No. 22-3121 ___________________________

Select Specialty Hospital - Sioux Falls, Inc., a Missouri business corporation

Plaintiff - Appellant

v. Brentwood Hutterian, Brethren, Inc., a South Dakota non-profit corporation; South Dakota Medical Holding Company, Inc., a South Dakota corporation doing business as Dakotacare; Hutterian Brethren General Medical Fund, a South Dakota non-profit corporation

Defendants - Appellees ____________

Appeal from United States District Court for the District of South Dakota - Southern ____________

Submitted: March 21, 2023 Filed: August 30, 2023 ____________ Before BENTON, ERICKSON, and KOBES, Circuit Judges. ____________ KOBES, Circuit Judge.

After suffering a stroke, Mary, a member of the Brentwood Hutterite Brethren, received care at a Select Specialty Hospital. During her time at Select, she was covered by Brentwood’s insurance. But after Mary applied for and received Medicaid, it retroactively covered her time at Select. Select accepted $300,000 from Medicaid for Mary’s care—far less than it was expecting from Mary’s Brentwood insurance. Select now seeks payment from Brentwood, the Hutterite Brethren General Fund (the Fund), and South Dakota Medical Holdings Company (Dakotacare) for breach of contract. It also seeks damages from Brentwood and the Fund for fraud and deceit. The district court 1 granted summary judgment to Brentwood, the Fund, and Dakotacare. We affirm.

I.

Select, a long-term care facility, provided $1.9 million of care to Mary between March and December 2018. As a Brentwood member, Mary was insured under Brentwood’s insurance plan (the Plan), which covers all members until “the Participant leaves the Colony, turns age 65, or becomes deceased.” The Plan was sponsored by the Fund—a consortium of Hutterite Colonies that provides medical coverage for members—and administered by Dakotacare. Before Select cared for Mary, it received preauthorization from Dakotacare.

As part of her care, Mary needed to be transferred to a ventilator facility, but the ventilator facility closest to her family required Medicaid. A director of the Fund, Jared Wollman, applied for disability benefits on Mary’s behalf, which would make her automatically eligible for Medicaid. Mary’s application for disability benefits stated that she did not have “any private, group or government health insurance that pays the cost of her medical care.” But Mary did have insurance coverage under the Plan.

On May 1, 2018, Mary qualified for disability benefits and automatically became Medicaid-eligible. Wollman then realized that Mary also qualified for retroactive coverage, meaning that Medicaid—not the Plan—could cover Mary’s care even before May 1. Wollman was notified in late November that Mary was

1 The Honorable Karen E. Schreier, United States District Judge for the District of South Dakota. -2- approved for retroactive Medicaid coverage for her entire time at Select. After receiving this approval, Wollman sent Mary’s Plan termination forms to Dakotacare.

Select suspected that Mary’s coverage could not have been terminated and initially instructed its staff to wait on seeking Medicaid payment for Mary. But then Select decided to move forward with Medicaid “in the event [it was] not successful” getting reimbursed by Dakotacare. In May 2019, Medicaid approved the payment, and Select accepted about $300,000 from Medicaid.