Gurpreet Padda v. Xavier Becerra, No. 21-2823 (8th Cir. 2022)
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The government alleges that Medicare overpaid Plaintiff and his medical practice approximately $5.31 million. While the third level of administrative review, a hearing before an Administrative Law Judge (“ALJ”), was pending, Medicare began to recover the overpaid funds by withholding new reimbursements. Plaintiff argued that recovery prior to an ALJ hearing and decision violates procedural due process. He moved for a preliminary injunction to prevent Medicare from recovering payments prior to the ALJ decision. The district court denied the preliminary injunction and Plaintiff appealed.
The Eighth Circuit affirmed the denial of the preliminary injunction finding that Plaintiff has not satisfied the requirements for a preliminary injunction. Further, he has not shown that he is likely to prevail on the merits of his procedural due process claim nor that he is likely to suffer irreparable harm. The court explained that if an audit shows that a provider has been overpaid, Medicare may seek to recover the overpaid funds. Moreover, if a Medicare contractor determines a provider has been overpaid, the provider may challenge that decision through administrative and judicial review.
Here, Plaintiff’s interest in avoiding erroneous recoupment outweighs the government’s interest in prompt repayment. However, there is no evidence in the record that any delay in recovery against Plaintiff will cause long-term harm to Medicare or prevent Medicare from providing services to other beneficiaries. Further, Plaintiff’s claims of irreparable harm are undercut by his apparent failure to try to ease the burdens of recoupment.
Court Description: [Melloy, Author, with Colloton and Gruender, Circuit Judges] Civil case - Medicare. The government alleged that Medicare had overpaid plaintiff and his medical practice $5.31 million and, after two levels of administrative review had affirmed the overpayment, but while the matter was awaiting a hearing before and ALJ, the government began to recover the overpaid funds by withholding new reimbursements. Plaintiff sued and sought a preliminary injunction to prevent Medicare from recovering the payments prior to an ALJ decision. The district court denied the preliminary injunction, and plaintiff appealed. The district court did not err in denying the request for an injunction as plaintiff failed to show he was likely to prevail on the merits of his procedural due process claim or that he was likely to suffer irreparable harm; given the procedures plaintiff had already received, he has not demonstrated that an ALJ hearing and decision will afford him such significant additional protections that they are constitutionally required prior to recoupment.
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