Appeal from the Circuit Court of Cook County. 01 CH 03281 The Honorable Dorothy Kirie Kinnaird Judge Presiding.
The opinion of the court was delivered by: Justice Greiman
This appeal arises out of the Illinois Department of Public Aid's decision to terminate the eligibility of the plaintiff, Dr. Jia Hwang, to participate as a provider in the Illinois Medical Assistance Program. 305 ILCS 5/5-1 et seq. (West 2000). The Medical Assistance Program is commonly referred to as Medicaid. State law requires that providers of medical services under Medicaid keep detailed records and make the records available to the Department of Public Aid (Department) for routine inspection. Plaintiff was ultimately terminated as a provider because he ignored repeated requests from the Department to inspect his medical records.
On September 20, 2000, the Department notified plaintiff regarding his possible termination and his right to a hearing. Specifically, the notification sent to plaintiff stated that he had 10 days to request a hearing; however, plaintiff never made such a request. On October 16, 2000, the date on which the hearing would have been held had one been requested, the Department proved up service of the notice sent to plaintiff. The administrative law judge then issued a recommended decision finding plaintiff in default and recommending that the Department's proposed action be final and binding. On January 22, 2001, the Director of the Department of Public Aid adopted the recommended decision as her final decision.
On February 26, 2001, plaintiff filed a complaint for administrative review in the circuit court of Cook County, Illinois. Plaintiff also sought a stay of the Department's decision. On administrative review, plaintiff argued that he received improper notice of the Department's proposed action against him. The trial court denied the stay and affirmed the Department's decision. Plaintiff appeals from the trial court's decision to uphold the ruling of the Department.
The issues presently before us are (1) whether plaintiff was provided proper notice; (2) whether, due to plaintiff's default, he is precluded from raising any issues other than subject matter or personal jurisdiction; (3) assuming plaintiff is not barred from raising other issues, whether the Department of Public Aid was entitled to adopt a default procedure and terminate plaintiff as a provider in the absence of additional evidence; (4) whether the Department of Public Aid gave plaintiff proper notice of its default motion; (5) whether the Department of Public Aid properly notified plaintiff of its final decision; and (6) whether the trial court properly denied plaintiff's request for a remand.
We affirm the trial court's decision to uphold the administrative ruling. More specifically, we hold that plaintiff was provided proper notice and that, due to plaintiff's default, he is precluded from raising any issues other than subject matter or personal jurisdiction. Consequently, there is no need for us to discuss any issues beyond whether plaintiff was provided proper notice.
The Medical Assistance Program, contained in Article V of the Public Aid Code (the Code) (305 ILCS 5/5-1 et seq. (West 2000)) and in the regulations of the Department of Public Aid, sets out the plan for administering Medicaid in Illinois. Section 5-5 of the Code states that the Department of Public Aid must require health care providers enrolled in the program to "maintain records that document the medical care and services provided to recipients of Medical Assistance under this Article." 305 ILCS 5/5-5 (West 2000).
On eight separate dates, between late February and early June 2000, the Department of Public Aid made 14 requests that plaintiff furnish his medical records to the Department or make them available for inspection. These requests were made by telephone, facsimile, regular mail, certified mail, and personal delivery. Despite these requests, the Department contends that plaintiff failed to submit his records or make them available.
On September 20, 2000, the Department issued to plaintiff a "Notice of Right to Hearing and Department Action to Terminate." The notice specifically stated that the Department had determined that plaintiff had failed to furnish or make available his medical records and, therefore, the Department was seeking to terminate his eligibility to participate in the program. Pursuant to the notice, plaintiff was advised that he had the right to request a hearing, and that if a hearing was requested, it would be held on October 16, 2000. Accompanying the notice was a "Statement of Grounds," listing each unsuccessful request for records, the dates of the requests, and the methods by which the requests had been made.
The September 20, 2000, notice and the accompanying statement of grounds were sent to plaintiff via certified mail, return receipt requested, at three addresses. Specifically, notice was sent to (1) Highland Medical Center, 8201 South Ashland Avenue, Chicago, Illinois 60620; (2) South Shore Hospital, 8015 South Luella, Suite 211, Chicago, Illinois 60617; and (3) South Shore Hospital, 8012 South Crandon, Chicago, Illinois 60617. Each envelope was addressed to plaintiff. Despite this request and all earlier requests, plaintiff failed to request a hearing on the Department's intended action to terminate his participation in the program.
On October 16, 2000, the date the hearing would have been held had it been requested, counsel for the Department appeared before the administrative law judge and asked that plaintiff be found in default. Counsel for the Department tendered to the administrative law judge a certified mail return receipt showing delivery of the notice and the accompanying statement of grounds to South Shore Hospital. The signature on the return receipt is illegible.
On October 16, 2000, the administrative law judge issued a recommended decision finding that plaintiff's eligibility should be terminated. The administrative law judge determined that plaintiff had been served with the notice, that the notice adequately informed plaintiff of his right to request a hearing, and that plaintiff had not made such a request and had not appeared on October 16, 2000. The administrative law judge also noted that under the Department's regulations, its action becomes final and binding when a respondent fails to request a hearing or fails to appear at a hearing without good cause. Thus, the administrative law judge concluded that the Department's action was final and binding.
A copy of the recommended decision, along with a letter notifying plaintiff of his right to file written exceptions with the Director within 10 days, was mailed to plaintiff at South Shore Hospital. The record does not reflect that plaintiff filed exceptions to the recommended decision.
On January 22, 2001, the Director of the Department of Public Aid adopted the recommended decision as the decision of the Department and terminated plaintiff's eligibility. The Director notified plaintiff of her decision in a letter dated January 22, 2001. The Director's letter informed plaintiff of his right to seek administrative review of the decision by filing a complaint within the circuit court within 35 days.
On February 26, 2001, plaintiff filed a timely complaint for administrative review in the circuit court. The complaint alleged that the Department's decision was contrary to law and violated due process because the Department improperly gave notice of its proposed action and hearing.
In May 2001, after the Department filed the administrative record, plaintiff moved for a stay of the Department's decision on three grounds. First, plaintiff asserted that his due process rights had been violated because the record did not establish that he had been given notice. Plaintiff specifically argued that notice was not proper because the signature on the return receipt is illegible. Second, plaintiff argued that his due process rights had been violated because the Department had not held a "prove-up." Plaintiff submitted his own affidavit and the affidavit of a Highland Medical Clinic employee stating that on an unspecified date a representative of the Department had come to his office to review his medical records and said that she would return to complete the review, but never did. Third, plaintiff complained that the administrative law judge's recommended decision was sent to the 8012 South Crandon address and the evidence in the record did not show that he received it.
The Department responded to the motion for stay and plaintiff replied. On June 7, 2001, the trial court denied the motion for stay without prejudice, permitting plaintiff to file ...