Pennsylvania, Department of Public Welfare v. Heckler

730 F.2d 923
CourtCourt of Appeals for the Third Circuit
DecidedMarch 28, 1984
DocketNos. 83-3190, 83-3280
StatusPublished
Cited by2 cases

This text of 730 F.2d 923 (Pennsylvania, Department of Public Welfare v. Heckler) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pennsylvania, Department of Public Welfare v. Heckler, 730 F.2d 923 (3d Cir. 1984).

Opinion

OPINION OF THE COURT

JAMES HUNTER, III, Circuit Judge:

The Department of Public Welfare of the Commonwealth of Pennsylvania (“DPW”) appeals from a refusal by the Secretary of Health and Human Services (“HHS”) to reimburse DPW for certain expenses incurred in administering Pennsylvania’s Aid to Families with Dependent Children (“AFDC”) program. As is common with appeals of this nature, the knotty question of our jurisdiction overshadows the merits of the underlying dispute. We conclude that we have jurisdiction to hear Pennsylvania’s appeal, and we will affirm the Secretary’s denial of reimbursement.

I.

On March 19, 1981, DPW entered into a cost-sharing agreement with the District Attorney of Philadelphia (“the Philadelphia DA”). Due to a dearth of funds and a surfeit of violent crimes, the Philadelphia DA had lagged far behind the rest of the state in prosecuting welfare fraud cases referred by DPW. To encourage the DA to enforce the welfare fraud statutes more zealously, DPW agreed to pay half the costs of prosecuting welfare cases in Philadelphia.

The cost-sharing plan achieved dramatic results. The DA established a Welfare Fraud Unit staffed by four lawyers, one administrative assistant, and a secretary. In 1980, the year before the agreement, the DA prosecuted only 16 cases. The next year that figure jumped to over 200 cases. In 1982, over 400 cases were prosecuted in the City of Philadelphia. By March, 1983, the DA had obtained restitution orders totalling $352,788 in AFDC cases, and an additional $552,800 from mixed AFDC/food stamp cases.

The District Attorney received $33,325 from DPW in the first year of the agreement. DPW, in turn, presented these costs to HHS for reimbursement as administrative expenses. The Regional Commissioner “disallowed” the claimed prosecution costs on October 15, 1982. The Commissioner relied on OMB Circular A-87, which establishes guidelines for allowable costs in fed[925]*925eral grant programs.1 As interpreted by the Social Security Administration, those guidelines prohibit reimbursement for the costs of prosecuting welfare fraud. Action Transmittal SSA-AT-78-8 (OFA) (March 16, 1978).

DPW petitioned the Departmental Grant Appeals Board to reconsider the disallowance. On May 18, 1983, the Appeals Board upheld the disallowance. DPW, intent on judicial review but unsure of the proper forum, filed simultaneous appeals in this court and the District Court for the Middle District of Pennsylvania.2

II.

The jurisdictional predicament that prompted DPW's simultaneous appeals has come before this court four times in the last two years. In the New Jersey trilogy, we devised and applied a functional test for ascertaining appellate jurisdiction from HHS denials of claimed costs. New Jersey v. Department of Health & Human Services, 670 F.2d 1262, 1268-77 (3d Cir.1981) (New Jersey I); New Jersey v. Department of Health & Human Services, 670 F.2d 1284, 1290-92 (3d Cir.), cert. denied, 459 U.S. 824, 103 S.Ct. 56, 74 L.Ed.2d 60 (1982) (New Jersey II); New Jersey v. Department of Health & Human Services, 670 F.2d 1300 (3d Cir.1982) (New Jersey III). More recently, we applied our functional test to a case involving the parties before us today. Commonwealth of Pennsylvania v. Department of Health & Human Services, 723 F.2d 1114 (3d Cir.1983).3

The recurring and complex nature of this jurisdictional problem stems from the obscure statutory directive of 42 U.S.C. § 1316 (1976). That provision prescribes two distinct procedures for reviewing disputes regarding reimbursement for state programs. The first provides direct review in the court of appeals of disputes in which the Secretary determines that the state program is not “in compliance” with federal requirements.4 The Secretary must afford the state a formal hearing, and is subject to stringent time restrictions. 45 C.F.R. § 213 (1982). The Secretary is given concomitantly sweeping powers: following a finding of noncompliance, she may cut off all payments to the state, not merely those for the disputed items. 42 U.S.C. § 604(a) (1976); 45 C.F.R. § 201.6(a) (1982).

The second avenue, termed a “disallowance” proceeding, is considerably less formal, and affords the Secretary a more limited sanction. Items may be disallowed by the Regional Commissioner without a hearing or other substantial formal proceeding. The state is entitled to reconsideration by the Departmental Grant Appeals Board of the disallowance, but the Board need not hold a hearing and is not bound to decide within any time limits. A disallowance determination entitles the Secretary to refuse payment only for the disputed item. 42 U.S.C. § 1316(d) (1976); 45 C.F.R. § 16 (1983).

For purposes of this case, the most pertinent feature of disallowance proceed[926]*926ings is that section 1316(d), unlike section 1316(a), makes no provision for judicial review. Some courts have concluded that an appeal necessarily must lie in the district court. See Illinois v. Schweiker, 707 F.2d at 276-77; County of Alameda v. Weinberger, 520 F.2d 344 (9th Cir.1975). The Secretary herself takes this position. New Jersey III, 670 F.2d at 1304 n. 8. This court has never had an opportunity to decide that question, nor need we here. For present purposes we need only note that appeal does not lie in the court of appeals from disallowance proceedings. New Jersey I, 670 F.2d at 1271.

Our jurisdiction to review disputes regarding AFDC reimbursements, then, depends on whether the dispute is characterized as a compliance or a disallowance matter. In the present case, the Secretary plainly characterized the dispute as a disallowance matter, and treated it accordingly. Were we to look no further than the record of the Secretary’s action below, we would dismiss the petition for review and invite Pennsylvania to test the jurisdiction of the district court. This court, however, has declined “to adopt an approach which would permit the Secretary to foreclose judicial review under section 1316(a) in situations where one administrative route is pursued when another would be more appropriate.” New Jersey I, 670 F.2d at 1272. Rather, we have held that

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730 F.2d 923, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pennsylvania-department-of-public-welfare-v-heckler-ca3-1984.