170 A.3d 269
Me.2017Background
- Dr. Stephen Doane, a Maine-licensed physician, was censured by the Board of Licensure in Medicine for prescribing-related failures; the Board renewed his license subject to probation and costs.
- The Maine Department of Health and Human Services (DHHS) notified Doane it would terminate his participation and reimbursement in MaineCare based on MaineCare Manual rules and federal Medicaid authority; it provided administrative informal review and hearing rights under the Manual.
- Doane sought a declaratory judgment in Superior Court that termination from MaineCare is a ‘‘license’’ revocation within the meaning of the Administrative Procedure Act (APA) and therefore falls under the District Court’s exclusive original jurisdiction; he sought to enjoin the administrative process.
- The Superior Court granted summary judgment for Doane, holding that participation/reimbursement in MaineCare is a ‘‘license’’ under 5 M.R.S. § 8002(5) and 4 M.R.S. § 152(9), so the District Court has jurisdiction.
- The Law Court vacated that judgment, holding that termination of MaineCare provider participation is not a ‘‘license revocation’’ of the kind the Legislature intended for District Court jurisdiction; DHHS’s administrative process (and Superior Court review under the APA) governs these sanctions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether termination of MaineCare participation is a "license" revocation under the APA | Doane: MaineCare participation is a statutory "approval"/permission and fits the APA definition of "license," so District Court has exclusive jurisdiction | DHHS: MaineCare provider status is contractual/administrative under the MaineCare Manual and subject to DHHS adjudication and Superior Court APA review, not a statutory license revocation | Held for DHHS: MaineCare termination is not the sort of professional license revocation placed in District Court; DHHS's administrative scheme controls |
| Whether the Legislature intended District Court jurisdiction over DHHS MaineCare sanctions | Doane: Broad APA definition of "license" and text of §152(9)/§10051(1) support District Court jurisdiction | DHHS: Statutory exceptions and the structure of licensing statutes show Legislature reserved professional licensing (e.g., Board of Licensure in Medicine) for other processes; MaineCare sanctions are distinct | Held: Statutory scheme and exceptions indicate license revocation jurisdiction refers to traditional professional licensing, not program participation under MaineCare |
| Proper forum for initial adjudication of MaineCare sanctions | Doane: Agency decision affects physician practice and thus merits neutral forum (District Court) | DHHS: Manual grants informal review, administrative hearing, final agency decision, and Superior Court APA appeal; DHHS is proper initial decisionmaker | Held: DHHS and its administrative process are the proper initial forum; Superior Court review under the APA (not District Court) applies |
| Effect of overlapping professional discipline (Board censure) and DHHS sanctions | Doane: Overlap does not alter that DHHS action is an APA "license" revocation | DHHS: Board licensing is the State’s exercise of police power over medical practice; MaineCare sanctions are program-specific and not a substitute for license revocation | Held: Board of Licensure is the State authority to revoke medical licenses; DHHS sanctions are programmatic and limited to MaineCare participation |
Key Cases Cited
- Grant v. Foster Wheeler, LLC, 140 A.3d 1242 (Me. 2016) (summary judgment standard and use of undisputed facts)
- Darling’s II (Ford Motor Co. v. Darling's), 151 A.3d 507 (Me. 2016) (statutory interpretation principles; avoid absurd results)
- Houlton Band of Maliseet Indians v. Boyce, 688 A.2d 908 (Me. 1996) (futility exception to administrative exhaustion)
- State v. Pelletier, 125 A.3d 354 (Me. 2015) (state police power to protect health and safety)
- Zablotny v. State Bd. of Nursing, 89 A.3d 143 (Me. 2014) (discussion of board adjudicatory paths for professional licensing)
- Midland Funding LLC v. Walton, 155 A.3d 864 (Me. 2017) (de novo review of subject-matter jurisdiction)