George G. Griffon v. United States Department of Health and Human Services

802 F.2d 146, 55 U.S.L.W. 2240, 1986 U.S. App. LEXIS 32226
Court of Appeals for the Fifth Circuit·Decided October 14, 1986·No. 85-4733·Published·Cited by 31 cases

Opinion

GOLDBERG, Circuit Judge:

Petitioner George Griffon was fined $44,-000 by an Administrative Law Judge (AU) for submitting 22 false claims to the Louisiana Medicaid program. The fine was imposed pursuant to provisions of the Civil Monetary Penalties Law (CMPL), 42 U.S.C. § 1320a-7a (1983), and of the implementing regulations issued by the Secretary of the Department of Health and Human Services (HHS), 45 C.F.R. §§ 101.100-101.133 (1984). Griffon challenges the regulations and statute as applied to him. In particular, he challenges retroactive application of the CMPL to fraudulent acts committed before the effective date of the statute. Because the AU did not have the authority to address such challenges, the AU did not decide the issue. Griffon then appealed to obtain review of the AU’s decision. We vacate that decision of the AU.

The central issue presented in this case is whether, in the absence of any dispositive congressional intent, the Secretary of the Department of Health and Human Services *147 (HHS) by regulation may sever and apply the procedural elements of the CMPL, thereby inferring and implementing congressional intent to apply the statute retroactively in part. Inferring the subjective intent of Congress when it has failed to speak is always fraught with peril; it is doubly hazardous when the appropriate canons of construction .fire at cross-purposes. See generally Llewellyn, Remarks on the Theory of Appellate Decision and the Rules or Canons about How Statutes Are to be Construed, 3 Vand.L.Rev. 395, 401-06 (1950) (listing 28 pairs of equal and opposite rules of statutory construction). This case wages a conflict of first impression, which simultaneously sounds two canons: first, that in the absence of congressional intent, substantive legislation is to be given prospective application, and; second, that procedural legislation is to be given retroactive application. When a statute of mixed procedural and substantive character appears in the midst of the fray, no single rule reveals the faction to which it belongs.

Because Congress has failed to provide adequate indicators of its intent regarding retroactivity, severability, or the nature of the CMPL, regulatory severance of the procedural and substantive provisions creates congressional intent out of whole cloth. The Secretary initially purports to infer a general retroactive intent of Congress, by characterizing the statute as procedural. She then attributes congressional cognizance of the inferred Due Process concerns raised by the first and second canons to subsequently infer that Congress would sever the statute, rather than apply it prospectively.

Such bootstrapping by progressively linked inferences is beyond the reach of any reasonable, interpretive powers. Although the power of an administrator to interpret the sources of her authority in order to effect congressional purposes is extremely broad, she cannot fictitiously create purposes to achieve specific results. 1 Some degree of interpretative contortion has a therapeutic effect on the law; too much contortion has a crippling effect. The Secretary here cannot simply fabricate a congressional intent to avoid concerns that otherwise would require inferred prospective application of a statute. We therefore nullify this administrative usurpation of the legislative prerogative to think clearly or not at all.

I. The Procedural History and the Standard of Review

On March 15, 1982, petitioner George Griffon was convicted of submitting 22 false claims to the Louisiana Medicaid program in 1979. Griffon, a pharmacist, had dispensed generic drugs to his customers under brand-name labels, and had submitted reimbursement claims based on brand-name drug prices. He was fined $110,000, $55,000 of which was characterized as restitution to Medicaid and $55,000 as a “criminal fine.” The Louisiana Supreme Court affirmed the criminal conviction and sentence on February 27, 1984. State v. Griffon, 448 So.2d 1287 (La.1984).

*148 On July 3, 1984, almost three years after passage of the CMPL, and almost ten months after the Secretary’s regulations, the Deputy Inspector General (IG) for Civil Fraud notified Griffon that HHS intended to impose a $44,000 fine under the CMPL. The IG cited numerous aggravating factors for imposing the maximum fine, and referenced the Louisiana conviction for the claims upon which the CMPL penalty was to be based.

In a decision and order dated May 15, 1985, the AU imposed on Griffon the $44,-000 fine for the 22 fraud counts. The ALJ found that the IG had shown by clear and convincing evidence that Griffon had knowingly submitted 22 false claims within the scope of 45 C.F.R. § 101.102, for which Griffon could have been held liable under the False Claims Act, 31 U.S.C. §§ 3729-3731 (1983). The AU also found that there were no mitigating and numerous aggrevating factors, that Griffon had adequate notice of the penalties, that the maximum penalty was appropriate, and that an AU is not empowered to reach the validity of application of the statute. Petitioner appealed the AU’s determination, pursuant to 42 U.S.C. § 1320a-7a(d), because the Secretary’s regulations retroactively apply the statute to claims falsely submitted before enactment of the CMPL. 2

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George G. Griffon v. United States Department of Health and Human Services, 802 F.2d 146, 55 U.S.L.W. 2240, 1986 U.S. App. LEXIS 32226 (5th Cir. 1986).

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