Commonwealth v. Stein

546 A.2d 36, 519 Pa. 137, 1988 Pa. LEXIS 221
CourtSupreme Court of Pennsylvania
DecidedAugust 10, 1988
Docket156 E.D. Appeal Docket 1987
StatusPublished
Cited by9 cases

This text of 546 A.2d 36 (Commonwealth v. Stein) 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 v. Stein, 546 A.2d 36, 519 Pa. 137, 1988 Pa. LEXIS 221 (Pa. 1988).

Opinions

OPINION ANNOUNCING THE JUDGMENT OF THE COURT

PAPADAKOS, Justice.

This case concerns the question of whether the Court of Common Pleas of Philadelphia County (per Judge William Porter) was correct in quashing 27 counts of Medicaid fraud brought against Appellant. The Superior Court concluded that the pre-trial order quashing these counts was in error. For the reasons set forth below, we reverse and reinstate the order of the Court of Common Pleas.

The facts in this case are as follows. Appellant, Dr. Kenneth A. Stein, D.P.M., is a licensed podiatrist. At the time of his arrest in the instant case, on September 22, 1983, Appellant was a registered health care provider with the Commonwealth's Department of Public Welfare (DPW), which is the state agency that administers our Medical Assistance Program. Appellant was paid by the Commonwealth for podiatric services that he billed to the Medical [140]*140Assistance Program. Appellant was arrested and charged with 99 counts of Medicaid fraud as set forth in three separate bills of information. Informations were filed against Appellant charging him with 33 violations of each of three different sections of the Fraud and Abuse Control provisions of the Public Welfare Code, 62 P.S. §§ 1407(a)(1), (a)(4) and (a)(9).1

Essentially, Appellant was charged with billing DPW for services which, DPW charged, did not qualify for payments to Appellant as a medical provider. The disputed billings were for some 33 renewals of prescriptions for orthopaedic shoes for the children of three qualified medical assistance recipients. It is admitted that Appellant did not have face-to-face encounters with the minor children for whom he wrote the renewal prescriptions in this case. Rather, Appellant was contacted by the child’s mother or elder sibling who indicated that there was a need for another prescription for orthopaedic shoes. Appellant claims that all of the children involved were from large families, that they were either at school or ill and so could not come to the doctor’s office, and that no prescriptions were renewed until after Appellant had actually seen the child’s mother or sibling at [141]*141his office. In any event, it is conceded that Appellant consulted each child’s office file and then wrote out the prescription requested. He subsequently billed DPW under Fee Schedule, Procedure Code # 90005.

The Commonwealth contends that the renewal of such prescriptions in this manner is not compensible because payments for such services are not authorized by DPW regulations. It further argues that by allegedly billing for “office visits,” Appellant had not rendered the type of service which must be rendered in order for a service to qualify for payment as an “office visit” under those regulations.

The DPW manual sets forth a Fee Schedule (R., 7a). Immediately prior to setting forth the Fee Schedule, there is a paragraph included under “General Provisions” which provides as follows:

Providers shall include the appropriate procedure codes and terminology on all claims submitted for payment. The following fee schedules are all inclusive; therefore, only those services identified by a procedure code are covered by the Medical Assistance Program.

Immediately following is the Fee Schedule itself. “Procedure Code” # 90005 is the first code number listed. The “terminology” for which it is applicable is stated as follows:

Office visit, brief examination, evaluation and/or treatment.

Appellant argues that the real nature of the offenses for which he is being charged is that he improperly reported code number 90005 on his billing statement for the services rendered (as described above).

Effective January 1,1983, the DPW manual was amended to include a “definitions” section. “Visit” is now defined as a “face-to-face encounter between a patient and a practitioner, except as otherwise stated in the specific Medical Assistance provider chapters, for the purpose of furnishing medically necessary medical services.” (R., 8a).

[142]*142Appellant filed a “Motion for Accelerated Rehabilitative Disposition and/or Motion to Strike the Information” with the Court of Common Pleas with respect to all 99 counts. Judge Porter treated this as a motion to quash (Trial court opinion, p. 1; R., 9a, n. 1) (see Pa.R.Crim.P. 306, and the comments thereto) and, as such, the motion was granted in part on November 6, 1985. Judge Porter quashed 9 counts on each of the three informations (27 counts in all). Each of the 27 counts which were quashed dealt with a billing for a prescription that had been written prior to January 1, 1983, the effective date of the amendments to the DPW manual defining a “visit” as a face-to-face encounter. Judge Porter concluded that the alleged offenses involved in the situations where the events occurred before the “face-to-face encounter” definition of January 1, 1983 became effective, were not offenses for which Appellant should be put on trial. The Court reasoned that the Pee Schedule — Procedure Code was subject to an ambiguous interpretation by a medical provider before the “face-to-face encounter” requirement was promulgated. The Court found that prior to January 1,1983, Appellant did receive an office visit or office contact by members of the patients' families and that he did examine the patients’ files or charts, and prescribed shoes for the patients’ conditions. While conceding that it might be argued that the term “brief examination” might mean a brief examination of the patient (and not of the patient’s file), and that the term “evaluation” might suggest an evaluation of the patient and not an evaluation of his or her file, the Court concluded that if only one interpretation could be gleaned from the preJanuary 1, 1983 regulations, there would have been no need to add the “face-to-face encounter” definition of “visit” by the January 1, 1983 amendment. Therefore, the Court was satisfied that enough of an ambiguity existed in the definition of “office visit” before the January 1, 1983, revision so as to create a reasonable basis for misinterpretation of the term “office visit” prior to the issuance of the revised definition of the term “visit.”

[143]*143Immediately following Judge Porter’s partial grant of the motion to quash, Appellant elected to waive his right to a jury trial and proceed to a non-jury trial before Judge Porter that same day on the remaining 72 counts, all of which related to prescriptions written after January 1, 1983. At the conclusion of the Commonwealth’s case on November 7, 1985 (two days later), Judge Porter sustained Appellant’s demurrer to 60 counts charged in the informations. Appellant was found not guilty on the remaining 12 counts. The Commonwealth promptly appealed both Judge Porter’s order quashing 27 counts (relating to prescriptions written before January 1, 1983); and Judge Porter’s order sustaining the demurrer to 60 counts. The two appeals were consolidated. The Commonwealth later discontinued its appeal with respect to the grant of the demurrer to the 60 counts on the basis of Smalis v. Pennsylvania, 476 U.S. 140, 106 S.Ct. 1745, 90 L.Ed.2d 116 (1986), which prohibits an appeal from the grant of a demurrer.

The Commonwealth’s appeal to the Superior Court proceeded on the sole issue of the propriety of Judge Porter quashing the 27 counts relating to prescriptions written before January 1, 1983.

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Commonwealth v. Stein
546 A.2d 36 (Supreme Court of Pennsylvania, 1988)

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Bluebook (online)
546 A.2d 36, 519 Pa. 137, 1988 Pa. LEXIS 221, Counsel Stack Legal Research, https://law.counselstack.com/opinion/commonwealth-v-stein-pa-1988.