Commonwealth, Department of Public Welfare v. Ludlow Clinical Laboratories, Inc.

374 A.2d 526, 473 Pa. 299, 1977 Pa. LEXIS 715
CourtSupreme Court of Pennsylvania
DecidedJune 3, 1977
Docket18
StatusPublished
Cited by9 cases

This text of 374 A.2d 526 (Commonwealth, Department of Public Welfare v. Ludlow Clinical Laboratories, Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Commonwealth, Department of Public Welfare v. Ludlow Clinical Laboratories, Inc., 374 A.2d 526, 473 Pa. 299, 1977 Pa. LEXIS 715 (Pa. 1977).

Opinion

OPINION OF THE COURT

PER CURIAM:

The Court being equally divided, the Order of the Commonwealth Court is affirmed.

O’BRIEN, J., files an Opinion in Support of Affirmance in which EAGEN, C. J., and POMEROY, J., join. ROBERTS, J., files an Opinion in Support of Reversal in which NIX, J., joins. *301 MANDERINO, J., files an Opinion in Support of Reversal. JONES, former C. J., took no part in the consideration or decision of this case.

OPINION IN SUPPORT OF AFFIRMANCE

O’BRIEN, Justice.

This appeal arises from an order of the Commonwealth Court sustaining the preliminary objections of appellee, Commonwealth of Pennsylvania, Department of Public Welfare, to “answer and new matter” of appellants, Ludlow Clinical Laboratories, Inc. (hereinafter “Ludlow”), Leonard Edelman, and Joseph C. Mogil. Commonwealth Court sustained the preliminary objections because of a lack of subject matter jurisdiction, but granted appellants leave to file new pleadings. Such new pleadings would allow the defense of “recoupment” to be put forth by appellant. 1

The facts surrounding this appeal are as follows: On February 27, 1975, the Commonwealth of Pennsylvania, Department of Public Welfare, filed a four-count complaint against Ludlow Clinical Laboratories, Inc., and against Leonard Edelman and Joseph C. Mogil, both in their capacities as officers of Ludlow Clinical Laboratories, Inc. and as individuals. Counts I and II of the Commonwealth’s complaint were filed in assumpsit.

*302 Count I alleges that Ludlow was accredited by the Federal Department of Health, Education and Welfare to provide laboratory testing services to eligible recipients under the Health Insurance for Agfed and Disabled Program and the Social Security Act. Ludlow was also certified by the Commonwealth as a participant in the Pennsylvania Medical Assistance Program. The Commonwealth provided a maximum fee schedule for billing of laboratory services. This maximum fee schedule was, however inoperative if the certified laboratory charged its private client a lesser fee for the same service. The Commonwealth would then pay only the amount charged the private client rather than the maximum fee provided for in the schedule. The Commonwealth contends that Ludlow overbilled by $1,301,579.44 and seeks recovery in that amount.

Count II of the Commonwealth’s complaint, also in assumpsit, avers that if a recipient qualifies for both the state medical assistance program and the federal medicare program, federal regulations require that the testing laboratory initially bill the federal government for all persons over sixty-five years of age. The Commonwealth contends that Ludlow fraudulently altered the age records to lower ages to under sixty-five, thereby making the Commonwealth initially liable. The Commonwealth seeks damages in the amount of $43,263.50 as a result of the alleged improper payments.

Counts III and IV of the complaint are in trespass and are factually based on the above transactions. The Commonwealth avers that “Edelman and Mogil, as individuals,” directed the above “fraudulent” billing and damages in identical amounts are sought.

Appellants filed an “answer and new matter.” The “answer” denies any fraudulent misrepresentation or alteration of the billing system of Ludlow. It also avers that the Commonwealth owes Ludlow $1,421,916.56. Ap *303 pellants in “new matter” itemized the $1,421,916.56 as follows.

1. $1,063,891.18 — for the period of August 13, 1974 through November 30, 1974 for laboratory services.
2. $323,394.50 — for the period of December 1, 1974 through January 10, 1975 for laboratory services.
3. $34,630.88 — for the period of January 1, 1974 through June 1, 1974 for laboratory work for recipients under both programs.

The Commonwealth filed preliminary objections, alleging a lack of jurisdiction in Commonwealth Court to hear the appellant’s claim. In addition, the Commonwealth sought a more specific pleading. The Commonwealth Court, per Judge Rogers, granted the Commonwealth’s preliminary objections as to jurisdiction, but granted leave to appellants to amend their answer and new matter to state a claim based on “recoupment.” This appeal followed. 2

Appellants in the instant case have filed a claim with the Pennsylvania Board of Arbitration of Claims concerning the same facts and series of transactions which were the basis of the Commonwealth’s complaint and appellants’ “new matter.”

Appellants argue that Commonwealth Court erred in dismissing their “answer and new matter” and limiting them to proceed in “recoupment” in the instant court case. We do not agree.

Initially, appellants contend that the Commonwealth Court erred in treating their “answer and new matter” as a “counterclaim.” We do not agree.

*304 Appellants sought an affirmative money judgment against the Commonwealth in the amount of $1,421,916.-56, arising out of the same contracts upon which the Commonwealth based its complaint. Such an affirmative judgment is not “defensive” as to be within the ambit of Pennsylvania Rule of Civil Procedure 1030. New Matter. 3 However, such a demand was clearly within the scope of counterclaim as set forth in Pa.R.C.P. 1031. 4

Commonwealth Court required that Ludlow pursue its “counterclaim” against the Commonwealth at the Board of Arbitration of Claims and required that Ludlow could only use such “counterclaim” as a defense in “recoupment.” We agree.

Article 1, § 11, of the Pennsylvania Constitution provides, inter alia:

“Suits may be brought against the Commonwealth in such manner, in such courts and in such cases as the Legislature may by law direct.”

*305 This constitutional provision has been consistently read by a majority of this court to prohibit all suits filed against the Commonwealth absent specific and clear legislative action permitting such suits. Biello v. Pa. Liquor Cont. Bd., 454 Pa. 179, 301 A.2d 849 (1973), Brown v. Commonwealth, 453 Pa. 566, 305 A.2d 868 (1973).

The Legislature, by the Act of May 20, 1937, P.L. 728, No. 193, § 1, et seq., as amended 72 P.S. § 4651-1, et seq., established the Board of Arbitration of Claims.

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Bluebook (online)
374 A.2d 526, 473 Pa. 299, 1977 Pa. LEXIS 715, Counsel Stack Legal Research, https://law.counselstack.com/opinion/commonwealth-department-of-public-welfare-v-ludlow-clinical-laboratories-pa-1977.