Appeals from Decisions of the Auditor General and the Department of Public Welfare in case of Temple University Hospital Financial Report to the Commonwealth of Pennsylvania Hospital Care and Services.
Matthew M. Strickler, with him Andrew R. Rogoff, and of counsel, Ballard, Spahr, Andrews & Ingersoll, for petitioner.
Timothy J. Holland, with him Robert P. Meehan, and Lester Eisenstadt, for respondent, Auditor General.
Betty F. Perry, Assistant Attorney General, for respondent, Department of Public Welfare.
President Judge Bowman and Judges Crumlish, Jr., Mencer, Blatt, DiSalle, Craig and MacPhail. Judges Wilkinson, Jr. and Rogers did not participate. Opinion by President Judge Bowman.
[ 44 Pa. Commw. Page 285]
Temple University -- of the Commonwealth System of Higher Education (University) as operator of the Temple University Hospital (Hospital) has filed two petitions for review of administrative agency decisions. One challenges the Auditor General's certification to the Department of Public Welfare (Department) of certain cost reports necessary for the reimbursement of the University's expenses covered by the Pennsylvania Medical Assistance Program. The second seeks review of the Department's determination to pay the University in accordance with the contested cost reports as certified. The Auditor General and the Department filed motions to quash, which are now before us, as are the merits of the dispute.
The health care plan involved in this matter is structured by both federal and state statutes and regulations. Specifically, Pennsylvania hospitals are reimbursed by the state for inpatient hospital care expenses pursuant to Section 443.1 of the Public Welfare Code (Code), Act of June 13, 1967, P.L. 31, as amended, added by the Act of July 31, 1968, P.L. 904, as amended, 62 P.S. § 443.1. Section 443.1 states:
The following medical assistance payments shall be made in behalf of eligible persons whose institutional care is prescribed by physicians:
(1) The reasonable cost of inpatient hospital care, as specified by regulations of the department adopted under Title XIX of the Federal Social Security Act and certified to the department by the Auditor General. . . .
The state is in turn compensated for its expenditures by the federal government under the provisions
[ 44 Pa. Commw. Page 286]
of Title XIX of the Federal Social Security Act (Title XIX), 42 U.S.C. § 1396 et seq. Title XIX requires a state plan for medical assistance to "provide for the establishment or designation of a single State agency to administer or to supervise the administration of the plan." 42 U.S.C. § 1396a(a)(5). The Department is the "single State agency" for the ...