IN THE MATTER OF COUNTY OF ONEIDA, PETITIONER-PLAINTIFF-RESPONDENT,
HOWARD A. ZUCKER, M.D., J.D., AS COMMISSIONER OF NEW YORK STATE DEPARTMENT OF HEALTH AND NEW YORK STATE DEPARTMENT OF HEALTH, RESPONDENTS-DEFENDANTS-APPELLANTS.
T. SCHNEIDERMAN, ATTORNEY GENERAL, ALBANY (VICTOR PALADINO OF
COUNSEL), FOR RESPONDENTS-DEFENDANTS-APPELLANTS.
WHITEMAN, OSTERMAN & HANNA LLP, ALBANY (CHRISTOPHER E.
BUCKEY OF COUNSEL), FOR PETITIONER-PLAINTIFF-RESPONDENT.
PRESENT: WHALEN, P.J., SMITH, PERADOTTO, DEJOSEPH, AND
from a judgment (denominated order and judgment) of the
Supreme Court, Oneida County (Bernadette T. Clark, J.),
entered December 7, 2015 in a CPLR article 78 proceeding and
declaratory judgment action. The judgment denied the motion
of respondents to dismiss petitioner's first cause of
action and directed respondents to pay petitioner's
reimbursement claim in the amount of $251, 467.
hereby ORDERED that the judgment so appealed from is
unanimously reversed on the law without costs, the second
decretal paragraph is vacated, the motion is granted and the
first cause of action is dismissed.
Petitioner-plaintiff (petitioner) commenced this combined
CPLR article 78 proceeding and declaratory judgment action
seeking, inter alia, to compel respondents-defendants
(respondents) to pay claims that petitioner submitted to
respondents, in which petitioner sought reimbursement for
Medicaid expenditures known as overburden expenditures
(see e.g. Matter of County of Chautauqua v Shah, 126
A.D.3d 1317, 1317, affd sub nom. Matter of County of
Chemung v Shah, 28 N.Y.3d 244). In the first cause of
action in the petition-complaint (petition), petitioner
alleged that respondents failed to act upon a claim within
the time limits set forth in 18 NYCRR 601.4, and that
respondents therefore had a ministerial duty to pay the claim
without regard to its underlying merits. Respondents appeal
from a judgment that denied their motion to dismiss the first
cause of action and granted petitioner's request for
judgment in its favor on that cause of action. We agree with
respondents that Supreme Court erred in denying their motion.
regulation at issue states that respondents are responsible
for examining claims such as the one at issue here, and
respondents' "[i]nitial determinations objecting to
the allowability of a claim for reimbursement will be made in
a timely manner not to exceed 90 days from the time of
receipt by [respondents], unless [respondents notify
petitioner] that a specified amount of additional time, not
to exceed an additional 90 days, is necessary to complete
examination of the claim" (18 NYCRR 601.4). In the claim
at issue on this appeal, the court concluded that respondents
notified petitioner, on the 87th day after receipt of the
claim, that they required up to an additional 90 days in
which to determine the claim, and then denied it on the 179th
day after receiving the claim. The court found that the
denial of the claim was untimely because the court
interpreted the regulation as mandating that the additional
90 days began to run on the day that petitioner received the
notice that respondents required additional time, with the
result that the denial was issued 92 days after the notice
well settled that "the interpretation given to a
regulation by the agency which promulgated it and is
responsible for its administration is entitled to deference
if that interpretation is not irrational or
unreasonable" (Matter of Gaines v New York State
Div. of Hous. & Community Renewal, 90 N.Y.2d 545,
548-549; see Matter of IG Second Generation Partners L.P.
v New York State Div. of Hous. & Community Renewal, Off.
of Rent Admin., 10 N.Y.3d 474, 481). "Put another
way, the courts will not disturb an administrative
agency's determination unless it lacks any rational
basis" (IG Second Generation Partners L.P., 10
N.Y.3d at 481, citing Matter of Gilman v New York State
Div. of Hous. & Community Renewal, 99 N.Y.2d 144,
interpretation of the regulation is that the additional 90
days is added to the initial 90 days so that, upon notifying
petitioner that it required additional time in which to
determine the claim, respondents had a total of 180 days in
which to make the determination. We agree with respondents
that their interpretation of the regulation is rational and
entitled to deference. There is no indication in the part of
the regulation at issue that the additional time began to run
upon receipt of notice by petitioner, whereas a subdivision
of the same regulation states that "reductions,
recoupments or adjustments when made by [respondents] are
final and binding when [petitioner] is notified that the
reduction, recoupment or adjustment has been or will be
made" (18 NYCRR 601.4 [h]). Three other subdivisions
contain similar references to receipt of notice by a claimant
(see 18 NYCRR 601.4 [e], [f], [g]). Regulations are
generally subject to the same canons of construction as
statutes (see Matter of ATM One v Landaverde, 2
N.Y.3d 472, 477). One such canon provides that, "
[w]here a law expressly describes a particular act, thing or
person to which it shall apply, an irrefutable inference must
be drawn that what is omitted or not included was intended to
be omitted or excluded' " (Matter of Town of
Riverhead v New York State Bd. of Real Prop. Servs., 5
N.Y.3d 36, 42-43). Thus, respondents rationally concluded
that, inasmuch as the part of the regulation at issue
contains no language supporting the interpretation advanced
by petitioner and adopted by the court, that language was
" intended to be omitted or excluded' "
(id. at 43).
to petitioner's contention, there is no evidence that
respondents previously interpreted the regulation in the
manner advanced by petitioner. The mere fact that respondents
issued their denials prior to the expiration of the full 180
days on three other claims, all decided at the same time, is
not evidence that such action was meant to indicate that such
a course of action was required, particularly in view of the
unique circumstances of those simultaneous denials.
it is well settled that, "[a]bsent an express limitation
upon the power of a particular agency to act after the
expiration of the relevant statutory period, the time limits
within which an administrative agency must act generally are
construed as discretionary" (Matter of Meyers v
Maul, 249 A.D.2d 796, 797, lv denied 92 N.Y.2d
807). As the Court of Appeals noted, " [a] rule that
rendered every administrative decision void unless it was
determined in strict literal compliance with statutory [or
regulatory] procedure would not only be impractical but would
also fail to recognize the degree to which broader public
concerns, not merely the interests of the parties, are
affected by administrative proceedings' "
(Matter of Dickinson v Daines, 15 N.Y.3d 571, 575).
Even assuming, arguendo, that the regulatory time limit was
exceeded by one or two days, we conclude that ...