Appeal from the Order of the Pennsylvania Department of Public Welfare in case of Appeal of St. Christopher's Hospital for Children, Re: Dwight Blunt and Carol Jackson, No. 1297 184 TC.
William G. Frey, Reed, Smith, Townsend & Munson, for petitioner.
Phillip B. Rosenthal, Assistant Counsel, for respondent.
President Judge Crumlish, Jr. and Judges Williams, Jr. and Barbieri, sitting as a panel of three. Opinion by Judge Williams, Jr.
[ 78 Pa. Commw. Page 114]
This is an appeal from an order of the Department of Public Welfare (DPW) dismissing, on the basis of untimeliness, the administrative appeal taken by St. Christopher's Hospital for Children on behalf of a minor patient who was determined to be ineligible for medical assistance. St. Christopher's challenges DPW's action on due process grounds. Specifically, the hospital asserts that DPW unconstitutionally denied it a hearing on the issue of whether its administrative appeal was timely filed. St. Christopher's argues alternatively that, as there was a delay of six days between the determination of ineligibility and its receipt of notice of the decision,
[ 78 Pa. Commw. Page 115]
the appeal period should run from the date it received notice of the determination of ineligibility rather than the date that the determination was made. Finally, St. Christopher's contends that even if the appeal is deemed to have been filed out of time, equitable considerations justify the granting of an appeal nunc pro tunc. Because we conclude that the hospital was entitled to an evidentiary hearing on the timeliness issue, we decline to reach the other questions.
While there is no evidentiary record, there appears to be little conflict between St. Christopher's and DPW with regard to much of the case history underlying this appeal. That history reveals that the hospital, on July 15, 1981, received from Mrs. Carol Jackson a power of attorney to act as her representative to obtain medical assistance benefits on behalf of her twelve-year old brother, Dwight Blunt, for whom she was legal guardian. Dwight was admitted to St. Christopher's on July 11, 1981, and remained there until his death on August 12, 1981. It is the hospital bill for medical services rendered during Dwight's month-long hospitalization that is the subject of the application for medical benefits.
The application for benefits was filed with the Philadelphia County Board of Assistance (CBA) on July 15, 1981. By a determination dated August 5, 1981, the CBA denied the claim on the basis of lack of verification of Dwight's income and assets. According to St. Christopher's the determination was made because Mrs. Jackson, Dwight's guardian, failed to keep an interview at the CBA office. St. Christopher's received notice of the determination of ineligibility on August 11, 1981. In the weeks following receipt of the determination, St. Christopher's credit manager attempted to see that the necessary
[ 78 Pa. Commw. Page 116]
income verification was provided by Mrs. Jackson. However, when such verifying information had not been provided by September 1, 1981, the hospital sent a letter of appeal to the CBA. September 1st was the twenty-seventh day of the thirty day appeal period.
The CBA office to which the appeal was sent is approximately two miles from the hospital. However, the CBA date-stamped the appeal as having been received on September 9, 1981, thirty-five days after the date of the adverse determination. Without holding a hearing on either timeliness or the merits of the claim, DPW's Office of Hearings and Appeals, on September 30, 1981, dismissed the appeal as untimely, stating: "[t]he date of ...