated in at least 12 cases where its decisions were appealed to the Hinds County Chancery Court.

Medicaid’s brief

Crossgates’ brief

various other providers have filed amicus briefs.

Argument can be heard here. The panel consists of Justices Dickinson, Lamar and Chandler.

Guaranteed to appeal to the civil procedure buffs out there.

2 thoughts on “Oral arg. – Miss.S.Ct. – Tues., Dec. 16, 2014

  1. Jane,

    I did administrative appeals for the Division of Medicaid for several years. My understanding was that decisions appealed from Medicaid’s administrative determinations were to Circuit Court?

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