Doe v. Livanta LLC

Full title: Jane Doe, Plaintiff, v. LIVANTA LLC, and Steven H. Stein, Defendants.

Court: UNITED STATES DISTRICT Court, EASTERN DISTRICT OF NEW YORK

Date published: Sep 24, 2020

Facts

Defendant Livanta is a Quality Improvement Organization (“QIO”), that hears appeals by Medicare recipients of discharge determinations by health care facilities in New York State. (Compl. ¶¶ 8-9; 20.) Defendant Stein serves as Livanta’s medical director. (Id. ¶ 10.) The plaintiff is a 79-year-old Medicare beneficiary. (Id. ¶ 7.) The plaintiff previously resided in an in-patient rehabilitation facility and is alleged to suffer from medical conditions requiring neuro-muscular rehabilitation. (Id. ¶¶ 13, 15.)

Livanta is a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). See https://www.livantaqio.com/en/About/BFCC-QIO (accessed Sept. 23, 2020). BFCC-QIOs “handle cases in which beneficiaries want to appeal a health care provider’s decision to discharge them from the hospital or discontinue other types of services.” See https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs (accessed Sept. 23, 2020).

On June 11, 2020, Plaintiff was admitted to Maimonides Medical Center (the “Hospital”), for treatment of a septic bone infection related to a bed sore. (Id. ¶ 14.) On June 24, 2020, the hospital “sought to discharge” Plaintiff to an SNF. (Id. ¶ 17.) The plaintiff requested that Livanta conduct an expedited review of the hospital’s decision to discharge the plaintiff to an SNF as opposed to an inpatient rehabilitation facility. (Id. ¶¶ 20, 23.) In support of her request, Plaintiff submitted 49 pages of written evidence to Livanta. (Id. ¶¶ 21-22.) On June 26, 2020, Livanta affirmed the Hospital’s discharge determination and found that Plaintiff was liable for hospital costs as of June 27, 2020, at noon. (Id. ¶ 23-24.)

Issue

Decision

For the foregoing reasons, Plaintiff’s motion for reconsideration of the Court’s denial of a temporary restraining order is DENIED.

SO ORDERED.

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