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SELMA DEMPSEY v. COMMONWEALTH PENNSYLVANIA (11/01/85)

decided: November 1, 1985.

SELMA DEMPSEY, PETITIONER
v.
COMMONWEALTH OF PENNSYLVANIA, UNEMPLOYMENT COMPENSATION BOARD OF REVIEW, RESPONDENT



Appeal from the Order of the Unemployment Compensation Board of Review in the case of In Re: Claim of Selma Dempsey, No. B-227971.

COUNSEL

Robert E. Paul, Shein and Brookman, P.A., for petitioner.

Charles G. Hasson, Acting Deputy Chief Counsel, for respondent.

Judges Craig and Palladino, and Senior Judge Barbieri, sitting as a panel of three. Opinion by Judge Craig. Dissenting Opinion by Senior Judge Barbieri.

Author: Craig

[ 92 Pa. Commw. Page 526]

Claimant Selma Dempsey has appealed an order of the Unemployment Compensation Board of Review which affirmed a referee's denial of benefits on the ground of willful misconduct.*fn1

The claimant worked for the Philadelphia Child Guidance Clinic for over seven years. In her position, the claimant had broad administrative responsibility for the administration of the employer's preschool and parent awareness program. Her duties included the submission of medical claims to the Department of Public Welfare (DPW) to obtain payment for services rendered to eligible clients of DPW's medical assistance program (Medicaid). The clinic terminated the claimant's employment as of May 17, 1983 after their investigation indicated that she and her staff had submitted fraudulent Medicaid claims amounting to thousands of dollars to DPW for services never rendered to clients.

In this appeal, the sole issue which we must resolve is whether the claimant's failure to bring a questionable billing procedure instituted by a former supervisor to her new supervisor's attention constituted willful misconduct so as to render her ineligible for benefits.*fn2

[ 92 Pa. Commw. Page 527]

The pertinent findings of the board, which the claimant does not dispute, were these:

4. On or about January 26, 1981 claimant's supervisor instructed the claimant that all hours that the preschoolers were in the classroom should be billed to a federally funded medical assistance program rather than only those hours that the preschoolers met in group session with the program's clinical psychologist. (Emphasis in original.)

5. Though claimant questioned the ethical and legal implications of the above billing instructions, she was assured by her supervisor that the procedure was both legal and ethical.

6. The billing practice became the standard procedure and the clinical psychologist signed forms indicating the services had been rendered when, in fact, the psychologist had not been present at the clinic that day and the ...


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