St. Francis Hospital v. State

44 Ill. Ct. Cl. 157, 1992 Ill. Ct. Cl. LEXIS 6
CourtCourt of Claims of Illinois
DecidedFebruary 6, 1992
DocketNos. 86-CC-2775, 86-CC-2975, 86-CC-3195, 86-CC-3252, 87-CC-0076, 87-CC-0310, 87-CC-0452 cons.
StatusPublished
Cited by1 cases

This text of 44 Ill. Ct. Cl. 157 (St. Francis Hospital v. State) is published on Counsel Stack Legal Research, covering Court of Claims of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Francis Hospital v. State, 44 Ill. Ct. Cl. 157, 1992 Ill. Ct. Cl. LEXIS 6 (Ill. Super. Ct. 1992).

Opinion

OPINION

Burke, J.

Respondent has filed a motion asking that the Court permit these seven section 11—13 claims to be consolidated for the purpose of addressing Respondent’s motions that they be dismissed and for judgment on the pleadings. The five Claimant hospitals are represented by the same counsel in each of these matters. The State contends that the seven actions present common issues of law, and that none of the Claimants would be prejudiced by such consolidation.

The medical goods and services for which payments are here sought can be summarized and identified, by patient name and dates of service (DOS), as follows:

1. by St. Francis Hospital, in No. 86-CC-2775, commenced on March 24, 1986, the patient is Anthony Harmon, and assumed date of service (DOS) is December 9, 1984;

2. by St. Anthony Hospital, in No. 86-CC-3195, commenced on May 7,1986, the patient is Albert Jones, and the DOS are November 28 through December 8, 1984;

3. by Holy Cross Hospital, in No. 86-CC-3252, commenced on May 15, 1986, the patient is Andres Games, and the DOS are February 20 through 24,1984;

4. by Northwest Hospital, in No. 86-CC-2975, commenced on April 18, 1986, the patient is Akthar Khan, and the DOS are February 19 through March 15, 1983;

5. by Northwest Hospital, in No. 87-CC-0076, commenced on July 21, 1986, the patient is Manuel Lawson, and the DOS are August 17 through 24,1985;

6. by Northwest Hospital, in No. 87-CC-0310, commenced on August 22, 1986, the patient is Nancy Moody, and the DOS are December 11 through 29,1984; and

7. by University of Illinois Hospital, in No. 87-CC-0452, commenced on September 17,1986, the patient is Eleanor Cleaver, and the DOS are November 21, 1984, through April 4,1985.

Most of these vendor-payment actions were initially filed as lapsed-appropriation matters, contrary to our holding in Canlas v. State (1987), 39 Ill. Ct. Cl. 150; and certain of them have since been amended by presentation on medical-service vendor complaint forms and related bills of particulars, at the suggestion of the Illinois Department of Public Aid (IDPA). In each instance, the complaint and its attached exhibits lack a specific allegation that the Claimant’s charges for the subject services had been submitted to IDPA, on an invoice form as prescribed by the Department pursuant to IDPA rule 140.20 (see subsections (a) and (b) of said rule, at 89 Ill. Admin. Code sec. 140.20, effective March 4, 1981), within the specified period following rendition of such services as required by subsection (c) of said IDPA rule.

Respondent has moved to dismiss each complaint and underlying cause as substantially insufficient in law and as failing to state a cause of action, and for judgment on the pleadings in each of these claims, pursuant to section 790.90 of the Court of Claims Regulations and section 2—615 of the Illinois Civil Practice Law (Ill. Rev. Stat., ch. 110, par. 2—615). Due notice thereof having been given, the Court grants Respondent’s motion to dismiss as to each claim, based upon the findings set out herein.

The rules of this Court require that a claimant “must set forth fully” in its complaint a number of specified allegations, including a statement

“[w]hether the claim has been previously presented to any State department * * * and if so presented: (A) claimant shall state when and to whom; [and] (B) claimant shall state any action taken on behalf of 0 ® “ the appropriate State agency in connection with said claim.” (Section 790.50(a) of the Court of Claims Regulations, codified at 74 Ill. Admin. Code sec. 790.50(a); see Ill. Rev. Stat., ch. 37, par. 439.11.)

Serving a related purpose is our Court rule requirement that

“the claimant shall before seeking final determination of his claim before the Court of Claims exhaust all other remedies, whether administrative, legal or equitable.” (Section 790.60 of the Court of Claims Regulations, 74 Ill. Admin. Code sec. 790.60; see Ill. Rev. Stat., ch. 37, par. 439.24—5)

We conclude that, in adopting these requirements, the Court and the General Assembly anticipated that many Court claims would result from claimants’ prior, unsuccessful efforts to obtain payment from departments of State government, for whatever reason. Requiring claimants specifically to allege such prior efforts, and the responses of Respondent’s departments, serves to encourage the parties to define each claim’s subject matter and focus upon its merits; to facilitate Respondent’s investigation; and to enable the Court to assess the bases for a department’s past refusal or failure to pay the claim.

These pleading requirements are especially pertinent when applied to complaints such as these, filed pursuant to section 11—13 of the Public Aid Code (Ill. Rev. Stat., ch. 23), by vendors of medical services furnished to persons alleged to be public aid recipients. (United Cab Driveurself, Inc. v. State (1987), 39 Ill. Ct. Cl. 91; see orders of this Court filed in Barnes Hospital v. State (1982), 35 Ill. Ct. Cl. 434; Rock Island Franciscan Hospital v. State (1988), 36 Ill. Ct. Cl. 377; and Convalescent Home of First Church of Deliverance v. State (1985), 41 Ill. Ct. Cl. 39.) A vendor’s section 790.50(a) obligation, specifically to plead its prior invoices submitted to IDPA and the Department’s voucher-responses, is directly related to the requirement in IDPA Rule 140.20, that such invoices be timely submitted to and received by IDPA.

In a series of decisions, this Court has given recognition to IDPA’s regulatory requirement that vendors’ initial invoices, charging for goods and services supplied to recipients, must be received by the Department within six months following the date services were rendered or goods supplied, in order for Respondent to be liable for paying such charges. (Weissman v. State (1977), 31 Ill. Ct. Cl. 506; Rush Anesthesiology Group v. State (1983), 35 Ill. Ct. Cl. 851; St. Joseph’s Hospital v. State (1984), 37 Ill. Ct. Cl. 340; St. Anthony Hospital v. State (1984), 37 Ill. Ct. Cl. 342; Mercy Hospital v. State (1985), 38 Ill. Ct. Cl. 388, 389; Bethesda Hospital v. State (1986), 39 Ill. Ct. Cl. 299; and Louis A. Weiss Memorial Hospital v. State (1986), 39 Ill. Ct. Cl. 299; Riverside Medical Center v. State (1986), 39 Ill. Ct. Cl. 301; St. Bernard Hospital v. State (1986), 39 Ill. Ct. Cl. 300; Rock Island Franciscan Hospital v. State (1987), 39 Ill. Ct. Cl. 100; Canlas v. State (1987), 39 Ill. Ct. Cl. 150; Krakora v. State (1987), 40 Ill. Ct. Cl. 233; Simon v. State (1987), 40 Ill. Ct. Cl. 246; Pinckneyville Medical Group v. State (1988), 41 Ill. Ct. Cl. 176; and Passavant Area Hospital v. State (1988), 41 Ill. Ct. Cl. 222.) We have also considered exceptions to the six-month invoicing deadline, available in certain circumstances under subsection (c) of IDPA Rule 140.20. Rock Island Franciscan Hospital v. State (1984), 37 Ill. Ct. Cl. 343; Franciscan Medical Center v. State (1988), 40 Ill. Ct. Cl. 274; Riverside Medical Center v. State (1988), 40 Ill. Ct. Cl. 275; and Pilapil v. State (1988), 41 Ill. Ct. Cl. 217, 223.

A comparison of the above-referenced pleading requirements, with the averments made in these seven complaints, discloses the deficiencies in Claimants’ claims.

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Related

St. Therese Medical Center v. State
45 Ill. Ct. Cl. 370 (Court of Claims of Illinois, 1992)

Cite This Page — Counsel Stack

Bluebook (online)
44 Ill. Ct. Cl. 157, 1992 Ill. Ct. Cl. LEXIS 6, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-francis-hospital-v-state-ilclaimsct-1992.