After decades, health center claims appear to be under negotiation

By The Star Staff

It appears that the Corporación de Servicios Integrales de Salud (CSI), or Integrated Health Services Corp., in the areas of Barranquitas, Comerío, Corozal, Naranjito and Orocovis, along with Atlantic Medical Center, are negotiating the centers’ claims for payment from the Puerto Rico government that go back to the 1990s.

U.S. District Court Judge Laura Taylor Swain has adjourned the consolidated case amid the request from the parties for time to negotiate the claims. Swain stayed the case pending further order of the court and dismissed a petition for dismissal. The parties were directed to submit a joint status report by July 20.

The case has been lingering in the courts for decades. The centers provide care to medically underserved populations and are partially funded through Medicaid.

Under federal law, the commonwealth government is partially responsible for paying certain Medicaid-related expenses. States (as well as Puerto Rico) must make these payments “in no case less frequently than every four months,” according to the law.

If the commonwealth fails to make the requisite Medicaid payments, the health or medical centers have the right to enforce those payments by suing the commonwealth. CSI alleges that the commonwealth since 1989 has largely ignored payment requirements. There are several processes that began in commonwealth court.

In November 2018, Swain dismissed, in separate cases, claims pursued by Atlantic and CSI. In the proceedings, the nonprofit medical centers sought a ruling that claims under the federal Medicaid program weren’t dischargeable under Title III and that they couldn’t be impaired under the Puerto Rico Oversight, Management and Economic Stability Act, widely known as PROMESA. Magistrate Judge Judith Dein had found in August 2018 that the court didn’t have jurisdiction over the claims and that the claims weren’t ripe for adjudication. Swain agreed with her findings.

The medical centers had argued that because the judgments for some of the money owed to them under Medicaid had been finalized in commonwealth courts, the issue was ripe for review. But Swain found that the centers must wait for Puerto Rico to file a plan of adjustment and attempt to discharge the claims before the court can address the issue of dischargeability.

The matter went to the U.S. First Circuit Court of Appeals, which on April 8 of last year remanded to the district court for reconsideration consistent with the opinion issued that day.

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