Indiana Family & Social Services Administration v. Amhealth (Evansville), Inc.

790 N.E.2d 162, 2003 Ind. App. LEXIS 1057, 2003 WL 21403884
CourtIndiana Court of Appeals
DecidedJune 19, 2003
Docket49A05-0203-CV-117
StatusPublished
Cited by6 cases

This text of 790 N.E.2d 162 (Indiana Family & Social Services Administration v. Amhealth (Evansville), Inc.) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Indiana Family & Social Services Administration v. Amhealth (Evansville), Inc., 790 N.E.2d 162, 2003 Ind. App. LEXIS 1057, 2003 WL 21403884 (Ind. Ct. App. 2003).

Opinions

OPINION

MATTINGLY-MAY, Judge.

The Indiana Family and Social Services Administration (“FSSA”) promulgated emergency rules changing Medicaid reimbursement formulas for nursing homes. A number of nursing homes and the Indiana Health Care Association (collectively, “Am-health”) challenged the rules, and the trial court entered a declaratory judgment in favor of Amhealth on the basis that FSSA had not properly adopted the emergency rules. It permanently enjoined FSSA from enforcing those rules and ordered FSSA to reprocess the nursing homes’ claims submitted under the emergency rules. FSSA appeals,1 raising a number of issues. We address two but find one dis-positive: whether budget committee members had adequate notice of the emergency rulemaking and an opportunity to participate in the deliberations.

We reverse and remand.

Is the Appeal Moot?

We address initially Amhealth’s argument that this appeal is moot because the subject matter of the emergency rules challenged below has since been embodied in permanent rules that have been in effect since at least July 12, 2002. Even if we find the injunction was improper, Am-health says, the decision would have no impact on Amhealth’s Medicaid reimbursement. FSSA argues the appeal is not moot because it is entitled to relief if it wins this appeal—specifically, it will be entitled to restitution from the nursing homes for Medicaid overpayments made during the time the injunction was in effect.

Amhealth’s argument that FSSA cannot seek reimbursement of overpayments made while the emergency rules were enjoined is based on the premise that while there may be a right to recover damages arising out of a wrongful injunction upon [165]*165reversal of a preliminary injunction, there is no such right upon reversal of a permanent injunction. This general rule is recognized in 42 Am.Jur.2d Injunctions § 337 (2000), where it is stated that the federal rules and the statutes of most states require an injunction bond, which “protects the enjoined party from damages or injustices caused by hastily issued orders of injunetion[.]” (Emphasis supplied.)

The author observes that

a large portion of the cases involving claims on injunction bonds involves temporary restraining orders or temporary injunctions. Indeed, the federal rules require a bond only for restraining orders and preliminary injunctions, and state statutes often allow damages only for the wrongful issuance of temporary injunctions and not for permanent injunctions.

Id. However, that source also notes that under the principles of restitution, a party who obtains benefits from an improperly issued injunction has a duty to restore those benefits to those injured by the granting of the injunction. This remedy is “separate from the theory of malicious prosecution and in the absence of an injunction bond.” Id. § 339.

We addressed this question in Community Care Centers, Inc. v. Sullivan, 701 N.E.2d 1234, 1240 (Ind.Ct.App.1998), trans. denied 726 N.E.2d 299 (Ind.1999). There, we determined the State could obtain restitution from nursing homes that were reimbursed at a higher rate than they would have been had the State’s reimbursement formula not been enjoined to the extent it was. Community Care had obtained two injunctions, one in state court and one in federal court, to prevent the State’s use of certain aspects of its nursing home reimbursement formula. The injunctions were reversed on appeal and the State brought an action for restitution. The trial court determined on summary judgment that the State was entitled as a matter of law to recover “the difference between the sums paid to Community Care under the erroneous injunctions and the amounts it would have received under the State’s lawful rate-setting methodology in the absence of the injunctions[,]” id. at 1238, and we affirmed.

We stated:

In situations like the one before us, where a valid government regulation or procedure has been enjoined and improper payments have been made pursuant to the subsequently reversed injunction, this type of “enrichment” in the form of improper payments has typically been characterized as unjust.

Id. at 1240.

One of the underlying injunctions in that case was preliminary and one was permanent, indicating the remedy of restitution is available regardless of the nature of the injunction that is subsequently reversed. Because FSSA is entitled to restitution from Amhealth for Medicaid overpayments made during the time the emergency rules were enjoined, we decline to hold that this appeal is moot.

Were the Emergency Nursing Home Rules Properly Promulgated?

When findings of fact and conclusions of law are entered by the trial court, as occurred here, we will not set aside the judgment unless it is clearly erroneous; that is, unless we are definitely and firmly convinced the trial court committed error. The findings must disclose a valid basis for the legal result reached in the judgment, and evidence at trial must support each of the specific findings. We defer to the trial court when such evidence conflicts. We will not reweigh the evidence nor reassess the credibility of the witnesses be-
[166]*166fore the court. Rather, we will affirm if there is sufficient evidence of probative value to support the decision, viewing the evidence most favorable to the judgment and the reasonable inferences drawn therefrom. To the extent that the judgment is based on erroneous findings, those findings are superfluous and are not fatal to the judgment if the remaining valid findings and conclusions support the judgment.
Conclusions of law, however, are reviewed de novo. A “clearly erroneous” judgment can result from application of the wrong legal standard to properly-found facts, and in that situation we do not defer to the trial court. We are not bound by the trial court’s characterization of its results as “findings of fact” or “conclusions of law.” Rather, we look past these labels to the substance of the judgment and will review a legal conclusion as such even if the judgment wrongly classifies it as a finding of fact. This court may affirm the judgment on any legal theory supported by the findings.

AmRhein v. Eden, 779 N.E.2d 1197, 1206 (Ind.Ct.App.2002) (citations and internal quotations omitted).

The trial court determined the regulations were not adopted in conformity with Public Law 291-2001 section 48 (“Section 48”), Ind.Code § 4-22-2-19.5, or Ind.Code § 12-15-21-12. FSSA asserts the case before us is controlled by the Walgreen decision, which held the State followed proper procedures in promulgating emergency pharmacy reimbursement rules, which were promulgated at the same time FSSA promulgated the emergency nursing home rules at issue here.

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790 N.E.2d 162, 2003 Ind. App. LEXIS 1057, 2003 WL 21403884, Counsel Stack Legal Research, https://law.counselstack.com/opinion/indiana-family-social-services-administration-v-amhealth-evansville-indctapp-2003.