MONTEFIORE MED. CTR. v. EMPIRE HEALTHCHOICE HMO, INC.

Index No. 26952/18E. Appeal No. 13058. Case No. 2019-04389.

191 A.D.3d 438 (2021)

140 N.Y.S.3d 517

2021 NY Slip Op 00631

Montefiore Medical Center, Respondent, v. Empire Healthchoice HMO, Inc., et al., Appellants.

Appellate Division of the Supreme Court of New York, First Department.

Decided February 4, 2021.


Attorney(s) appearing for the Case

Hogan Lovells US LLP, New York ( Robin Muir and Erin Chapman of the Bar of the District of Columbia and State of Virginia, admitted pro hac vice, of counsel of counsel), for appellants.

Garfunkel, Wild, P.C., Great Neck ( Michael J. Keane of counsel), for respondent.

Concur—Manzanet-Daniels, J.P., Singh, Kennedy, Mendez, JJ.


Empire claims that the plain language of the Medicaid statute and regulations compel a different result from that reached by Supreme Court, as Montefiore was precluded from pursuing any additional payment once it accepted "payment in full" from the Medicaid program for the services it provided (see 42 CFR 447.15 [a healthcare provider can participate in the Medicaid program only if the provider agrees to "accept, as payment in full, the amounts paid" by the state Medicaid...

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