Documentos de Académico
Documentos de Profesional
Documentos de Cultura
No. 11-2006
THREE
LOWER
INCORPORATED,
COUNTIES
COMMUNITY
HEALTH
SERVICES,
Plaintiff - Appellant,
v.
MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE; JOSHUA M.
SHARFSTEIN, in his official capacity as Secretary of the
Maryland Department of Health and Mental Hygiene,
Defendants - Appellees.
No. 11-2175
THREE
LOWER
INCORPORATED,
COUNTIES
COMMUNITY
HEALTH
SERVICES,
Plaintiff - Appellee,
v.
MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE; JOSHUA M.
SHARFSTEIN, in his official capacity as Secretary of the
Maryland Department of Health and Mental Hygiene,
Defendants - Appellants.
Appeals from the United States District Court for the District
of Maryland, at Baltimore.
William M. Nickerson, Senior
District Judge. (1:10-cv-02488-WMN; 1:05-cv-01280-AMD)
Argued:
Decided:
PER CURIAM:
This is the second suit by Appellant Three Lower Counties
Community
Health
Department
of
Services,
Health
and
Inc.
(TLC)
Mental
against
Hygiene
(the
the
Maryland
Department)
healthcare
services
to
low-income
enrollees.
patients
and
Medicaid
Department
failed
to
it
ensure
TLC
provided
to
was
compensated
out-of-network
for
the
emergency
services
Medicaid
patients.
rendered.
TLC moved for summary judgment.
order,
the
district
court
denied
In a January 5, 2011,
TLCs
motion
on
its
for
retroactive
monetary
relief
barred
by
42
U.S.C.
with
the
1396b(m)(2)(A)(vii)
organizations
to
requirement
that
provide
it
set
forth
contract
reimbursements
3
in
with
for
42
U.S.C.
managed
care
out-of-network
Community
Health
Services,
Inc.
v.
Maryland
(Three
TLC
subsequent
district
court
order
issued
on
remand.
The
TLC
carefully
reviewed
the
briefs,
record,
and
for
the
reasons
thorough opinions.
stated
by
the
district
court
in
its