Issue

Medicaid reimbursements—prepayment review—constitutional violations alleged—no genuine issue of material fact

Summary

In a complex business case arising from the decision of the N.C. Department of Health and Human Services (DHHS) to place a medical services company on Medicaid reimbursement prepayment review for alleged overbilling practices, the trial court correctly granted summary judgment to DHHS where the company's evidentiary forecast did not demonstrate any genuine issue of material fact with regard to its substantive due process and equal protection violation claims. The agency's decision was not arbitrary and capricious where its reasons for placing the company on prepayment review were rationally related to a legitimate government interest of combating Medicaid fraud and where there was no evidence that DHHS treated the company differently from other personal care providers similarly situated.

Summary from the North Carolina Reports digest (official subject index). Read the opinion →