City of New York v. Novello

65 A.D.3d 112, 880 N.Y.S.2d 60
Appellate Division of the Supreme Court of the State of New York·Decided June 4, 2009·Published·Cited by 6 cases

Opinion

OPINION OF THE COURT

Renwick, J.

In this case of statutory interpretation, the issue is whether the State can disregard a particular statutory directive to act within a specified time. The issue arises within the context of a dispute between New York State and the City of New York over the timeliness of the State’s revocation of a $27 million reimbursement to the City for home health care services the City provided. The State argues that the statutory deadline to invoke the revocation is merely directory. This Court, however, finds that the State may not disregard peremptory language that contains a plain, clear and distinct expression of mandatory legislative intent.

The seeds of this dispute were sown by the State Legislature when it promulgated legislation intended to reduce the recent spiraling costs of home-health-care-related services. Home health care services provided throughout the state by localities like the City of New York are eligible for reimbursement under the State’s Medicaid program, which is jointly funded by the federal government and participating states (Social Services Law § 365-a). The State pays 40% of the cost of home health care services provided by localities, the federal government pays 50%, and the locality itself pays the remaining 10%.

The Legislature enacted a target method to compel local social services districts to reduce the cost of home health care. Specifi[114]*114cally, pursuant to chapter 62, part Z2, § 26 of the Laws of 2003, the New York State Department of Health (DOH) developed “district-specific targets” (savings targets) to create incentives for each local district, such as the City of New York, to efficiently manage the cost of home health care services. The statute provides a methodology for calculating savings targets for a given year, and identifies “target periods” for DOH to analyze in determining if the City, as well as the other localities, is meeting the savings target set for it. Since 1997, the Legislature has enacted the target methodology, and reenacts it periodically to cover specific periods of time.

The statute provides that if the local district fails to meet the savings target, DOH will “intercept” home health care service payments and other payments to the district in an amount “sufficient to reimburse the state for [the amount the district exceeded] the savings target” (id., amending L 1997, ch 433, § 36 [6]). The intercept process occurs in four stages. In the first stage, by January 1 of the applicable year, DOH notifies each district as to its progress toward reaching the savings target (L 1997, ch 433, § 36 [3], as amended by L 1999, ch 412, part F, § 31, L 1999, ch 1, § 43 and L 2003, ch 62, part Z2, § 26). By March 1, DOH again notifies the district as to its progress toward reaching the savings target, and specifies an amount, if any, by which DOH projects that the district will fall short, and the amount of state payments DOH would intercept (L 1997, ch 433, § 36 [4] [a], as amended through L 2003, ch 62, part Z2, § 26). In the third step, DOH makes an initial intercept by March 31, if it projects that a district will fail to meet its savings target (L 1997, ch 433, § 36 [5] [a], as amended through L 2003, ch 62, part Z2, § 26). Finally, “as soon as possible, but in no event later than three months after the end of the target period,” DOH makes the final intercept if its final calculation indicates the district failed to meet the savings target, or issues a refund if the initial intercept exceeded the final calculation (L 1997, ch 433, § 36 [6], as amended through L 2003, ch 62, part Z2, § 26 [emphasis added]).

The relevant target period in this case is fiscal year 2003-2004. At the inception, DOH set a savings target amount of $32,003,775. On or about March 24, 2004, it made an initial estimate that the City of New York would fall short of the target by $1,391,461, but did not set a final intercept by the end of the required statutory deadline of June 30, 2004. Instead, for some unexplained reason, DOH delayed its decision for another four [115]*115months. Specifically, on October 29, 2004, DOH notified the City of its final calculation, demanding a final intercept of $27,375,822.

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City of New York v. Novello, 65 A.D.3d 112, 880 N.Y.S.2d 60 (N.Y. Ct. App. 2009).

65 A.D.3d 112 (City of New York v. Novello) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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