Source: http://masslegalresources.com/tag/gamble
Timestamp: 2019-04-22 12:45:20+00:00

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that the plaintiffs’ motions must be DENIED and the defendants’ Cross Motion must be ALLOWED, for reasons set forth herein.
1 This Court was informed by counsel at the hearing on these Motions that the DoN regulations have since been amended. As this Court understands it, any changes with regard to content have no bearing on this case. The amendment has changed the number references for those regulations, however. Because the parties agree that the earlier version of the regulations apply and because they have cited to that earlier version in their pleadings, this Court uses the citations to those older regulations, even though they have now been superseded.
the Health Facilities Appeals Board. G.L.c. 111 §25E. Within sixty days of that filing, the Board is to issue a final decision either denying the appeal or remanding it for further action.
In the instant case, all these procedural steps were followed. On December 7, 2016, BCH filed an Application for a DoN in connection with a project to create new clinical space, including a neonatal intensive care unit and improved Heart Center at the hospital’s Longwood Avenue location (the Project) If approved, the Project would require the destruction of the Prouty Garden. The plaintiffs are a group of taxpayers who oppose destruction of the garden. They are duly registered with the Department as a “party of record” to the DoN proceedings and may file comments to the Application, which they did.
constituted so that the determination by the Department was considered final. 105 C.M.R. §100.970(B); 105 C.M.R. §100.551(A). This lawsuit ensued.
The Legislature has determined what standard that this Court applies in reviewing a Department decision to issue a DoN. That standard is set forth in G.L.c. 111 §25E, which states that the Department’s determination may be set aside only where there has been an “abuse of discretion” or where it is in violation of the procedural or substantive law. Contrary to the plaintiffs’ position, this Court does not apply the more rigorous “substantial evidence” standard. Howe v. Health Facilities Board, 20 Mass.App.Ct. 531, 534-537 (1985); see also Shoolman v. Health Facilities Appeals Board, 404 Mass. 33 (1989). Rather, the review is even more deferential. As explained by the SJC, the decision to issue the DoN can be overturned only if it was “arbitrary and capricious.” Shoolman, 404 Mass. at 36. If there is a rational basis for the decision and it is not otherwise unlawful, then it must be affirmed. Applying this standard, this Court concludes that the plaintiffs have not met their burden of demonstrating that the Department’ decision to issue a DoN to BCH should be overturned.
or in part health care requirements of the project population of the applicable services area, without any duplication of services and other adverse service consequences…” ” 105 C.M.R. §100.533(B) (2). Plaintiffs argues that the Project does not satisfy these requirements because it is based not on present needs but on BCH projections regarding future patient volume. Moreover, these projections (they argue) are not based on increased demand from Massachusetts patients but from international and out of state patients. Citing comments by the HPC, plaintiffs express concern that shifting patients from competing local pediatric care providers to BCH could have a destabilizing effect that would translate into higher health care costs overall. Plaintiffs argue that the Department ignored these concerns and that the Department’s decision that the regulatory factors were satisfied is wholly unsupported by the facts presented to it.
other things) reviewed population projections, historical trends, and two patient projection scenarios. That analysis concluded that the success of the Project would not require taking patients away from other local providers and was also “consistent with the Commonwealth’s effort to meet the health care cost containment goals.” In short, in making the findings that it did, the Department did not abuse its discretion or exceed its legal authority. Indeed, even under the less deferential “substantial evidence” standard, the DoN determination passes muster.
Significantly, the Department did not simply determine that BCH’s Application satisfied the nine mandatory factors imposed by the regulations. Additionally, it imposed eight conditions on BCH, among them “Condition 8.” That condition imposed three requirements on BCH that directly addressed the concerns expressed above. First, BCH was prevented from passing on its incremental operating costs to government and nongovernment Massachusetts payors or patients “in excess of the Commonwealth’s costs containment goals.” Second, BCH had to maintain its commitment to serving Medicaid patients. Third, it is required to make an annual report to the Department that includes among other things information concerning the degree to which the out-of-state demand it anticipated was actually being realized. Plaintiffs argue that this condition is somehow invalid or at the very least unworkable. This Court disagrees.
Condition 8 is not in accordance with 105 C.M.R. 100. §552, which requires that the condition be “within the control of the applicant.” But each of the three requirements that Condition 8 imposes are within BCH’s control and are matters for which the Department can hold BCH accountable. That Condition 8 by its terms gives to BCH an opportunity to argue that it is noncompliant with any of the requirements because of unexpected circumstances or events does not change the fact that the condition itself (including the submission of an annual report) concerns matters within BCH’s control. Nor does this so called “escape clause” render the Condition meaningless: a finding by the Department that BCH is not in compliance with Condition 8 permits the Department to require BCH to remove beds from service and to extract other payments. In short, this Court sees no legal grounds for overturning the Department’s decision.
At the same time that the plaintiffs filed their Cross Motion for Judgment on the Pleadings, they also filed a Motion to Amend the Complaint. This Motion seeks to add a count (Count 4) which alleges that since the issuance of the DoN, BCH is in violation of the conditions that the Department imposed and has otherwise not complied with applicable regulations. BCH argues that plaintiffs’ allegations are demonstrably false and that further amendment of the Complaint would futile. Although this Court must accept plaintiffs’ allegations as true, this Court does have some discretion to deny a request to amend a complaint, and does so here. See Rule 15(a), Mass.R.Civ.P.
should first be addressed to the Department, which has both the expertise and the primary responsibility for enforcing its own regulations and orders. See Athol Mem’l Hospital v. Comm’r of Div. of Med. Assistance, 437 Mass. 417, 421-422 (2002). Other parts of Count 4 do not appear to belong in this case at all. For example, plaintiffs allege public records violations, but have already filed a separate public records action which this Court has already refused to consolidate with the instant one. See Murby v. Marylou Sudders, Civ. No., 17-1036H (Suffolk Superior Court). 2 A motion to amend may also be properly denied based on “undue delay, bad faith, or dilatory motive on the part of the movant.” Vakil v. Vakil, 450 Mass. 411, 417 (2008), quoting Castellucci v. United States Fid. & Gaur. Co., 372 Mass. 288, 290 (1977). BCH argues (not without basis) that the plaintiffs here are more interested in delay than in seeking redress for real (as opposed to illusory) legal violations. In short, taking into account both the procedural background of this case together with the violations that are alleged, there is ample basis for this Court to exercise its discretion to deny the motion.
For all the foregoing reasons together with reasons articulated in the Memoranda of BCH and the Department, the plaintiffs’ Motion to Amend the Complaint and their Motion for Judgment on the Pleadings are both DENIED. The defendants’ Cross Motion for Judgment on the Pleadings is ALLOWED and it is hereby ORDERED that judgment enter affirming the Department’s DoN determination. The parties shall submit a proposed form of judgment within 10 days of receiving this opinion.
2 Based on plaintiffs’ Reply Memorandum, it appears that at least some of the information that plaintiffs sought was provided as of the date the Motion to Amend was filed, suggesting that at least some of the alleged violations are now moot or may soon become moot once the records are provided.

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