Free Answer - District Court of Federal Claims - federal

Case 1:04-cv-00633-ECH

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Filed 07/08/2004

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IN THE UNITED STATES COURT OF FEDERAL CLAIMS HEALTH AMERICA PENNSYLVANIA, INC., Plaintiff, v. THE UNITED STATES, Defendant. ) ) ) ) ) ) ) ) )

No. 04-633C (Judge Hewitt)

DEFENDANT'S ANSWER For its answer to plaintiff's complaint, defendant admits, denies and alleges as follows: 1. The allegations contained in the first sentence of paragraph 1 constitute

conclusions of law and plaintiff's characterization of this action to which no response is required; to the extent they may be deemed allegations of fact, they are denied. Denies the allegation contained in the second sentence of paragraph 1 that plaintiff provided the health care benefits required under the non-specified "Contract" referred to for lack of knowledge or information sufficient to form a belief as to the truth of the matters asserted. Denies the remainder of the allegations contained in the second sentence of paragraph 1. 2. Denies the allegations contained in the first sentence of paragraph 2 for lack of

knowledge or information sufficient to form a belief as to the truth of the matters asserted. Admits the allegations contained in the second sentence of paragraph 2. 3. Denies the allegations contained in the first sentence of paragraph 3. Denies the

allegations contained in the second sentence of paragraph 3. Avers that OPM is ultimately responsible for making premium payments based upon payments it receives from the agencies and other enrollees.

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4.

The allegations contained in paragraph 4 are conclusions of law and plaintiff's

characterization of this action to which no response is required; to the extent they may be deemed allegations of fact, they are denied. 5. Admits the allegation in the first sentence of paragraph 5 that, on January 26,

2004, plaintiff submitted an administrative claim for underpayments to the Office of Personnel Management ("OPM") for contract years 1987 through 1996. The remainder of the allegations contained in paragraph 5 are conclusions of law to which no response is required; to the extent they may be deemed allegations of fact, they are denied. 6. Denies the allegations contained in the first sentence of paragraph 6. Admits the

allegations contained in the second sentence of paragraph 6 to the extent supported by the Federal Employees Health Benefits Act (5 U.S.C. § 8901, et seq.) ("FEHB Act"), which is the best evidence of its contents; otherwise denies the allegations contained in paragraph 6. 7. Admits the allegations contained in paragraph 7 to the extent supported by the

FEHB Act, which is the best evidence of its contents; otherwise denies the allegations contained in paragraph 7. 8. Admits the allegations contained in paragraph 8 to the extent supported by the

FEHB Act, which is the best evidence of its contents; otherwise denies the allegations contained in paragraph 8. 9. Admits the allegations contained in the first sentence of paragraph 9 to the extent

supported by the contract cited, which is the best evidence of its contents. Denies the allegations contained in the second sentence of paragraph 9. Admits the allegations contained in the third sentence of paragraph 9. 2

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10.

Denies the allegations contained in paragraph 10 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 11. Denies the allegations contained in paragraph 11 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 12. Denies the allegations contained in paragraph 12 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 13. Denies the allegations contained in paragraph 13 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 14. Denies the allegations contained in paragraph 14 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 15. Denies the allegations contained in paragraph 15 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 16. Denies the allegations contained in paragraph 16 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 17. Denies the allegations contained in the first sentence of paragraph 17 for lack of

knowledge or information sufficient to form a belief as to the truth of the matters asserted. Denies the allegations contained in the second sentence of paragraph 17. Denies the allegations contained in the third sentence of paragraph 17 for lack of knowledge or information sufficient to form a belief as to the truth of the matters asserted. 18. Admits the allegations contained in paragraph 18 to the extent supported by the

contract and regulations referred to, which are the best evidence of their contents; otherwise denies the allegations contained in paragraph 18. 3

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19.

Admits the allegations contained in paragraph 19 to the extent supported by the

letter cited, which is the best evidence of its contents, otherwise denies. The remainder of the allegations contained in paragraph 19 are conclusions of law to which no response is required; to the extent they may be deemed allegations of fact, they are denied. 20. Admits the allegation contained in the first sentence of paragraph 20 that OPM

did not respond to the letter of January 26, 2004. The remainder of the allegations contained in paragraph 20 are conclusions of law to which no response is required; to the extent they may be deemed allegations of fact, they are denied. 21. through 20. 22. Denies the allegations contained in paragraph 22 for lack of knowledge or Defendant repeats and realleges each of its responses contained in paragraphs 1

information sufficient to form a belief as to the truth of the matters asserted. 23. 24. Admits. Denies the allegations contained in paragraph 24 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 25. Denies the allegations contained in paragraph 25 for lack of knowledge or

information sufficient to form a belief as to the truth of the matters asserted. 26. 27. Denies. The allegations contained in the first sentence of paragraph 27 are conclusions of

law and plaintiff's characterization of its claim to which no response is required; to the extent they may be deemed allegations of fact, they are denied. Denies the allegations contained in the second sentence of paragraph 27. 4

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28. 29.

Denies. Denies that plaintiffs are entitled to the relief set forth in the prayer for relief

immediately following paragraph 28 of plaintiff's complaint, or to any relief whatsoever. 30. Denies each and every allegation not previously admitted or otherwise qualified. AFFIRMATIVE DEFENSES 1. 2. Some or all of plaintiff's claims are barred by the applicable statute of limitations. Some or all of plaintiff's claims are barred by laches.

WHEREFORE, defendant requests that the Court enter judgment in its favor, order that the complaint be dismissed, and grant defendant such other and further relief as the Court may deem just and proper.

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Respectfully submitted, PETER D. KEISLER Assistant Attorney General DAVID M. COHEN Director s/ Kathryn A. Bleecker KATHRYN A. BLEECKER Assistant Director OF COUNSEL: JILL GERSTENFIELD Attorney Office of Personnel Management Office of the General Counsel 1900 E Street, N.W. Washington, D.C. 20415 s/ Carolyn J. Craig CAROLYN J. CRAIG Trial Attorney Commercial Litigation Branch Civil Division Department of Justice 1100 L Street, N.W. Attn: Classification Unit, 8th floor Washington, D.C. 20530 Tele: (202) 305-7561 Fax: (202) 305-7644 e-mail: [email protected] Attorneys for Defendant

July 8, 2004

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CERTIFICATE OF FILING I hereby certify that on July 8, 2004, a copy of the foregoing "DEFENDANT'S ANSWER" was filed electronically. I understand that notice of this filing will be sent to all parties by operation of the Court's electronic filing system. Parties may access this filing through the Court's system.