Blinzinger v. Americana Healthcare Corp.
| Decision Date | 23 March 1987 |
| Docket Number | No. 49A02-8602-CV-45,49A02-8602-CV-45 |
| Citation | 505 N.E.2d 449 |
| Parties | Donald BLINZINGER, Administrator, Indiana Dept. of Public Welfare, Indiana Dept. of Public Welfare, Appellants, (Defendants Below), v. AMERICANA HEALTHCARE CORPORATION, Elkhart-Americana, Inc., d/b/a Americana Health Care Center of Elkhart; Capitol Americana, Inc., d/b/a Americana Healthcare Center of Indianapolis-Midtown, Appellees, (Plaintiffs Below). |
| Court | Indiana Appellate Court |
Linley E. Pearson, Atty. Gen., Gordon E. White, Jr., Deputy Atty. Gen., Indianapolis, for appellants.
David F. McNamar, John H. Sharpe, Steers, Sullivan, McNamar & Rogers, Indianapolis, for appellees.
Americana Healthcare Corporation (Americana) is a provider of Medicaid and Medicare services. The Indiana Department of Public Welfare (Department) compensates Americana for the services it provides under the plans. The compensation is prospective and partly based upon a cost-related projection. I.C. 12-1-7-17 (Burns Code Ed.Repl.1981) P.L. 80-1984 and P.L. 133-1985 now I.C. 12-1-7-17.2(b) (Burns Code Ed.Supp.1986) (payments to skilled nursing and intermediate care facilities.)
The Medicaid-Medicare provider status may be terminated by the Department if, after investigation, it finds a statutory or Departmental rule violation. I.C. 12-1-7-15.3(a)(3) (Burns Code Ed.Supp.1986) P.L. 133-1985. Also, a Medicaid-Medicare provider may seek to have its rate of reimbursement increased. See 470 I.A.C. 5-4.1-6 (1984 Ed.).
In October, 1980, two of Americana's Indiana facilities were notified that termination 1 was pending. Americana sought and was denied an administrative hearing. Americana then obtained a preliminary injunction in federal court which prevented the Department from acting upon the termination issue. The grant of the preliminary injunction was later overturned by the Seventh Circuit Court of Appeals.
After the preliminary injunction was in place (but prior to the Seventh Circuit's reversal), Americana requested a rate of reimbursement increase. At an administrative hearing conducted May 20, 1982, upon the rate increase issue, both Americana and the Department agreed that the issue whether, and in what amount, Americana would receive a rate increase would be resolved subsequent to the question whether pending decertification barred any consideration of increased reimbursement. Solely for purposes of establishing "standing", Americana sought to introduce evidence which would demonstrate harm caused by a rate increase denial. The evidence was considered only for that purpose.
The Department determined that it would not take action on the request because of the pending termination action. The reviewing court reversed the Department's decision, concluding that the Department had erred in failing to promulgate the "no action directive" 2 in accordance with I.C. 4-22-2-1 (Burns Code Ed.Repl.1986) repealed by P.L. 31-1985, see I.C. 4-22-2-13 to -44 (Burns Code Ed.Repl.1986). The reviewing court then ordered the Department to,
"consider and determine the increase in rates requested by the plaintiffs with all due haste in order to minimize any further damages which may have accrued as a result of the agency's unlawful refusal to consider the request for increase of the rates of Medicaid reimbursement to be paid to the plaintiffs and determine the amounts due and owing plaintiff, if any, by reason of this wrongful refusal to consider the plaintiffs' request for an increase in rates." Record at 49.
On appeal, this court affirmed the reviewing court's determination that the rule was improperly adopted. Blinzinger v. Americana Healthcare Corp. (1984) 2d Dist.Ind.App., 466 N.E.2d 1371. 3 This court thus affirmed the reviewing court's remand to the Department to act upon Americana's rate increase request.
After the appeal, in September, 1984, the Department petitioned the reviewing court to deposit slightly more than $1,100,000. This amount apparently represented the Department's first calculation of the sum due Americana for the 1981 to 1984 period. The court allowed the Department to deposit, and Americana to withdraw, the money. Deposits and withdrawals were repeated in February and March, 1985. On these occasions Americana received approximately $76,000. 4 The deposit and withdrawal procedure was used because a dispute remained as to whether Americana was entitled to interest on funds the Department had withheld. The deposit and withdrawal procedure was apparently designed to prevent accrual of a greater interest obligation, if, after litigating the issue, one indeed existed.
During the deposit and withdrawal process, Americana filed a motion for partial summary judgment, in which it claimed entitlement to interest, both prejudgment and postjudgment. The court declined Americana's request to grant it prejudgment interest because the issue had not been presented prior to the motion for summary judgment. The court did, however, grant Americana postjudgment interest, pursuant to I.C. 34-2-22-1 (Burns Code Ed.Repl.1986), from forty-five days following June 29, 1983, the date upon which the trial court originally remanded the matter to the Department for consideration of the request for a rate increase. From this order, both parties prosecute appeals.
We reverse.
Despite its rather convoluted nature, the procedural history here is more notable for its omissions rather than its occurrences. After this court affirmed the reviewing court, the cause was remanded for the Department's consideration without regard to the pending termination action. From the record before us, it does not appear that the Department acted upon this remand. Rather, the Department chose to pay funds into, and Americana chose to withdraw those funds from, the court. There is simply no affirmative showing in the record that the Department acted upon the rate increase request. Neither is there an affirmative showing that the Department and Americana fully and finally agreed upon an amount to be paid. 5 Nor is there any information in the record which demonstrates that the Department or Americana communicated to the trial court that a finalized agreement had been reached, how that agreement was reached, or the terms of the agreement. Finally, there is no document present which seeks to invoke specifically the trial court's review powers. These omissions dictate that we reverse the trial court without reaching the merits of the issues which the parties seek to present.
As a prefatory matter, we note the adage, "[a]gree for the law is costly." 6 We commend whatever efforts the parties may have made toward reaching an agreement concerning the compensation due. A non-litigous resolution of a complex issue, such as reimbursement payable under the Medicaid and Medicare programs, 7 is indeed desirable. Such an agreement is often desirable when an agency and a party with which it has an ongoing relationship disagree as to an issue particularly within the agency's expertise. Preserving both judicial resources and the integrity of the administrative process are important goals served by a perhaps less formal and costly resolution procedure.
Nevertheless, we must reverse because the reviewing court had before it no judicially cognizable order, decree or agreement upon which it could exercise its authority to award interest. 8 The trial court's difficulty in ascertaining both a date and a dollar figure, for the purpose of calculating "postjudgment" interest, demonstrates this point. Apparently there were three deposits and only two withdrawals, leaving more than $3,000 with the court presently. There is nothing in the record before us to support a conclusion that the principle amount of the obligation or its due date had been fully settled.
Moreover, the fact that the reviewing court attached interest to a remand order underscores the lack of an appropriate order, decree or agreement in any form. The court's remand entry, prior to the first appeal, directed the Department to consider diligently the rate increase issue. It neither fixed a date nor fixed an amount for payment, and could not be considered the equivalent of a money judgment. Cf., Indiana Revenue Board v. State ex rel. Bd. of Commissioners of Hendricks County (1979) 270 Ind. 365, 385 N.E.2d 1131 (). Also, the evidence underlying the remand order would not have supported a determination equivalent to a money judgment. Both the Department and Americana recognized that the marginal increase due, if any, would be established subsequent to disposition of the question whether pending termination foreclosed a rate increase. Americana had not presented evidence to the Department, or the reviewing court, as to the precise increase it believed was due. With no evidence supporting a mandate order for payment of funds, the initial review court did only what it could--remand for consideration. See Blinzinger, supra, 466 N.E.2d at 1375. Thus the remand order fixed no amount due, nor fixed a date at which the obligation became due. It could not function as an order which permitted an award of interest.
The record discloses no other event or procedural device present which would have permitted the court below to exercise its authority in making its second judgment entry.
An important cornerstone of judicial review of administrative decisions is the finality requirement. " 'Courts are reluctant to review interim steps of an administrative body which are not, or have not become final.' " Indiana Alcoholic Beverage Commission v. McShane (1976) 2d Dist., 170 Ind.App. 586, 598, 354 N.E.2d 259, 267, quoting Downing v. Board of Zoning Appeals of Whitley County (1971) 149 Ind.App. 687, 690, 274 N.E.2d 542, 545. As a result of this reluctance, courts will not...
To continue reading
Request your trial