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JEWISH EMPLOYMENT AND VOCATIONAL SERVICE v. COMMONWEALTH PENNSYLVANIA (07/13/88)

decided: July 13, 1988.

JEWISH EMPLOYMENT AND VOCATIONAL SERVICE, PETITIONER
v.
COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFARE, RESPONDENT



Appeal from the Order of the Board of Claims, in the case of Jewish Employment and Vocational Service v. Commonwealth of Pennsylvania, Docket No. 827, dated June 9, 1986.

COUNSEL

Arthur K. Hoffman, with him, Michael M. Baylson, Duane, Morris & Heckscher, for petitioner.

Bruce G. Baron, Assistant Counsel, for respondent.

Judges MacPhail and Smith, and Senior Judge Barbieri, sitting as a panel of three. Opinion by Judge MacPhail.

Author: Macphail

[ 117 Pa. Commw. Page 582]

Jewish Employment and Vocational Service, Inc. (Petitioner) appeals the order of the Board of Claims (Board) relinquishing jurisdiction over a contract dispute between Petitioner and the Department of Public

[ 117 Pa. Commw. Page 583]

Welfare (DPW). The Board's order was predicated upon the finding that Petitioner failed to file its claim within six months after it accrued, as required by Section 6 of the Board of Claims Act, Act of May 20, 1937, P.L. 728, as amended, 72 P.S. § 4651-6.

Petitioner, a non-profit corporation, was approved by DPW to provide partial hospitalization services to eligible recipients in Petitioner's medical assistance program. The Petitioner was then reimbursed by DPW for the medical services provided. The Board found that in order for clinic providers to be compensated for services, they first had to submit claims of the services performed to the County Assistance Offices (CAO). The CAO is then responsible for determining the eligibility of the recipients for whom claims were submitted and verifying the quantity of medical assistance received by the recipient from the clinic provider.*fn1

If the CAO deemed the recipient to be eligible and within DPW's limited amount, the approved invoices were forwarded to DPW for payment by the controller.*fn2 In the instant case, the Petitioner submitted invoices to CAO in the amount of $331,656 for services provided from May 1, 1976 through January 31, 1980. Although none of the claims were rejected by CAO, DPW only reimbursed Petitioner in the amount of $303,266, the sum $28,390 less than the amount billed.

Petitioner then made various contacts with DPW in an effort to be reimbursed for the $28,390. DPW informed Petitioner by letters dated August 27, 1981 and October 2, 1981, that it would not pay the Petitioner's claim for the $28,390, unless the Petitioner provided specification of the unpaid invoices. The Board

[ 117 Pa. Commw. Page 584]

    that a clinic provider was obligated during the period 1976-1980 to attach a list of invoices, including each patient's name and the amount billed, should that clinic provider desire a detailed explanation of those ...


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