Court Opinion

ID: 9638961
Source: CourtListenerOpinion
Date Created: 2023-08-22 15:59:51.863113+00
Date Added: 2024-06-11T18:10:10.937853
License: Public Domain

Robert L. Brown, Justice, dissenting. Though I agree with the majority opinion that the trial court was operating within its discretion in denying the petition of the Department of Human Services (DHS) for writ of mandamus, I respectfully dissent from that portion of the majority opinion that affirms the denial of DHS’s petition for writ of certiorari. The General Assembly clearly intended to except Medicaid claims like Wadley’s claim for $2,835,828 from Claims Commission jurisdiction. In 1949, the General Assembly created the Claims Commission, and in doing so, limited its jurisdiction consistent with the current Arkansas Code: (b) The commission shall have no jurisdiction of, or authority with respect to, claims arising under the Workers’ Compensation Law, § 11-9-101 et seq., the Employment Security Law, § 11-10-101 et seq., the Arkansas Teacher Retirement System Act, § 24-7-201 et seq., the Arkansas Public Employees’ Retirement System Act, § 24-4-101 et seq., the State Police Retirement System Act, § 24-6-201 et seq., or under laws providing for old age assistance grants, child welfare grants, blind pensions, or any laws of a similar nature. . . . Ark. Code Ann. § 19-10-204 (Supp. 1997)(emphasis added). See 1949 Ark. Acts 462 § 2. Viewing the plain language of this section, which has remained virtually the same for approximately fifty years, Medicaid reimbursement is unquestionably “similar” to laws providing for old-age assistance grants, child-welfare grants, and blind pensions. The fact that the General Assembly has waived sovereign immunity for Wadley’s Medicaid claim under this statute is bolstered by the fact that Wadley itself first made its claim for an adjustment in Medicaid reimbursement to DHS and sought an appeal within DHS after that appeal was denied. In its complaint filed in the Claims Commission, Wadley described the sequence of events: 15. On May 11, 1995, Wadley, through its counsel Vinson & Elkins, requested an adjustment in the amounts it was paid in fiscal years 1992, 1993, and 1994 pursuant to its Provider Agreement with DHS. DHS did not respond. After numerous telephone calls and letters to DHS, on June 28, 1995, Wadley, through its counsel, Mitchell, Williams, Selig, Gates and Wood-yard, P.L.L.C., again requested an adjustment to the payments in 1992, 1993, and 1994. DHS did not respond. After further demand, on July 19, 1995, Breck Hopkins of DHS Office of Chief Counsel responded by letter of July 26, 1995, and denied any consideration of Wadley’s request. 16. Wadley then requested reconsideration of the Hopkins’ decision by following the appeals process found in Section 231.7 of the Provider Manual. By letter of September 14, 1995, DHS refused to allow the appeal stating that it was time barred and should have been brought in 1992 when the rate for out-of-state hospitals was reduced to $400. It is only after the door was closed to Wadley’s appeal within DHS that Wadley chose another route, which was its complaint before the Claims Commission. But, again, the Claims Commission has no jurisdiction over Medicaid claims. This is a matter intended to be heard within the executive branch under § 19-10-204, with judicial review of the agency decision clearly residing in circuit court under the Administrative Procedure Act. See Ark. Code Ann. § 25-15-212 (Repl. 1996). The reason that the General Assembly determined to keep hands off of these Medicaid claims is obvious. Medicaid reimbursement is a matter of considerable complexity, and DHS has the requisite expertise to decide these Medicaid questions. We have faithfully acknowledged such expertise and acumen within our state agencies. See, e.g., Arkansas Dep’t of Human Servs. v. Thompson, 331 Ark. 181, 959 S.W.2d 46 (1998); Arkansas Health Servs. Agency v. Desiderata, Inc., 331 Ark. 144, 958 S.W.2d 7 (1998). To be sure, a claim against the State based on a contract must be submitted to the Claims Commission. Ark. Code Ann. § 19-10-208(c) (Repl. 1994). But to contend that this is merely a claim for breach of contract is a terrible understatement. Wadley’s claim requires interpretation of federal law and regulations, declaration of what constitutes the supreme law of the land, an alleged violation of the Equal Protection Clause of the Fourteenth Amendment, and judicial review of a state agency decision. Because the Claims Commission, which is an arm of the legislative branch, is attempting in this case to exercise powers reserved by § 19-10-204 to the executive branch, the instant case is materially different from Fireman’s Ins. Co. v. Arkansas State Claims Comm’n, 301 Ark. 451, 784 S.W.2d 771 (1990), cert. denied, 498 U.S. 824 (1990), and Wells v. Purcell, 267 Ark. 456, 592 S.W.2d 100 (1979), where this court held that writs of certiorari and mandamus could not issue to the General Assembly because the challenged conduct fell squarely within the exercise of legislative powers. A writ of certiorari lies to correct proceedings erroneous on the face of the record, when there is no other adequate remedy. King v. Davis, 324 Ark. 253, 920 S.W.2d 488 (1996); Lupo v. Lineberger, 313 Ark. 315, 855 S.W.2d 293 (1993); Sexton v. Supreme Court, 297 Ark. 154-A, 761 S.W.2d 602 (1988); Bridges v. Arkansas Motor Coaches, 256 Ark. 1054, 511 S.W.2d 651 (1974). It is available in the exercise of superintending control over a tribunal which is proceeding illegally where no other mode of review has been provided. Id. The Claims Commission is assuming what is clearly a matter to be decided by DHS under § 19-10-204, subject to judicial review. It has no jurisdiction over the case. I would grant the petition for writ of certiorari. Thornton, J., joins.