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STEPHEN STOFFAN v. COMMONWEALTH PENNSYLVANIA (07/21/77)

decided: July 21, 1977.

STEPHEN STOFFAN, M.D., PETITIONER
v.
COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFARE, RESPONDENT



Appeal from the Order of the Department of Public Welfare in case of Appeal of: Stephen Stoffan, M.D., No. A-75-57.

COUNSEL

Bresci R. P. Leonard, with him Robb, Leonard & Edgecombe, for appellant.

Robert S. Englesberg, Assistant Attorney General, with him Robert P. Kane, Attorney General, for appellee.

Judges Crumlish, Jr., Wilkinson, Jr. and Blatt, sitting as a panel of three. Opinion by Judge Crumlish, Jr.

Author: Crumlish

[ 31 Pa. Commw. Page 204]

Dr. Stephen Stoffan, M.D. (Appellant) appeals the decision of the Department of Public Welfare (DPW) which barred him from further participation in the Pennsylvania Medical Assistance Program (Program) and denied him payment of claims for services which he allegedly rendered.

The Program reimburses participating physicians for medical services rendered to DPW recipients. After a hearing, Appellant was barred from the Program due to his failure to maintain medical records which would support his invoices submitted to DPW. Appellant objects to the decision on many ingenious but foundationless grounds. His objections are as follows:

[ 31 Pa. Commw. Page 205]

    first, DPW regulations requiring records are vague; second, the decision of the hearing officer was not supported by competent evidence; third, the hearing officer was biased; fourth, there was a failure to receive adequate notice of the charges; fifth, there was an improper commingling of judicial and prosecutorial functions within DPW; and finally, that the sentence was disproportionate to the offense.

It need not be said again that the scope of review of this Court in reviewing decisions of an administrative agency is limited by the Administrative Agency Law, Act of June 4, 1945, P.L. 1388, as amended, 71 P.S. ยง 1710.44, to a determination of whether the decision was in accordance with law, the findings of fact made by the hearing officer were supported by substantial evidence, or the constitutional rights of the defendant were violated.

Accordingly, we affirm the decision of DPW.

A physician receives reimbursement for each patient from DPW by periodically submitting Pa. Form 259 entitled "Standard Medical Invoice." On the top right corner of the invoice is a small square where the doctor records the "Technical Diagnosis." Also, there is a box entitled "Explanation" where Appellant would record whether medicine was prescribed.*fn1 Directly above the required physician's signature is the following statement: " Vendor's Records and Certification -- I hereby certify that services were provided as shown and under conditions 1 through 5 as shown on the reverse of this form." Conditions one and two are:

1. I agree to keep such records as necessary to disclose fully the extent of services provided to ...


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