LeadingAge New York, Inc. v. Shah

56 Misc. 3d 594, 53 N.Y.S.3d 804
CourtNew York Supreme Court
DecidedNovember 13, 2015
StatusPublished
Cited by2 cases

This text of 56 Misc. 3d 594 (LeadingAge New York, Inc. v. Shah) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
LeadingAge New York, Inc. v. Shah, 56 Misc. 3d 594, 53 N.Y.S.3d 804 (N.Y. Super. Ct. 2015).

Opinion

OPINION OF THE COURT

Denise A. Hartman, J.

In January 2012, Governor Andrew Cuomo issued Executive Order No. 38 (9 NYCRR 8.38) directing the Department of Health, among other agencies, to promulgate regulations (a) requiring that at least 75% of state financial assistance or state-authorized funds be used for direct care or services; and (b) prohibiting the use of such funds for executive compensation in excess of $199,000 per year. In May 2013, the Department of Health adopted final regulations imposing these limits on administrative costs and executive compensation of care providers that receive state financial assistance or state-authorized funds {see 10 NYCRR part 1002). Going beyond the terms of the executive order, the regulations also impose a “soft cap” on executive compensation from all sources—including non-taxpayer funds—except under certain conditions {see 10 NYCRR 1002.3).

Plaintiffs-petitioners (collectively petitioners) are multiple not-for-profit and for-profit health care providers, managed care plans, and trade associations. They commenced these two hybrid declaratory judgment actions/CPLR article 78 proceedings to challenge the Executive Order and the Department of Health’s regulations. By order dated August 13, 2014, Supreme Court (Ceresia, J.) consolidated the cases and dismissed pursuant to CPLR 3211 (a) (7) all causes of action but those alleging a violation of the separation of powers doctrine and that the regulations are arbitrary and capricious. Defendants-respondents, the Department of Health and its Commissioner and the Governor (collectively respondents), then answered. The court heard oral argument on September 2, 2015.

The court concludes that, with the exception of the “soft cap” provision imposing limits on executive compensation regardless of the source of funds, the Department of Health regula[597]*597tions implementing the Executive Order do not violate the separation of powers doctrine, nor are they arbitrary and capricious.

Background

In January 2012, Governor Cuomo issued Executive Order No. 38 declaring that the State has “an ongoing obligation to ensure that taxpayers’ dollars are used properly, efficiently and effectively,” and that “in certain instances providers of services that receive State funds or State-authorized payments have used such funds to pay for excessive administrative costs and outsized compensation for their senior executives, rather than devoting a greater proportion of such funds to providing direct care or services to their clients” (Executive Order [Cuomo] No. 38 [9 NYCRR 8.38]). In an effort to focus taxpayers’ dollars on paying for direct care and services to those in need, the Executive Order directed agencies that give state financial assistance or state-authorized payments to providers of care or services to promulgate regulations requiring that no less than 75% of state financial assistance or state-authorized payments to a provider for operating expenses shall be for direct care or services rather than administrative costs. It directed agencies to ratchet up the minimum direct care percentage to 85% by April 1, 2015.

The Executive Order also directed “ [t] o the extent practicable” that reimbursement with state financial assistance or state-authorized funds shall not be provided for compensation paid to any executive in an amount greater than $199,000 per year (9 NYCRR 8.38 [2] [b]). It permitted the agencies to adjust that figure annually, subject to the approval of the director of the budget, but not to exceed the federal rate of basic pay set forth in the executive schedule promulgated by the U.S. Office of Personnel Management.

In May 2013, after notice and public comment, the Department of Health promulgated regulations to implement Executive Order No. 38 (see 10 NYCRR part 1002). The regulations set limits on “administrative expenses” and “executive compensation” for “covered providers,” and address waivers, reporting, and penalties for noncompliance. “Covered providers” include, among others, hospitals and nursing homes, home care services agencies, residential health care facilities, long term health care programs, AIDS care programs, hospices, assisted living residences, and emergency service entities that receive state funds or state-authorized payments above certain [598]*598thresholds (10 NYCRR 1002.1 [d] [3]). An entity is “covered” if, pursuant to an agreement with a state, county or local government to render program services, it receives state funds or state-authorized payments averaging in a two-year period more than $500,000 annually, and receives more than 30% of its total in-state revenues from state funds or state-authorized payments {id. § 1002.1 [d] [1], [2]).

Administrative Expenses Regulation

The regulation sets limits on the amount of administrative expenses that may be paid using state funds or state-authorized payments. The regulation defines “administrative expenses” as those expenses “incurred in connection with the covered provider’s overall management and necessary overhead that cannot be attributed directly to the provision of program services” (10 NYCRR 1002.1 [a]). They include the “portion of the salaries and benefits of staff performing administrative and coordination functions that cannot be attributed to particular program services,” such as the executive director or chief executive officer, financial officers, and accounting, public relations, information technology, and human resources personnel {id. § 1002.1 [a] [1] [i]). They also include legal expenses and office expenses that cannot be attributed directly to the provision of program services, such as the costs of telephone and computer systems, licenses and permits, office supplies, subscriptions and conferences, and insurance {id. § 1002.1 [a] [1] [ii], [iii]).

The regulation mandates that “[n]o less than 75 percent of the covered operating expenses of a covered provider paid for with State funds or State-authorized payments shall be program services expenses rather than administrative expenses” {id. § 1002.2 [a]). The percentage, which became effective for all covered providers on July 1, 2013, was required to be increased by 5% each year until it reached 85% in 2015 {id.).

Executive Compensation Regulations

The regulations impose two different limits on compensation for “covered executives.” The term “covered executive” includes “a compensated director, trustee, managing partner, or officer,” and “key employees” whose salary and/or benefits, in whole or in part are administrative expenses {id. § 1002.1 [b]). The definition confines “key employees” to the top 10 highest paid individuals, and excludes chairs, directors, and other clinical and program personnel in hospitals or other facilities that provide program services {id.).

The first limit on executive compensation is what petitioners term a “hard cap.” Absent a waiver, a covered provider “shall [599]*599not use State funds or State-authorized payments for executive compensation given directly or indirectly to a covered executive in an amount greater than $199,000 per annum” {id. § 1002.3 [a]). The Department of Health must review that hard cap amount annually and adjust it as necessary, subject to the approval of the Division of the Budget {id.). The “hard cap” applies only to the use of state funds or state-authorized payments for executive compensation.

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Related

Matter of LeadingAge N.Y., Inc. v. Shah
32 N.Y.3d 249 (New York Court of Appeals, 2018)
Matter of Leadingage N.Y., Inc. v. Shah
2017 NY Slip Op 5136 (Appellate Division of the Supreme Court of New York, 2017)

Cite This Page — Counsel Stack

Bluebook (online)
56 Misc. 3d 594, 53 N.Y.S.3d 804, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leadingage-new-york-inc-v-shah-nysupct-2015.