MaineGeneral Medical Center v. Shalala

LYNCH, Circuit Judge.

This case concerns what recourse is available to a provider hospital that, although eligible to receive Medicare reimbursement for certain expenses, mistakenly fails to ask for that reimbursement in a timely manner. The Secretary of Health and Human Services reimburses hospitals and other organizations for services they provide to beneficiaries of the Medicare program, 42 U.S’.C. § 1395 et seq. After the end of each fiscal year, a hospital must submit a cost report to a “fiscal intermediary,” a private firm that processes claims for the Secretary. The intermediary reviews…