TEXAS DEPARTMENT OF HEALTH and TEXAS DEPARTMENT OF HUMAN SERVICES, Appellants v. TEXAS HEALTH ENTERPRISES, INC., Appellee

SUPREME COURT CASES

Laws-info.com » Cases » Texas » 5th District Court of Appeals » 1993 » TEXAS DEPARTMENT OF HEALTH and TEXAS DEPARTMENT OF HUMAN SERVICES, Appellants v. TEXAS HEALTH ENTERPRISES, INC., Appellee

State: Texas

Court: Texas Northern District Court

Docket No: 05-92-01322-CV

Case Date: 12/10/1993

Plaintiff: TEXAS DEPARTMENT OF HEALTH and TEXAS DEPARTMENT OF HUMAN SERVICES, Appellants

Defendant: TEXAS HEALTH ENTERPRISES, INC., Appellee

Preview:TEXAS DEPARTMENT OF HEALTH and TEXAS DEPARTMENT OF HUMAN SERVICES, Appellants v. TEXAS HEALTH ENTERPRISES, INC., Appellee
Affirmed and Opinion filed December 10, 1993.

S In The Court of Appeals Fifth District of Texas at Dallas ............................ No. 05-92-01322-CV ............................ TEXAS DEPARTMENT OF HEALTH and TEXAS DEPARTMENT OF HUMAN SERVICES, Appellants V. TEXAS HEALTH ENTERPRISES, INC., Appellee .............................................................. On Appeal from the 160th Judicial District Court Dallas County, Texas Trial Court Cause No. 91-12466-H .............................................................. OPINION Before Justices Thomas, Chapman, and Rosenberg Opinion By Justice Rosenberg The Texas Department of Health (TDH) and the Texas Department of Human Services (Human Services) appeal the trial court's summary judgment granted to Texas Health Enterprises, Inc. (the nursing home). Appellants, FN:1 in three points of error, contend that summary judgment is improper because the trial court lacked jurisdiction, rendered an advisory opinion, and did not require the nursing home to exhaust its administrative remedies. We conclude that the trial court properly exercised jurisdiction over this cause. In point of error four, appellants complain that the trial court erred in declaring that Human Services is prohibited from withholding Medicaid vendor payments pending the exhaustion of the nursing home's administrative appeal. We conclude that Human Services did not have the statutory or contractual authority to withhold contract payments pending an administrative challenge. We overrule appellants' points of error. We affirm the trial court's judgment. The nursing home entered into a Medicaid vendor contract with Human Services, the administrator of the State's medical assistance program. TDH, the contract compliance review agency, revoked the nursing home's Medicaid certification after several on-site inspections. TDH decertified the nursing home subject to an informal pretermination review and a full post-termination due process review. TDH notified Human Services that the nursing home was no longer a qualified Medicaid health-care provider. During the appeals process, Human Services canceled its Medicaid vendor contract with the nursing home. The nursing home sought to enjoin Human Services from suspending Medicaid vendor payments during the pendency of its administrative appeal. In seeking injunctive relief, the nursing home challenged neither the rulemaking nor the enforcement authority of appellants. The nursing home urged that Human Services violated its own regulations prohibiting the withholding of Medicaid vendor payments during the pendency of an administrative appeal. The nursing home sought declaratory relief to prevent the wrongful acts of appellants. The nursing home moved for summary judgment. Appellants did not file a response to the summary judgment motion. The trial court granted summary judgment to the nursing home. Appellants filed a motion for new trial. The trial court denied the motion for new trial. TDH and Human Services now
file:///C|/TX/Folder%2002/05-92-01322-cv-11.html[7/20/2013 1:56:50 AM]

appeal. The standards of review of the trial court's grant of a summary judgment are well known. Summary judgment is proper only if the record shows that there is no genuine issue of material fact and that the movant is entitled to judgment as a matter of law. Tex. R. Civ. P. 166a(c); Rodriguez v. Naylor Indus., Inc., 763 S.W.2d 411, 413 (Tex. 1989). The rule provides a method for summarily ending a case that involves only a question of law and no genuine material fact issue. See Gaines v. Hamman, 163 Tex. 618, 358 S.W.2d 557, 563 (1962). In reviewing a summary judgment record, we apply the following standards: (1) the movant for summary judgment has the burden of showing there is no genuine issue of material fact and that it is entitled to judgment as a matter of law; (2) in deciding whether there is a disputed material fact issue precluding summary judgment, we must take evidence favorable to the nonmovant as true; and (3) we indulge every reasonable inference in favor of the nonmovant and resolve any doubts in its favor. Nixon v. Mr. Property Management Co., 690 S.W.2d 546, 548-49 (Tex. 1985). Here, the facts are not in dispute. Accordingly, this is a proper case for a summary judgment. See Gaines, 358 S.W.2d at 563. This case involves a pure question of law: Whether Human Services may withhold Medicaid vendor payments from the nursing home pending the exhaustion of the administrative appeals process challenging either the nursing home's decertification or the cancellation of its Medicaid contract. Human Services administers the federally funded Medicaid program, and TDH certifies health-care facilities as qualified Medicaid providers. See Tex. Hum. Res. Code Ann.

Download 05-92-01322-cv-11.pdf