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PENNSYLVANIA DENTAL ASSOCIATION v. COMMONWEALTH PENNSYLVANIA (12/20/88)

decided: December 20, 1988.

PENNSYLVANIA DENTAL ASSOCIATION, PETITIONER
v.
COMMONWEALTH OF PENNSYLVANIA, INSURANCE DEPARTMENT, RESPONDENT



Appeal from the Order of the Pennsylvania Insurance Department in the case of Re: Blue Shield Filings Nos. 6-W-1987 and 7-W-1987, dated September 11, 1987.

COUNSEL

Thomas A. Beckley, with him, John G. Milakovic, Beckley & Madden, for petitioner.

Arthur Selikoff, Assistant Counsel, with him, Terrance J. Fitzpatrick, Chief of Litigation, and Linda J. Wells, Chief Counsel, for respondent.

Thomas E. Wood, Keefer, Wood, Allen & Rahal, for intervening respondent, Pennsylvania Blue Shield.

President Judge Crumlish, Jr., Judge McGinley, and Senior Judge Narick, sitting as a panel of three. Opinion by Judge McGinley. Judge MacPhail did not participate in the decision in this case.

Author: Mcginley

[ 122 Pa. Commw. Page 242]

Pennsylvania Dental Association (PDA) appeals a decision of the Pennsylvania Insurance Department (Department) which denied PDA's Petition to Intervene in a statutory comment procedure under Section 6329(b) of the Professional Health Service Plan Corporations Act (Act), 40 Pa. C.S. ยง 6329(b). We affirm.

On July 13, 1987, the Medical Service Association of Pennsylvania, d/b/a Pennsylvania Blue Shield (Blue Shield) submitted Filing No. 7-W-1987 to the Department requesting the Department's approval of a two percent (2%) increase to dentists under Blue Shield's dental program pursuant to the Act. Simultaneously, Blue Shield Filing No. 6-W-1987 requested a two and one-half percent (2 1/2%) payout increase to physicians under Blue Shield's medical surgical programs.

The Department published notices of the filings and of the opportunity to submit comments in the Pennsylvania Bulletin on August 1, 1987. 17 Pa.B. 3286. An administrative hearing on the filing was not scheduled.*fn1

[ 122 Pa. Commw. Page 243]

In letters to the Department dated August 31, 1987, PDA informed the Department of PDA's interest in assuring an adequate increase, and in obtaining fair treatment because of the discrepancy in the proposed payout for dentists as compared to the proposed payout to physicians. PDA requested that the Department require Blue Shield to produce for inspection ". . . all documents, studies, statistics and other information relevant to Filing No. 7-W-1987."*fn2 An identical request was made pertaining to Filing No. 6-W-1987, relating to physicians.*fn3 Accompanying the letters were written Petitions to Intervene in the rate proceedings and a Motion to Consolidate. PDA also sought a formal acknowledgment by the Department that PDA would have the right to review the requested documentation and submit its position to the Department before the Department acted upon the filings.

By letter dated September 11, 1987, the Department informed PDA that there would be no formal administrative proceeding on the filings and forwarded PDA requests to a Department actuary to be considered as comments as set forth in the Pennsylvania Bulletin notice.*fn4 No date was supplied. After a similar exchange of correspondence the PDA petitioned our Court for review.

Our scope of review is limited to a determination of whether an error of law was committed, constitutional rights were violated, or whether necessary findings of fact are supported by substantial evidence. Estate of McGovern v. State ...


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