Court Opinion

ID: 9707891
Source: CourtListenerOpinion
Date Created: 2023-08-26 02:24:00.821425+00
Date Added: 2024-06-11T18:22:39.529077
License: Public Domain

*46DISSENTING OPINION BY
Judge PELLEGRINI.
In granting summary relief, the majority directs that $800 million from the General Fund be transferred to the MCARE Fund. Because the abatements have been paid and doctors have received everything “promised,” the net result of the majority decision is an $800 million personal windfall to doctors, with the consequential effect of making 2009-2010 budget out of balance. Accordingly, I respectfully dissent.
I.
Under the Medical Care Availability and Reduction of Error (MCARE) Act,1 physicians, hospitals, and health care providers in the Commonwealth are required to maintain minimum medical liability coverage. Providers must also contribute to the MCARE Fund, which provides a secondary layer of coverage used to pay claims against doctors for malpractice awards in excess of doctors’ basic insurance coverage.2 The MCARE Fund is funded by annual assessments levied against doctors, the amount of which is determined based upon each doctor’s prior claim history and private medical malpractice insurance premiums.3
Due to the high costs of medical malpractice coverage in the Commonwealth and the perception that physicians would purportedly leave Pennsylvania if something was not done to alleviate these costs, the General Assembly enacted the Health Care Provider Retention (HCPR) Program (Abatement Law) in 2003.4 This law provided subsidies to participating MCARE providers to reduce the amount of them annual assessments to the MCARE Fund for their medical malpractice insurance.5
The subsidies were funded by increases in certain taxes. First, the tax on cigarettes was raised by 25 cents per pack.6 Second, motor vehicle violation surcharge revenue was also to be made available to help fund the Abatement Law, if necessary. See Section 6506 of the Vehicle Code, 75 Pa.C.S. § 6506.
Under Section 1112(a) of the Abatement Law, the funds were to be placed in the HCPR Account “subject to an annual appropriation by the General Assembly to the Department of Public Welfare.”7 The *47Budget Secretary was given the authority to make transfers from the HCPR Account to the MCARE Fund and to determine the amount of such transfers up to a certain limit. Specifically, Section 1112(c) of the Abatement Law provides, “The Secretary of the Budget may annually transfer from the [HCPR] account to the [MCARE] Fund an amount up to the aggregate amount of abatements granted by the Insurance Department under section 1104(b).” 40 P.S. § 1303.1112(c). (Emphasis added).
The MCARE Fund is a special fund to pay claims against participating health care providers, including doctors, for losses or damages against them in excess of the basic insurance coverage that the MCARE Act requires them to purchase. Section 1303.712(a) of the MCARE Act, 40 P.S. § 1303.712(a). The MCARE Fund is:
funded by an assessment on each participating health care provider.... The assessment shall be based on the prevailing primary premium for each participating health care provider and shall, in the aggregate, produce an amount sufficient to do all of the following:
(i) Reimburse the fund for the payment of reported claims which became final during the preceding claims period.
(ii) Pay expenses of the fund incurred during the preceding claims period.
(iii) Pay principal and interest on moneys transferred into the fund in accordance with section 713(c).8
(iv)Provide a reserve that shall be 10% of the sum of subparagraphs (i), (ii) and (iii).
Section 1303.712 of the MCARE Act, 40 P.S. § 1303.712(a). In 2002, before the HCPR Program went into affect, health care providers paid $348 Million in assessments. When the HCPR Program was extant, health care providers paid assessments of $200 Million in 2003, $212 Million in 2004, $216 million in 2005, $162 Million in 2006, and $120 Million in 2007. After the General Assembly ended the HCPR Program in 2007, health care provider assessments rose to $229 Million for 2008. Worth noting is that from 2002 to 2007, the MCARE Fund balance was between $11 and $59 Million, but in 2008, it rose to $104 Million. In that same period, claims paid for malpractice were $346 Million in 2002, $379 Million in 2003, $320 Million in 2004, $232 Million in 2005, $210 Million in 2006, $191 Million in 2007, and $174 Million in 2008.
Because the HCPR Program was repealed in 2007, all abatements to doctors have been paid, and it has been asserted that no further money is needed in the MCARE Fund to pay malpractice claims. Therefore, at the center of this case is what happens to the tax money that was previously in the HCPR Account. Specifically, does all money in that Account have to be transferred to the MCARE Fund even though that will result in the Fund being overfunded by hundreds of millions of dollars? The answer to that question is important because the Abatement Law *48provides that any excess monies in the MCARE Fund upon termination of the program is to be given back to the doctors even though doctors had received all the abatement that they were entitled to receive under the HCPR Program and there are sufficient funds to pay malpractice claims. Section 1303.712(k) provides as follows:
(k) Termination. — Upon satisfaction of all liabilities of the fund, the fund shall terminate. Any balance remaining in the fund upon such termination shall be returned by the department to the participating health care providers who participated in the fund in proportion to their assessments in the preceding calendar year.
40 P.S. § 1303.712(k).
II.
It is undisputed that from 2003 to 2007, a total of $731,517,112 was deposited into the HCPR Account and during that time-frame, the Commonwealth granted $946 million in abatements to health care providers. In 2004 and 2005, Executive Branch Agencies transferred approximately $330 million from the HCPR Account to the MCARE Fund that had the net effect of paying loans previously made by the Motor Vehicle Fund to the MCARE Fund.9 In addition, approximately $170 million in motor vehicle surcharge revenue was deposited into the MCARE Fund from 2004 to 2007. No funds were transferred from the HCPR Account to the MCARE Fund after 2005 even though abatements continued to be awarded through 2007.
Despite this lack of transfers, it is also undisputed that as of December 31, 2008, after all expenses and obligations were paid for that year, the MCARE Fund still had a balance of over $104 million. According to Peter J. Adams (Commissioner Adams), the Pennsylvania Insurance Department’s Deputy Insurance Commissioner for MCARE, the MCARE Fund has continually been able to fulfill its obligations to pay claims and expenses since its inception in 2002. Commissioner Adams also averred that “[e]ven after the transfer of $100 million to the General Fund, the MCARE Fund will have sufficient funds to fulfill its current obligations to pay claims and expenses.”
Despite this apparent overfunding and lack of any need for the funds to give doctors abatements for their medical malpractice claims, the Petitioners (collectively, “Medical Society”) sought to have somewhere between $446 million and $616 million transferred from the HCPR Account to the MCARE Fund. To do so, the Medical Society filed a petition for review alleging Respondents (collectively, “Executive Branch Agencies”) were required under the Abatement Law to transfer funds from the HCPR Account into the MCARE Fund in an amount equal to the abate-ments granted and that Executive Branch Agencies had failed to do so. The Medical Society requested declaratory judgment regarding Executive Branch Agencies’ statutory duties under the Abatement Law, a writ of mandamus directing transfer of funds from the HCPR Account into the MCARE Fund in the amount needed *49to fully fund the abatements, and an order directing the Executive Branch Agencies not to use or transfer the money in the HCPR Account for any other purpose. They also demanded an accounting and alleged that Executive Branch Agencies’ administration of the HCPR Account violated the Uniformity Clause of the Pennsylvania Constitution because it shifted the burden of funding the MCARE abate-ments onto doctors and resulted in a nonuniform tax burden.10 Executive Branch Agencies filed preliminary objections in the nature of a demurrer.
On July 24, 2009, this Court issued an unreported memorandum opinion agreeing with Executive Branch Agencies that because the abatements were not taxes the Uniformity Clause did not apply and Count II of the petition was, therefore, dismissed. All of Executive Branch Agencies’ remaining preliminary objections were overruled and the case was scheduled for argument on Medical Society’s application for summary relief regarding the issue of whether Executive Branch Agencies had the legal duty to use the HCPR Account funds to fully fund the abatements.
However, the underlying issue of whether the Executive Branch Agencies were statutorily required to transfer funds from the HCPR Account to the MCARE Fund was vitiated when the General Assembly relieved the Executive Branch Agencies of any obligation to do so. On October 9, 2009, before oral argument was even held on the matter before us, the General Assembly enacted the “Budget”11 which abolished the HCPR Account and transferred the remaining $708 million from that account to the General Fund in order to help alleviate the Commonwealth’s financial distress and reach a compromise to the budget impasse. In addition, $100 million was transferred from the MCARE Fund to the General Fund to be appropriated for other purposes. In doing so, the General Assembly implicitly made the legislative determination that those funds were no longer needed to provide subsidies to doctors. Notwithstanding the General Assembly’s actions abolishing the HCPR Account and transferring all of the money at issue to the General Fund, the Medical Society did not amend its Petition for Review. It still alleges that it is entitled to the entire amount transferred out of these accounts and that approximately $808 million must be transferred to the MCARE Fund because the Medical Society has vested rights to these funds under the Abatement Law.
The gravamen of this case then is not whether doctors’ subsidies will be paid because they all have been paid. It is not whether judgments against those doctors who committed malpractice will be paid, because they will be paid. Instead it is whether doctors in the Commonwealth are entitled to the $808 million in excess funds.
III.
The majority, mainly relying on this Court’s unreported opinion dismissing the preliminary objections, grants summary relief by agreeing with the Medical Society’s claim that the Executive Branch Agencies still have a duty to make transfers of tax money from the HCPR Account, an account which no longer exists, *50to the MCARE Fund, which does not need the money. Even though the Abatement Law does not require that the Budget Secretary “shall” make such transfers, only that he “may ” transfer tax money from the HCPR Account to the MCARE Fund, the Majority goes on to require that approximately $808 million be transferred to those accounts rather than to where the General Assembly directed it — the General Fund. The net effect of the Majority’s holding is twofold: the 2009-2010 Pennsylvania Budget is out of balance, and the doctors of this Commonwealth are eligible to receive an $808,000,000 windfall from taxes imposed on ordinary citizens of the Commonwealth which is not needed to provide subsidies for the doctors’ malpractice assessments.
IV.
In arriving at its decision, the majority mainly relies on our previous July 24, 2009 decision overruling Executive Branch Agencies’ preliminary objections which found that those agencies had an affirmative obligation to transfer funds from the HCPR Account to the MCARE Fund to fund abatements. In arriving at that conclusion, the majority mainly relies on the following portion of our previous opinion regarding preliminary objections where we stated, in pertinent part:
Here, [the Commonwealth] reifies] on Section 1112(c) of the Abatement Law which states that ‘the Secretary of the Budget may annually transfer from the account to the [MCARE] Fund an amount up to the aggregate amount of abatements granted by the Insurance Department under section 1104(b).’ 40 P.S. § 1308.1112(c). (Emphasis added). The language of this section appears to give the Budget Secretary discretion to transfer funds from the HCPR Account to the MCARE Fund. However, as its name suggests, the HCPR Program was established to retain health care providers in Pennsylvania by reducing the burden of paying professional liability insurance premiums under the MCARE program. The General Assembly established mandatory abatements, a mandatory account from which to fund the abatements and two mandatory funding sources for the abatements, (footnote omitted)
When Section 1112 is read in conjunction with the rest of the HCPR statute, including its title, and the description of the purpose and funding mechanisms for the HCPR program, to give the Budget Secretary complete unfettered discretion to decide whether to fund the MCARE Fund, regardless of the need for the funds, is obviously inconsistent with the statutory scheme. It certainly appears that the General Assembly has mandated that the HCPR Account pay for the abatements. As Petitioners point out, there is no provision for the [Insurance Department] to refuse to award abate-ments or decline to notify DPW when abatements are awarded. In addition, the General Assembly has taken measures to assure that the abatements are paid by the Fund, not providers. If a provider has already paid the assessment prior to the award of the abatement the General Assembly has directed in Section 1110 of the Abatement Law that “[t]he Insurance Department shall either issue refunds or credits for monies due health care providers under this chapter. [”] (citation omitted)
The Pennsylvania Med. Soc’y v. Dep’t of Pub. Welfare (Nos. 584, 585 M.D. 2008, filed July 24, 2009), slip op. at 13 — 14. Ignoring that this decision was based on law no longer extant, I disagree with the majority because it both misinterprets the effect of that decision — what, if any vested rights doctors have — and is based on the *51misimpression that the payment of obligations is what is at issue in this case. For that reason and the following reasons, I disagree with the majority decision.
First, the doctors have already received all the benefits to which they claim they are entitled. In dismissing certain preliminary objections, all we held was that under the Abatement Law, sufficient transfers had to be made from the HCPR Account to the MCARE Fund to fund abatements, nothing more. Because the HCPR Program ended in 2007, abate-ments were only granted to subsidize doctors’ malpractice assessments up to 2007, and they have long ago received those abatements. That part of the deal has already been completed, and doctors have received all of the abatements they are entitled to, vested or not.
Second, doctors do not have a vested right to receive hundreds of millions of dollars from tax money in the HCPR Account. The money that used to be in the Account is not needed because doctors have received all the abatements to which they were entitled. By directing the transfer of funds from the HCPR Account to the MCARE Fund, the majority will overfund the MCARE Fund by hundreds of millions of dollars which, under 40 P.S. § 1303.712(k), will then go to the doctors upon termination of the Fund. That is why in Section 1112(c) of the Abatement Law, the General Assembly only stated that the Budget Secretary “may,” not must, transfer funds to the MCARE Fund. If the General Assembly wanted all designated tax funds transferred to the MCARE Fund, it would have just placed the taxes directly into that Fund. If doctors have any vested rights under the Abatement Law, it is to the abatements themselves, nothing more; they have no vested right in having those subsidies funded from any particular source.
Third, there are disputed facts. To the extent that there are insufficient funds to pay claims, Commissioner Adams has filed an affidavit stating that “[e]ven after the transfer of $100 million to the General Fund, the MCARE Fund will have sufficient funds to fulfill its current obligations to pay claims and expenses.” Under Section 1303.71(c) of the MCARE Act, the doctors’ cumulative assessment is statutorily fixed and will not change even if the transfer of the $800 Million taken to fund the 2009-2010 budget is ultimately deposited in the MCARE Fund. Given that those assessments are in excess of the current amount needed to cover all MCARE obligations, including the payout of malpractice claims, there appears to be sufficient funds to pay current obligations of the Fund. In any event, because this is a genuine issue of material fact, the application for summary relief must be denied for this reason alone. Sherman v. Kaiser, 664 A.2d 221, 225 (Pa.Cmwlth.1995).
Fourth, because they have not been harmed, doctors, and hence, the Medical Society have no standing to maintain this action. “In seeking judicial resolution of a controversy, a party must establish as a threshold matter that he has standing to maintain the action.” Stilp v. Commonwealth, 596 Pa. 62, 940 A.2d 1227, 1233 (2007). As our Supreme Court explained in William Penn Parking Garage, Inc. v. City of Pittsburgh, 464 Pa. 168, 346 A.2d 269, 280-81 (1975), (plurality), the core concept of standing is that a person who is not adversely affected in any way by the matter he seeks to challenge is not aggrieved thereby and has no standing to obtain a judicial resolution of his challenge. In this case, because the doctors have received all that they were entitled to receive and the amount of their statutory assessment is fixed no matter what, their *52representative, the Medical Society, does not have standing to maintain this action.
Fifth, by ordering the Executive Branch Agencies to transfer funds from the HCPR Account to the MCARE Fund, the majority is ordering them to do something that is impossible for them to do. After the preliminary objections were decided, the General Assembly enacted the 2009-2010 Budget legislation which abolished the HCPR Account, directed that $100 million be taken from the MCARE Fund, and transferred all of those funds to the General Fund. The Secretaries of these Executive Branch Agencies have no authority to make a transfer from the General Fund to any other account without first having express authorization from the General Assembly to do so. Moreover, the State Treasurer would not allow such a transfer to take place.
Sixth, the General Assembly is an indispensable party to the lawsuit. A party is deemed indispensable “when his or her rights are so connected with the claims of the litigants that no decree can be made without impairing those rights.” Vernon Township Water Auth. v. Vernon Township, 734 A.2d 935, 938 n. 6 (Pa.Cmwlth.1999). The General Assembly passed the Budget which transferred the funds from the HCPR Account and MCARE Fund to the General Fund. In effect, what the Medical Society is stating is that the 2009-2010 Budget legislation is unconstitutional. To enact the remedial legislation, authorizing legislation would be needed to appropriate the funds from the General Fund to the MCARE Fund. Here, the only entities named as Executive Branch Agencies were the Executive Branch Agencies, not the Commonwealth or the appropriate officials of the General Assembly needed to enact remedial legislation.12 Because the failure to join an indispensable party to a lawsuit deprives the court of subject matter jurisdiction, Pennsylvania Game Commission v. K.D. Miller Lumber Co., Inc., 654 A.2d 6, 9 (Pa.Cmwlth.1994); O’Hare, III v. County of Northampton, 782 A.2d 7, 13 (Pa.Cmwlth.2001), this action must be dismissed.
Finally, the matter is non-justieiable. The political question doctrine is considered to derive from the legal principle of separation of powers — the notion that the executive branch, the judiciary, and the legislature are co-equal, independent branches of government. Pennsylvania School Boards Association, Inc. v. Commonwealth Association of School Administrators, 569 Pa. 436, 805 A.2d 476 (1977) (citing Sweeney v. Tucker, 473 Pa. 493, 375 A.2d 698 (1977)). Certain functions and powers have been reserved to each of the branches by the constitution and the doctrine of separation of powers mandates that the judiciary not review those actions exclusively committed to another branch of government. Harrisburg School District v. Hickok, 762 A.2d 398 (Pa.Cmwlth.2000) (citing Sweeney, 473 Pa. at 508-09, 375 A.2d at 705-06). The courts must, therefore, determine whether judicial intervention is in fact warranted on an issue before the merits of a case can be heard. In Sweeney, the Supreme Court of Pennsylvania adopted the standard announced by the U.S. Supreme Court in the seminal case Baker v. Carr, 369 U.S. 186, 82 S.Ct. *53691, 7 L.Ed.2d 663 (1962), for determining whether a case involves a non-justiciable political question:
Prominent on the surface of any case held to involve a political question is found a textually demonstrable constitutional commitment of the issue to a coordinate political department; or a lack of judicially discoverable and manageable standards for resolving it; or the impossibility of deciding without an initial policy determination of a kind clearly for nonjudicial discretion; or the impossibility of a court’s undertaking independent resolution without expressing lack of the respect due coordinate branches of the government; or an unusual need for unquestioning adherence to a political decision already made; or the potentiality of embarrassment from multifarious pronouncements by various departments on one question.
The case before this Court involves more than merely interpreting the laws of the Commonwealth and determining the constitutionality of legislative action. It requires us to appropriate money and dictate to the General Assembly how to budget, functions which have been constitutionally committed to the Executive and Legislative branches. Article VIII, Section 12 of the Pennsylvania Constitution mandates that every year the Governor shall submit a proposed, balanced operating budget to the General Assembly outlining in detail proposed expenditures and estimated revenues. If a deficiency exists, the Governor must also “recommend specific additional sources of revenue sufficient to pay the deficiency.” Pa. Const, art. 8, § 12(a). It is then up to the General Assembly to make appropriations from the Commonwealth’s revenues and surplus and to adopt a balanced budget. Pa. Const, art. 8, § 13.
The Governor and General Assembly were well within their constitutionally granted powers when they enacted the Budget legislation last October. The Commonwealth was facing an enormous financial crisis. In order to enact a budget and make up for our huge deficit, the General Assembly authorized the transfer of $708 million from the HCPR Account and $100 million from the MGARE Fund to the General Fund to be appropriated for other purposes. Even if the Commonwealth is somehow obligated to place more funds in the MCARE Fund, it is not for this court to direct that a particular tax be dedicated to fund some indefinite obligation; it is within the sole purview of the General Assembly to determine how that obligation will be satisfied. Judicial intervention in the legislative process is not warranted because it goes to the core question of the budgeting process making the enforcement of any order problematic.
Accordingly, for all of the foregoing reasons, I respectfully dissent.

. Act of March 20, 2002, P.L. 154, as amended, 40 P.S. §§ 1303.101-1115.

. Section 712 of the MCARE Act, 40 P.S. § 1303.712(a).

. Section 712 of the MCARE Act, 40 P.S. § 1303.712(d).

. Originally enacted as Act of December 23, 2003, P.L. 237, formerly 62 P.S. §§ 443.7 and 1301-A, et seq., repealed by the Act of December 22, 2005, P.L. 458, and reenacted as an amendment to the MCARE Act, 40 P.S. § § 1303.1101-1115.

. While the initial legislation only provided abatements for the calendar years 2003 and 2004, the General Assembly later extended the program through 2007.

. Act of March 4, 1971, P.L. 6, as amended 72 P.S. § 8211 (Cigarette Tax Law), added by the Act of December 23, 2003, P.L. 250. Section 1211 of the Cigarette Tax Law stated:
There is established in the General Fund a special account to be known as the [HCPR] Account. Eighteen and fifty-two hundredths per cent of the proceeds of the tax imposed by section 1206 shall be deposited in the account. Funds in the account shall be subject to an annual appropriation and shall be administered as provided by law.
72 P.S. § 8211.

.40 P.S. § 1303.1112(a), repealed by Act of October 9, 2009, P.L. 537, No. 50, § 7(5). Section 1112(a) of the Abatement Law provides as follows:
(a) Fund established. There is established within the General Fund a special account to be known as the [HCPR] Account. *47Funds in the account shall be subject to an annual appropriation by the General Assembly to [DPW]. [DPW] shall administer funds appropriated under this section consistent with its duties under section 201(1) of ... the Public Welfare Code.

. Section 713(c) provides that the "Governor may transfer to the fund from the Catastrophic Loss Benefits Continuation Fund, or such other funds as may be appropriate, such money as is necessary in order to pay the liabilities of the fund until sufficient revenues are realized by the fund. Any transfer made under this subsection shall be repaid with interest. ...”

. In 2003, the Motor License Fund was the source of a $220 Million loan to the Fund to pay liabilities. In 2004, the Motor License Fund provided another $207 Million loan and the first transfer of $100M was transferred into the MCARE Fund, but $225.4 Million was repaid to the Motor Vehicle Fund. In 2005, there was a transfer from the HCPR Account to the Fund of $230 Million. Again, the Motor Vehicle Fund received repayment of its loan of $214.6 Million. After 2006, there were no loans from the Motor Vehicle Fund or transfers from other accounts.

. Given the Commonwealth's dire financial status during the summer of 2009, Medical Society were concerned the Governor and General Assembly would utilize funds in the HCPR Account to help alleviate the budget crisis. So they also filed applications for a preliminary injunction and a temporary restraining order, both of which were denied as premature.

. Act of October 9, 2009, P.L. 537, No. 50, § 7(5).

. See, e.g., Pennsylvania State Association of County Commissioners, County of Allegheny, County of Bucks, County of Cumberland, County of Dauphin, County of Erie, County of Forest, County of Fulton, County of Monroe, County of Snyder, County of Tioga, Medical. Society v. Commonwealth of Pennsylvania; Commonwealth of Pennsylvania, General Assembly; Mark S. Schweiker in his Official Capacity as President Pro-Tempore of the Pennsylvania Senate and Matthew J. Ryan in his Official Capacity as Speaker of the House of Representatives, 545 Pa. 324, 681 A.2d 699 (1996).