Pentskiff Interpreting Services v. Department of Health, Division of Medicaid & Health Financing Office of Formal Hearings

2013 UT App 157, 305 P.3d 218, 737 Utah Adv. Rep. 33, 2013 WL 3081166, 2013 Utah App. LEXIS 153
CourtCourt of Appeals of Utah
DecidedJune 20, 2013
DocketNo. 20110824-CA
StatusPublished
Cited by1 cases

This text of 2013 UT App 157 (Pentskiff Interpreting Services v. Department of Health, Division of Medicaid & Health Financing Office of Formal Hearings) is published on Counsel Stack Legal Research, covering Court of Appeals of Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pentskiff Interpreting Services v. Department of Health, Division of Medicaid & Health Financing Office of Formal Hearings, 2013 UT App 157, 305 P.3d 218, 737 Utah Adv. Rep. 33, 2013 WL 3081166, 2013 Utah App. LEXIS 153 (Utah Ct. App. 2013).

Opinion

Memorandum Decision

CHRISTIANSEN, Judge:

11 Pentskiff Interpreting Services (Pentskiff) seeks review of a decision by the Utah Department of Health, Division of Medicaid and Health Financing Office of Formal Hearings (the Division) that it lacked jurisdiction to review Pentskiff's claims against Healthy U Managed Health Plan (Healthy U). We conclude that Pentskiff's petitions to this court were filed prior to any final agency action by the Division and are therefore premature.1

12 On March 28, 2011, Pentskiff filed a hearing request with the Division to consider 226 claims for interpretation services that had not been paid by Healthy U (the first administrative case). Pentskiffs case was dismissed by a Division administrative law Judge (ALJ) on August 30, 2011, for lack of jurisdiction. Pentskiff timely sought reconsideration of the ALJs' decision by the Division's deputy director. Before the deputy director issued his response, however, Pentskiff petitioned this court for judicial review on September 19, 2011. On September 830, 2011, the deputy director denied [220]*220Pentskiff's request for reconsideration, again for lack of jurisdiction, stating, "You will need to seek a judicial forum to resolve your dispute with Healthy U." The deputy director's decision also provided notice of Pentskiff's right to petition for judicial review within thirty days.

13 On September 13, 2011, Pentskiff requested another hearing relating to an additional 283 claims that had not been paid by Healthy U (the second administrative case). The ALJ-not the same ALJ who ruled in the first administrative case-dismissed this case on September 16, 2011, for lack of jurisdiction. Pentskiff timely sought reconsideration before the Division's deputy director. Again, before the deputy director issued his response, Pentskiff petitioned this court for judicial review on October 11, 2011. On October 18, 2011, the deputy director denied Pentskiff's request for reconsideration and again advised, "You will need to seek a judicial forum to resolve your dispute with Healthy U." Also, the deputy director provided notice of Pentskiff's right to petition for judicial review within thirty days. Both petitions for judicial review have been consolidated into one case before this court.

4 "As a threshold matter, we must determine whether we have jurisdiction" to review Pentskiff's claims. See Maverik Country Stores, Inc. v. Industrial Comm'n, 860 P.2d 944, 947 (Utah Ct.App.1998). Pentskiff filed its petitions for judicial review after the ALJs' decisions, but before resolution of its requests for reconsideration. Thus, we must determine if the ALJs' decisions constitute final ageney action.

15 Utah Code section 78A-4-108(2) grants judicial review of "a final order or decree resulting from ... a formal adjudicative proceeding of a state agency." Utah Code Ann. § (LexisNexis 2012) (emphasis added). Additionally, the Utah Administrative Procedure Act provides that "the Court of Appeals has jurisdiction to review all final ageney action resulting from formal adjudicative proceedings." Id. § 63G-4-403(1) (LexisNexis 2011) (emphasis added); see also id. § 68G-4-401(1) ("A party aggrieved may obtain judicial review of final ageney action ...." (emphasis added)).

16 An agency action is considered final when it meets a three-part inquiry:

"(1) Has administrative decisionmaking reached a stage where judicial review will not disrupt the orderly process of adjudication?;
(2) Have rights or obligations been determined or will legal consequences flow from the agency action?; and
(3) Is the agency action, in whole or in part, not preliminary, preparatory, procedural, or intermediate with regard to subsequent agency action?"

Heber Light & Power Co. v. Utah Pub. Serv. Comm'n, 2010 UT 27, ¶ 7, 231 P.3d 1203 (quoting Union Pac. R.R. Co. v. Utah State Tax Comm'n, 2000 UT 40, ¶ 16, 999 P.2d 17). "All three questions must be answered in the affirmative for an order to qualify as final agency action." Id.

T7 Because Pentskiff filed its petitions with this court prior to resolution of the reconsideration requests, we conclude that the ALJ#' decisions do not satisfy the three-part test. First, the ALJs' decisions had not "reached a stage where judicial review would not disrupt the orderly process of adjudication." See id. At the time Pentskiff filed for judicial review, its requests for reconsideration were pending. The orderly process of adjudication would have been disrupted by having judicial review take place while the Division's deputy director was evaluating the requests for reconsideration. Second, no "rights or obligations" or "legal consequences" could flow from the ALJsg' decisions while resolution of the requests for reconsideration were pending. See id. Because the deputy director's decision could override any action taken by either ALJ, no legal rights, obligations, or consequences would take ef-feet until the requests for reconsideration were issued. Finally, the ALJs' decisions in this case were "intermediate with regard to subsequent agency action." See id. When it requested reconsideration, Pentskiff became obligated to abide by the deputy director's response, thus making the ALJs' decisions an intermediate step subject to subsequent agency action by the deputy director. Because the ALJg' decisions fail to meet the [221]*221three-part test, they do not constitute final agency action. As a result, Pentskiff's petitions to this court are premature and we lack jurisdiction to review them.

18 Our decision is consistent with McCoy v. Utah Disaster Kleenup, 2003 UT App 49, 65 P.3d 643. In that case, Utah Disaster Kleenup (Kieenup) filed a petition for review with this court one day before the Utah Labor Commission issued a final order denying Kleenup's request for reconsideration. See id. ¶ 8. We noted that the Labor Commission's final order "included a notice that the parties had thirty days from the date of that final order to petition this court for review." Id. ¶ 20. Kleenup never filed the petition for review during that thirty-day window. Id. Consequently, because Kleen-up's petition was premature, and because Kleenup never filed a subsequent petition during the thirty-day period, we lacked jurisdiction and dismissed. Id.

¶ 9 Like Kleenup, Pentskiff filed petitions for judicial review before the deputy director responded to Pentskiffs requests for reconsideration. Also, Pentskiff never petitioned for judicial review during the thirty-day period following the deputy director's denials. See Utah Code Ann. § 63G-4-401(8)(a) (Lex-isNexis 2011) ("A party shall file a petition for judicial review of final ageney action within 30 days.").

110 Pentskiff argues that the "request for reconsideration is not a prerequisite for seeking a judicial review which means that the judicial review can be done independently from reconsideration." Pentskiff relies on Utah Code section 63G-4-302(1)(b), which provides, "Unless otherwise provided by statute, the filing of the request [for reconsideration] is not a prerequisite for seeking judicial review of the order." See id. § 63G-4-302(1)(b).

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Pentskiff Interpreting v. Department of Health
2013 UT App 157 (Court of Appeals of Utah, 2013)

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2013 UT App 157, 305 P.3d 218, 737 Utah Adv. Rep. 33, 2013 WL 3081166, 2013 Utah App. LEXIS 153, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pentskiff-interpreting-services-v-department-of-health-division-of-utahctapp-2013.