Texas Tech Physicians Associates filed a lawsuit last week against the United States Department of Health and Human Services. The two sides have an $8 million disagreement according to court records.
According to court records, Texas Tech Physicians Associates (TTPA) is a non-profit corporation which agreed to implement a care management program for high-cost Medicare beneficiaries. The Centers for Medicare and Medicaid Services (CMS) agreed to pay management fees to TTPA.
The agreement required TTPA to reduce the Medicare costs of certain patients by 5 percent. According to the lawsuit, CMS used a flawed analysis to say TTPA failed to reduce costs by 5 percent.
“CMS demanded that Texas Tech [Physicians Associates] repay nearly $8 million in management fees,” the lawsuit said.
It also said, “CMS’s demand for repayment … [is] clearly erroneous, arbitrary, capricious, an abuse of discretion, and otherwise contrary to law.”
Among other things TTPA asked a federal judge to “issue a declaratory judgment that CMS is not entitled to repayment of $7,988,526 in management fees”
The U.S. Department of Health and Human Services has not yet filed its side of the story in court records.
