1. Administrative Law--declaratory ruling--underlying cases
previously decided--ruling undesirable
The trial court did not err by affirming a final agency
decision by the North Carolina Department of Health and Human
Services (DHHS) declining to issue a declaratory ruling regarding
Medicaid coverage for aliens where DHHS had previously decided
the actual cases from which petitioners drew their facts. The
APA requires agencies to issue declaratory rulings to aggrieved
parties as to the validity of a rule or the applicability of a
set of facts, with an exception when the agency for good cause
finds the issuance of a ruling undesirable. Respondents in this
case believed that ruling on two cases upon which it had already
ruled would be a waste of resources; this clearly constitutes
good cause.
2. Appeal and Error--preservation of issues--issues not raised
at trial--issues not assigned as error
Issues not before the trial court and not assigned as error were
not considered.
Appeal by petitioners from judgment entered 19 April 2000 by
Judge Stafford G. Bullock in Wake County Superior Court. Heard
in the Court of Appeals 19 April 2001.
Turner, Enochs & Lloyd, P.A., by Melanie M. Hamilton, Thomas
E. Cone, and Wendell H. Ott, for petitioner-appellants.
Michael F. Easley, Attorney General, by Grady L. Balentine,
Jr., Assistant Attorney General, for the respondent-
appellees.
THOMAS, Judge.
Petitioners, Charlotte-Mecklenburg Hospital Authority, Duke
University Medical Center, Mission-St. Joseph's Health System,
Inc., Moses Cone Health System, the North Carolina Baptist
Hospitals, Inc., and Wake Medical Center, appeal from the trial
court's order affirming the respondents' decision to decline
issuing a declaratory ruling. Petitioners set forth one
assignment of error. For the reasons discussed herein, we affirm
the trial court.
The facts are as follows: Petitioners are medical service
providers whose patients include legal aliens here on a temporary
visa who experience emergency medical conditions. Respondent,
the North Carolina Department of Health and Human Services
(DHHS), Division of Medical Assistance (DMA), has denied Medicaid
coverage for the aliens because they are in North Carolina on
currently unexpired visas. The denial of Medicaid coverage at
issue is based on DHHS's policy, set out in two manuals published
by DMA: the North Carolina Family and Children's Medicaid Manual
(MAF Manual) and the North Carolina Aged, Blind and Disabled
Medicaid Manual (MABD Manual). The relevant language of the MAF
Manual reads:
Non-immigrants may be legally admitted to the
U.S., but only for a temporary or specified
period of time. These aliens are NOT
ELIGIBLE for full Medicaid or emergency
medical services because they do not meet the
N.C. residency requirement.
NOTE: An alien admitted for a limited
period of time who does not leave the
U.S. when the period of time expires
becomes an illegal alien. If he then
establishes N.C. residency, he may be
eligible for emergency Medicaid only.
The North Carolina Family and Children's Medicaid Manual § 3404
(III.E.3) (emphasis in original). The relevant language
contained in the MABD Manual is identical. See The North
Carolina Aged, Blind & Disabled Medicaid Manual § 2504 (III.E.3).
On 29 March 1999, petitioners filed a petition with DHHS,
requesting a declaratory ruling that the provisions contained in
the two manuals referenced above are: (a) inconsistent with
superior federal and state law and regulations; (b) unenforceable
because they have not been properly promulgated in accordance
with the North Carolina Administrative Procedure Act; and (c)
invalid, void, and of no effect. As part of their petition,
petitioners offered factual scenarios of two aliens whose
applications for Medicaid coverage had been denied.
On 27 May 1999, DHHS sent a letter to petitioners informing
them of its refusal to issue a declaratory ruling. The reason
given was that the factual situations upon which petitioners
based their request are actual cases DHHS already decided in two
separate administrative hearings. On 21 June 1999, petitioners
then filed a Petition for Judicial Review in Wake County Superior
Court challenging DHHS's decision not to issue a declaratory
ruling. The trial court affirmed DHHS's decision on 19 April
2000. From this order petitioners appeal.
[1]By their only assignment of error, petitioners argue the
trial court erred in affirming the final agency decision
declining to issue a declaratory ruling. We disagree.
The North Carolina Administrative Procedure Act (APA)
establishes a uniform system of administrative adjudicatoryprocedures for North Carolina agencies, including DHHS. N.C.
Gen. Stat. § 150B-1 et seq. (1986). The APA requires agencies to
issue declaratory rulings to aggrieved parties as to the validity
of a rule, or the applicability of a set of facts to a statute
administered by the agency or of a rule or order of the agency.
Id. at § 150B-4(a). An exception to that requirement is when the
agency for good cause finds the issuance of a ruling undesirable.
Id. Additionally, the APA requires each agency to prescribe in
its rules the circumstances in which declaratory rulings shall or
shall not be issued. Id. Thus, pursuant to the APA's mandate,
DHHS adopted in its rules the following provision: Whenever the
Secretary [of DHHS] or his designee believes for good cause that
the issuance of a declaratory ruling is undesirable, he may
refuse to issue one. 10 N.C. Admin. Code tit. 10, r. 1B.0108(c)
(Nov. 1989).
In the instant case, respondents believed the issuance of a
declaratory ruling was undesirable because the two factual
situations upon which petitioners based their request for a
declaratory ruling are actual cases DHHS decided in two separate
administrative hearings. Petitioners are in fact asking DHHS to
rule on two cases upon which it has already ruled. Respondents
believed, and we agree, that this would be a waste of
administrative resources, and is clearly unnecessary.
The nature of the error asserted by the party seeking
judicial review of an agency decision dictates the proper
standard of review. Christenbury Surgery Ctr. v. N.C. Dep't ofHealth and Human Servs., 138 N.C. App. 309, 311-312, 531 S.E.2d
219, 221 (2000), review improvidently allowed, 353 N.C. 354
(April 6, 2001). If the party seeking review asserts the
agency's decision was affected by a legal error, de novo review
is required. Id. at 312, 531 S.E.2d at 221. Petitioners contend
DHHS erred as a matter of law when it refused to issue a
declaratory ruling and that de novo review is the appropriate
standard. Respondents likewise conceded at the trial court level
that de novo review was appropriate. We hold de novo review is
proper and accordingly proceed.
Here, DHHS believed the issuance of a declaratory ruling was
undesirable, and its refusal is valid under the APA and DHHS
regulations as long as good cause is shown. This Court has
previously held:
good cause exists for denial of a request for
a declaratory ruling where the denial is
based on the existence of a prior agency
ruling which necessarily required an
interpretation of the same statute which is
the subject of the request for declaratory
ruling. To hold otherwise would be to
require an agency to twice decide the same
case, between the same parties, by applying
the same statute to the same facts.
Catawba Mem'l Hosp. v. N.C. Dep't of Human Resources, 112 N.C.
App. 557, 563, 436 S.E.2d 390, 393 (1993). For these purposes,
the statutes at issue in Catawba are the equivalent of the
regulations at issue in this case. Thus, the fact DHHS had
previously decided the actual cases from which petitioners drew
their facts clearly constitutes good cause under Catawba. Therefusal to issue a declaratory ruling was proper under the APA
and DHHS regulations, and in accordance with our holding in
Catawba. We therefore reject the assignment of error.
[2]Petitioners next contend DHHS's policy regarding aliens
here on a temporary visa is in conflict with state and federal
law. However, the issue was not assigned as error by
petitioners. Accordingly, this argument is not properly before
us. N.C.R. App. P. 10(a) (2000). Even if petitioners had
assigned it as error, however, the merits of the policy regarding
Medicaid coverage was never before the trial court and is not an
issue for us to consider.
Petitioners also contend DHHS's policy, set out in the MAF
and MABD Manuals, is invalid because it was not promulgated in
accordance with the APA. However, petitioners likewise failed to
assign the issue as error and we do not consider it. N.C.R. App.
P. 10(a) (2000).
Accordingly, as to the issue properly before us, we affirm
the trial court.
AFFIRMED.
Judges Martin and Biggs concur.
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