Justia Government Contracts Opinion Summaries

Henderson was a VA Program Analyst. Veterans may, under certain circumstances, obtain medical care from private physicians and facilities after obtaining preauthorization from a VA supervisory physician. An “unresolved authorized consult” means that a veteran’s medical appointment with an outside provider has not been scheduled or completed, or the completed appointment has not been memorialized. Henderson was charged with 50 counts of making false statements related to health care matters, 18 U.S.C. 1035, for ordering VA employees under his direction to close 2700 unresolved authorized consults by falsely declaring the consults were completed or refused by the patients. The VA informed Henderson that it proposed to suspend him for an indefinite period, noting that if convicted, he would face a maximum sentence of five years in prison on each count. Henderson, through counsel, denied the allegations, requested documentary evidence from the VA regarding his alleged wrongdoing, and asked that the proposed suspension be stayed pending the outcome of the criminal proceedings. The VA indefinitely suspended Henderson. A Merit Systems Protection Board administrative judge found, and the Board, and Federal Circuit affirmed, that the indictment provided the VA with reasonable cause to believe that he had committed a crime for which imprisonment could be imposed. The VA established a nexus between the criminal charges and the efficiency of the service. View "Henderson v. Department of Veterans Affairs" on Justia Law

TRICARE provides current and former members of the military and their dependents' medical and dental care. Hospitals that provide TRICARE services are reimbursed under Department of Defense (DoD) guidelines. TRICARE previously did not require, DoD to use Medicare reimbursement rules. A 2001 amendment, 10 U.S.C. 1079(j)(2), required TRICARE to use those rules to the extent practicable. DoD regulations noted the complexities of the transition process and the lack of comparable cost report data and stated “it is not practicable” to “adopt Medicare OPPS for hospital outpatient services at this time.” A study, conducted after hospitals complained, determined that DoD underpaid for outpatient radiology but correctly reimbursed other outpatient services. TRICARE created a process for review of radiology payments. Each plaintiff-hospital requested a discretionary payment, which required them to release “all claims . . . known or unknown” related to TRICARE payments. Several refused to sign the release and did not receive any payments. Although it discovered calculation errors with respect to hospitals represented by counsel, TRICARE did not recalculate payments for any hospitals that did not contest their discretionary payment offer. The Claims Court dismissed the hospitals’ suit. The Federal Circuit reversed in part, finding that they may bring a claim for breach of contract but may not bring money-mandating claims under 10 U.S.C. 1079(j)(2) and 32 C.F.R. 199.7(h)(2) because the government’s interpretation of the statute was reasonable. View "Ingham Regional Medical Center v. United States" on Justia Law

LFD operates a Lake Cumberland, Kentucky marina under a lease from the Army Corps of Engineers, covering approximately 130 acres of water and 36 acres of land. The Lease states: The right is reserved to the United States ... to enter upon the premises at any time and for any purpose necessary or convenient ... to flood the premises; to manipulate the level of the lake or pool in any manner whatsoever; and/or to make any other use of the lands as may be necessary in connection with project purposes, and the Lessee shall have no claim for damages. By 2007, Wolf Creek Dam, which created the lake, was at a high risk of failure; the Corps began lowering the lake's water level. The Corps returned the lake to its previous levels in 2014, when restoration was complete. LFD submitted a certified claim to the District Engineer, asserting $4,000,000 in damages. The Federal Circuit affirmed rejection of the claim. While the Lease is a contract for “the disposal of personal property” under 41 U.S.C. 7102(a)(4), giving the court jurisdiction, LFD did not properly present its reformation claim to the District Engineer. Rejecting a breach of contract claim, the court stated the Lease granted the Corps the right to manipulate the level of the lake in any manner whatsoever. View "Lee's Ford Dock, Inc. v. Secretary of the Army" on Justia Law