A Mississippi nursing home’s breach of contract lawsuit against a Medicare-related billing services contractor will head to trial, a federal court said Monday.
Madison County Nursing Home in Canton, MS, sued The Broussard Group LLC for breach of contract, claiming the company failed to timely submit claims and supporting documents to Medicare and other insurance program. The nursing home claims this cost it more than $1.2 million in lost reimbursements.
The nursing home entered into a contract with Broussard to provide Medicare-related billing services in 2010. During an audit, nursing home executives said they found multiple instances where the company failed to timely submit claims and supporting documents to Medicare.
After Broussard was notified of the review, the nursing home alleges the company altered resident accounts by “removing charges that could no longer be billed to Medicare because they were time-barred.”
During a second review, Madison executives said they found that billing errors resulted in a $1.2 million loss, according to the complaint.
The Broussard Group responded that it relied on billing documents from the nursing home, and that they were often incomplete or deficient. Broussard said it wasn’t responsible for billing and/or collecting payments from insurers other than Medicare, nor oversaw collecting payments on charges that had been pending for more than 60 days.
The nursing home was seeking to exclude the testimony of The Broussard Group’s expert witnesses and a summary judgement in the lawsuit on grounds that the company didn’t retain a qualified expert to refute its claims.
But the court denied the nursing home’s motion to exclude the company’s expert witnesses. The request for summary judgement was also denied.
The trial is set for February 2020.