Appeal from the Order of the Department of Public Welfare in the case of John R. Jones, D.C. v. Department of Public Welfare, File No. 9-82-9.
Carl Gainor, for petitioner.
Roger T. Margolis, with him, Bradford Dorrance, Assistant Counsel, for respondent.
Judges MacPhail and Colins, and Senior Judge Rogers, sitting as a panel of three. Opinion by Senior Judge Rogers.
[ 98 Pa. Commw. Page 145]
This is the appeal of John R. Jones, D.C. (petitioner) from an order of the Pennsylvania Department of Public Welfare (DPW) finding the petitioner liable to reimburse the DPW for all payments made by the DPW to him for medical services rendered to twelve medical assistance patients, and suspending him from participation in the Pennsylvania Medical Assistance Program until June 23, 1987.
The petitioner is a chiropractor. From 1978 through 1980 he was a participating provider in the Pennsylvania Medical Assistance Program. On September 6, 1981, the petitioner moved his residence and practice to California.
By letter, dated March 25, 1982, the DPW requested the petitioner to furnish for review copies of his records relating to twelve cases. On March 30, 1982, the petitioner by telephone and in writing informed
[ 98 Pa. Commw. Page 146]
DPW that he had moved to California and that his medical records as well as his other personal property which were in the possession of movers had been water and heat damaged enroute to California. He wrote that the medical records were "unsalvageable."
On June 23, 1982, DPW issued upon the petitioner an order to show cause why he should not be suspended from participation in the Medical Assistance Program for four years for failing to provide the medical records requested, and directing him to make restitution to DPW of $15,120.62 in payments made to him from 1978 through 1981 on account of every Medical Assistance patient he treated during that time. The amount ordered to be repaid included payments to the petitioner on account of the twelve patients named in the DPW's earlier communication.
By letter dated June 28, 1982, the petitioner requested a hearing. He also began searching among his records to see if those of some of his Medical Assistance patients were salvageable. Although the records seem to have been damaged, had been rearranged and placed in mis-marked boxes, the petitioner was able to locate the records of the twelve patients first mentioned. He notified the DPW by telephone that he had retrieved the twelve requested records and offered to send them for review. The petitioner was first directed to send the records to the DPW. However, he was later informed by Bradford Dorrence, Esquire, assistant division counsel of the DPW, that he should not send these records because the DPW was no longer interested in reviewing them; that a hearing had been ...