64 Pa. Commw. 178 | Pa. Commw. Ct. | 1982
Opinion by
This is an appeal by the Commonwealth of Pennsylvania, Department of Public Welfare (DPW), from a decision of the Board of Claims ordering DPW to pay Ludlow Clinical Laboratories, Inc. (Ludlow) $1,394,327.38 plus interest. The amount of the award constituted moneys remaining unpaid by DPW on in
The facts, as found by the Board of Claims (Board), indicate that Ludlow commenced its clinical laboratory business effective September, 1972, the month in which its licensing and approval from all the necessary governmental entities became operative.
Although the regional director of HEW sent Ludlow a letter dated August 31, 1974, affirming that agency’s position that Ludlow continued to meet its standards of operation, DPW informed the lab in September, 1974, that invoices, as yet unpaid, for services rendered prior to August 15, 1974, were not being processed for payment pending the outcome of another Utilization Review.
Reimbursement for those invoices was received the following November; however, Ludlow was notified by letter of January 24,1975, that invoices submitted for services performed after August 15, 1974, would not be honored by DPW. The letter demanding restitution of $1,344,842.94, charged Ludlow with overbilling, inability to produce records to adequately substantiate
In April, 1975, Ludlow filed this action with the Board,
In examining the allegation made by DPW that Ludlow materially breached their contract, the Board
Concerning the assertion that the fee schedules were improperly used, because Ludlow had a separate schedule for physicians, the Board again noted that DPW had known of this since Ludlow filed its schedules and it had not notified Ludlow that this was in violation of their contract. Furthermore, the Board noted that this was a common practice in the trade.
Relative to the allegation that Ludlow had improperly billed DPW for charges that should have been directed to HEW, the Board found that Ludlow had incorrectly directed the payment to DPW, and therefore could not claim that DPW’s failure to notify it of the error justified its demand for reimbursement. The Board therefore dismissed that portion of the complaint.
In its appeal to this Court, DPW raises the same issues, and additionally questions whether the Board erred in finding its counterclaim unsupported.
It is clear that an order of the Board must be affirmed unless we find that it is not in accordance with the law or that there is not substantial evidence to support the findings of fact.
Department of Transportation v. Paoli Construction Co., 35 Pa. Commonwealth Ct. 390, 392, 386 A.2d 173, 174 (1978).
Our examination of the record indicates that the findings are based on testimony and exhibits present in the record, and they must therefore be accepted by this Court. Department of Transportation v. DePaul, 29 Pa. Commonwealth Ct. 447, 371 A.2d 261 (1977).
Concerning the counterclaim filed by DPW, the Court determines that the Board’s exercise of its prerogative to resolve issues of fact and credibility disposes of the matter. Had the Board made findings which settled such issues in the opposite manner, then, ipso facto, the counterclaim would have been supported by substantial evidence. This Court, however, cannot alter properly made findings. DePaul, supra.
We therefore affirm the order of the Board entering judgment for Ludlow Clinical Laboratories, Inc.
Order
And Now, this 19th day of January, 1982, the Order of the Board of Claims dated August 22, 1980, entering judgment in favor of Ludlow Clinical Laboratories, Inc. and against the Commonwealth of Pennsylvania in the amount of $1,394,327.38 plus interest from January 24,1975 is affirmed.
The U.S. Department of Health, Education and Welfare, the Commonwealth of Pennsylvania, Department of Health, and DPW all provided the necessary authorizations.
Excerpt from letter of January 7, 1975 from the president of Ludlow to its customers.
Then, the Board of Arbitration of Claims.
Section 4 of the Act of October 5,1978, P.L. 1104, 72 P.S. §4651-6, reads in pertinent part:
The board shall have no power and exercise no jurisdiction over a claim asserted against the Commonwealth unless the claim shall have been filed within six months after it accrued.