Palm Valley Health Care, Inc. v. Alex M. Azar, II, Secretary of Health and Human Services
1. Whether an administrative process that is fraught with delay and
fundamental unfairness and that clearly violates the provider's
constitutional Due Process rights rendered a valid and defensible
decision.
2. Whether Respondent applied an incorrect and more onerous Medicare
coverage criteria for homebound status based on subsequently issued
rules due to its excessive delay in adjudicating the home health
denials.
3. Whether Respondent committed error in adopting a non-scientific
sampling methodology and extrapolation of the overpayment to the
universe of 10,699 claims.
Whether an administrative process that is fraught with delay and fundamental unfairness and that clearly violates the provider's constitutional Due Process rights rendered a valid and defensible decision