Arbitrator rules Metropolitan Health Plan should receive $690,000

Friday, July 26, 2013

What started as a demand for money from a Hennepin County agency ended up with the county receiving money, thanks to the work of the Hennepin County Attorney’s Civil Division.

Best Care Home Health Services sued Metropolitan Health Plan (MHP) for $1.2 million. When the case was done, an arbitrator ruled in June that the company was due nothing and, instead, should pay MHP approximately $690,000.

Best Care had two contracts dating back to about 2000. One of the contracts was for home health care services for Medicare and Medicaid patients. The other was to take blood from children suspected of suffering from lead poisoning. By late 2008, MHP officials realized that hundreds of blood samples they were billed for either never turned up at the lab or were so poorly done that they were invalid, said Assistant Hennepin County Attorney Mike Miller who handled the case. By 2010, MHP had ended both contracts.

"Mike Miller, and his superb civil team, has done it again," commented Hennepin County Attorney Mike Freeman. "This is a huge victory that we are all very proud of."

Two years ago, Best Care sued Metropolitan Health Plan saying it had breached the two contracts and it owed the company $1.2 million. Miller filed a counterclaim, alleging that Best Care was the one in breach of the contracts and that it had defrauded MHP by billing for more blood draws than it had actually done.

A week-long hearing before an arbitrator in April, which involved about 15 witnesses and 11,000 pages of documents, resulted in the arbitrator agreeing that Best Care did defraud MHP and they should pay. Miller has filed the necessary motion to confirm the award in Hennepin County District Court and Best Care’s lawyers have filed a motion to dismiss the arbitrator’s award. A Hennepin County judge will rule on these motions.