UNITED HEALTH, INC., ET AL., APPELLANTS,
v.
DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES, APPELLEE
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Licensed long-term care facilities appealed the Department of Health and Rehabilitative Services' denial of their request for formal administrative hearings challenging a frozen Medicaid reimbursement rate. The court reversed, holding that appellants were entitled to section 120.57 administrative hearings to seek monetary relief even if the underlying validity of the rate-freeze rule might need to be challenged separately.
Appellants were entitled to section 120.57 administrative hearings because their substantial interests had been affected by agency action and they sought monetary relief unavailable in other proceedings. The department's position that appellants must exhaust a rule challenge before pursuing a section 120.57 proceeding lacks legal authority and is impracticable given the timing requirements.
[1] A party is entitled to a formal administrative hearing under section 120.57(1), Florida Statutes, if they demonstrate that their substantial interests have been affected…
[2] Monetary relief sought by a party affected by agency action cannot be obtained in a section 120.56 rule challenge proceeding.
Previewing 2 of 5 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“To be entitled to a section 120.57 hearing, a party must establish that its substantial interest has been affected by agency action. To accomplish this, a party must show (1) that he will suffer injury in fact which is of sufficient immediacy to entitle him to a section 120.57 hearing, and (2) that his substantial injury is of the type or nature which the proceeding is designed to protect.”
Establishes the legal standard for entitlement to administrative hearing
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Join FLexlaw to unlock all legal intelligenceThe department notified appellants of their Medicaid reimbursement per diem rate effective January 1, 1990, which had been frozen at the December 31, …
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PER CURIAM.
Appellants, licensed long-term care facilities, appeal final orders of the Department of Health and Rehabilitative Services denying their request for formal administrative proceedings under section 120.57(1), Florida Statutes.
The department notified appellants of their Medicaid reimbursement per diem rate, effective January 1, 1990. The rate had been frozen at the December 31, 1989 level pursuant to Rule 10C ER89-21 and Rule 10C-7.0482, Florida Administrative Code. Appellants filed petitions requesting a formal administrative hearing, contesting the department’s alleged unlawful rate determination, and requesting monetary relief. By final order, the department denied appellants’ request for a hearing, asserting that appellants’ petitions constituted a chai- lenge to its rule implementing the rate freeze, and that such challenges cannot be heard in a section 120.57(1) or (2) administrative hearing. We reverse.
To be entitled to a section 120.57 hearing, a party must establish that its substantial interest has been affected by agency action. To accomplish this, a party must show (1) that he will suffer injury in fact which is of sufficient immediacy to entitle him to a section 120.57 hearing, and (2) that his substantial injury is of the type or nature which the proceeding is designed to protect. Agrico Chemical Co. v. Department of Environmental Regulation, 406 So. 2d 478 (Fla. 2d DCA 1981), rev. denied, 415 So. 2d 1359 (Fla.1982).
Appellants’ petitions demonstrate that their substantial interests have been affected by agency action. They are seeking monetary relief which is not available in a section 120.56 proceeding. Greynolds Park Manor v. Department of Health and Rehabilitative Services, 491 So. 2d 1157 (Fla. 1st DCA 1986).
Even if, as the department argues, the validity of Rule 10C-7.0482 may have to be questioned in a rule challenge proceeding in order to finally determine appellants’ entitlement to the relief sought, nothing precludes appellants from filing a rule challenge in conjunction with their 120.57 proceeding, and thereafter requesting either a consolidation of the proceedings, or a stay of the 120.57 proceeding until the rule challenge is resolved.
There is no authority for the department’s position that appellants must exhaust their rule challenge before they can properly request a 120.57 proceeding. Further, contrary to the position urged by the department in oral argument before this court, it would have been impracticable, if not impossible, for appellants to have sought a 120.56 rule challenge proceeding and have it resolved before they were required to file a timely petition for a 120.57 proceeding. (See, Model Rule 28-5.111, Florida Administrative Code, which requires that persons requesting a 120.57 proceeding file their petition within twenty-one days of receipt of the written notice of the agency decision, and Department of Health and Rehabilitative Services Rule 10-2.031, Florida Administrative Code, adopting this model rule of procedure.)
REVERSED and REMANDED for proceedings consistent with this opinion.
SMITH, NIMMONS and MINER, JJ., concur.
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Winick v. Dep't of Child. & Fam. Servs., 161 So. 3d 464 (Fla. 2d DCA 2014)…adequate, the applicable statute provides that “[fjailure to proceed under [*469] this section shall not constitute failure to exhaust administrative remedies.” § 120.56(1)(e); see also United Health, Inc. v. Dep’t of Health & Rehabilitative Servs., 579 So. 2d 342, 342-43 (Fla. 1st DCA 1991) (holding no requirement to exhaust rule challenge before contesting Medicaid reimbursement rate determination and requesting monetary relief). Additionally, exhaustion of administrative remedies is not required where non…
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A.W. LEE, Jr. v. State of Fla. Dep't OF Transp., 596 So. 2d 802 (Fla. 1st DCA 1992)…ppellant to remove the signs. A party is not foreclosed from initiating a rule challenge under section 120.56 and consolidating it with a section 120.57 enforcement proceeding. See, e.g., United Health, Inc. v. Department of Health & Rehab. Servs., 579 So. 2d 342, 343 (Fla. 1st DCA 1991); Department of Revenue v. U.S. Sugar Corp., 388 So. 2d 596, 597 (Fla. 1st DCA 1980). Appellant, however, having failed to initiate a rule challenge under section 120.56 or argue the rule’s invalidity until after the evidenti…
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Authorities Cited
- Agrico Chem. Co. v. Dep't OF Env't Reg., 406 So. 2d 478 (Fla. 2d DCA 1981)
- Greynolds Park Manor, Inc. v. Dep't of Health & Rehabilitative Servs., 491 So. 2d 1157 (Fla. 1st DCA 1986)