Hospital Center at Orange v. Guhl

751 A.2d 1077, 331 N.J. Super. 322
CourtNew Jersey Superior Court Appellate Division
DecidedJune 2, 2000
StatusPublished
Cited by21 cases

This text of 751 A.2d 1077 (Hospital Center at Orange v. Guhl) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hospital Center at Orange v. Guhl, 751 A.2d 1077, 331 N.J. Super. 322 (N.J. Ct. App. 2000).

Opinion

751 A.2d 1077 (2000)
331 N.J. Super. 322

HOSPITAL CENTER AT ORANGE, St. Francis Medical Center, St. Mary Hospital (Passaic), Deborah Heart and Lung Center, Cathedral Health Care System, Inc., St. Francis Hospital (Jersey City), Mountainside Hospital, Palisades General Hospital, Rancocas Hospital, St. Mary Hospital (Hoboken), and Hackettstown Community Hospital, Plaintiffs-Appellants,
v.
Michele K. GUHL, Commissioner of the Department of Human Services, and Margaret Murray, Director of the Division of Medical Assistance and Health Services, Defendants-Respondents.

Superior Court of New Jersey, Appellate Division.

Argued January 11, 2000.
Decided June 2, 2000.

*1079 Calvin A. Jones, for plaintiffs-appellants (Reed, Smith, Shaw & McClay, attorneys; Murray J. Klein, Princeton, of counsel; Mr. Jones and Steven M. Ziolkowski, Newark, on the brief).

Rhonda S. Berliner-Gold, Deputy Attorney General, for defendants-respondents (John J. Farmer, Jr., Attorney General, attorney; Mary C. Jacobson, Assistant Attorney General, of counsel; Ms. Berliner-Gold and Barbara Pryor Waugh, Deputy Attorney General, on the brief).

Before Judges SKILLMAN, D'ANNUNZIO and NEWMAN.

*1078 The opinion of the court was delivered by SKILLMAN, P.J.A.D.

This case deals with the obligation of the Division of Medical Assistance and Health Services (Division) to provide prompt review of hospitals' appeals from administrative determinations of Medicaid reimbursement rates.

On February 17, 1999, appellants, which are twelve non-profit acute care hospitals that participate in the Medicaid program, initiated this action in lieu of prerogative writs in the Law Division. The named defendants were Margaret Murray, the Director of the Division, and Michele K. Guhl, the Commissioner of the Department of Human Services. Appellants alleged that they had filed administrative appeals with the Division challenging the Medicaid reimbursement rates established in January 1996, October 1996, January 1997 and January 1998, but that the Division had "continually and consistently failed to make any determination or issue any decision with respect to any of the... rate appeals." Appellants sought an order directing the Division to decide all their pending rate appeals within thirty days. Appellants also sought an order directing the Division to decide any future rate appeals within 120 days. In addition, appellants sought an order requiring "defendants to pay ... all costs and fees, including attorneys fees, incurred in prosecuting this action."

Appellants' claims were based on principles of state administrative law as well as Title XIX of the Federal Social Security Act, commonly known as the Medicaid Act, 42 U.S.C.A. §§ 1396-1396v, and the regulations adopted thereunder. In addition, appellants contended that the Division's failure to promptly decide their Medicaid rate appeals violates the Due Process Clause of the Fourteenth Amendment. Appellants asserted that their federal claims were maintainable under 42 U.S.C.A. § 1983.

Respondents filed a motion to dismiss appellant's complaint or, in the alternative, to transfer the case to this court. On May 13, 1999, the Law Division transferred the case, concluding that this court has exclusive jurisdiction because appellants seek review of the inaction of a state administrative agency.

On June 29, 1999, appellants filed a motion for the summary entry of an order compelling the Division to immediately decide their pending Medicaid rate appeals.

On July 9, 1999, while appellants' motion was pending, the Division issued final decisions in all of appellants' pending Medicaid rate appeals except for four filed by Deborah Heart and Lung Center.[1] Twentynine *1080 of these decisions consisted of identical form letters that denied the hospitals' Medicaid rate appeals on the ground that the "hospital did not sustain a marginal loss in providing inpatient services to Medicaid beneficiaries at the rates under appeal." The other two were form letters that dismissed the hospitals' rate appeals on the ground that they had been filed beyond the twenty-day period allowed under N.J.A.C. 10:52-9.1(b)(1).

Following these decisions, respondents filed a motion to dismiss this appeal on the ground that appellants' claim that the Division had failed to decide their rate appeals within a reasonable period of time was moot because the Division had issued decisions. Appellants opposed the motion on the ground that their claims were not limited to a demand for issuance of decisions in the pending rate appeals. We denied respondents' motion.

Appellants now ask this court to grant declaratory and injunctive relief that would require the Division to decide future Medicaid rate appeals in a timely manner. Specifically, appellants seek an order that would require the Division "to issue written determinations of hospitals' rate appeals within 120 days." Appellants also seek a determination that the decisions issued by the Division on July 9, 1999 were "incomplete" and an order directing the Division to issue "complete" decisions in their rate appeals. In addition, appellants seek an award of attorney's fees under 42 U.S.C.A. § 1988.

We conclude that the Division has an obligation to decide Medicaid rate appeals within a reasonable period of time, and that the Division failed to satisfy that obligation in processing the appeals that precipitated this action. However, neither federal nor state law obligates the Division to decide Medicaid rate appeals within 120 days or any other fixed time period, and we do not believe it would be appropriate for this court to impose such an obligation. Therefore, we deny appellants' request for injunctive relief compelling the Division to decide future Medicaid rate appeals within a specified time period. We also reject appellants' demand for a declaration that the decisions in the rate appeals issued on July 9, 1999, are "incomplete." We reject appellants' claim for attorney's fees under 42 U.S.C.A. § 1988.

I

Preliminarily, we note that the Law Division properly transferred the case to this court.

Rules 2:2-3(a)(2) and 2:2-4 "contemplate [] that `every proceeding to review the action or inaction of a state administrative agency [shall] be by appeal to the Appellate Division.'" Pascucci v. Vagott, 71 N.J. 40, 52, 362 A.2d 566 (1976) (quoting Central R.R. v. Neeld, 26 N.J. 172, 185, 139 A.2d 110, cert. denied, 357 U.S. 928, 78 S.Ct. 1373, 2 L.Ed.2d 1371 (1958)). "The term `action,' found in [Rules 2:2-3(a) and 2:2-4], includes inaction." Mathews v. Finley, 46 N.J.Super. 175, 177, 134 A.2d 441 (App.Div.), certif. denied, 25 N.J. 283, 135 A.2d 590 (1957). Therefore, the Appellate Division has exclusive jurisdiction to consider a claim of state administrative agency inaction. Pascucci v. Vagott, supra, 71 N.J. at 52, 362 A.2d 566; Johnson v. New Jersey State Parole Bd., 131 N.J.Super. 513, 517-21, 330 A.2d 616 (App.Div.1974), certif. denied, 67 N.J. 94, 335 A.2d 47 (1975); see also Toll Bros., Inc. v. State of New Jersey, Dept. of Envtl. Protection, 242 N.J.Super. 519, 525-26 n. 3, 577 A.2d 845 (App.Div. 1990); Equitable Life Mortgage & Realty Investors v. New Jersey Div. of Taxation, 151 N.J.Super. 232, 237-38, 376 A.2d 966 (App.Div.), certif. denied, 75 N.J. 535, 384 A.

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751 A.2d 1077, 331 N.J. Super. 322, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hospital-center-at-orange-v-guhl-njsuperctappdiv-2000.