B.L. VS. DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES (DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES) ( 2018 )

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court."
Although it is posted on the internet, this opinion is binding only on the
parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-3997-16T3
B.L.,
Petitioner,
v.
DIVISION OF MEDICAL ASSISTANCE
AND HEALTH SERVICES,
Respondent-Respondent.
FUTURE CARE CONSULTANTS, LLC,
Intervenor-Appellant.
Submitted August 8, 2018 – Decided August 16, 2018
Before Judges Hoffman and Currier.
On appeal from the Division of Medical
Assistance and Health Services.
SB2 Inc., attorneys for appellant (John P.
Pendergast, on the brief).
Gurbir S. Grewal, Attorney General, attorney
for respondent (Melissa H. Raksa, Assistant
Attorney General, of counsel; Jacqueline R.
D'Alessandro, Deputy Attorney General, on the
brief).
PER CURIAM
B.L. is a resident at an assisted living facility; the Office
of the Public Guardian (OPG) was appointed to serve as her plenary
guardian and submitted an application for Medicaid benefits on
B.L.'s behalf. After respondent, New Jersey Department of Human
Services, Division of Medical Assistance and Health Services
(DMAHS) denied the application, OPG appealed, and the matter was
transferred to the Office of Administrative Law (OAL).
Appellant Future Care Consultants, LLC (FCC), the fiscal
agent for the assisted living facility, moved to intervene in the
appeal. OPG submitted a letter opposing the motion, and advising
FCC had requested it be appointed B.L.'s Medicaid Designated
Authorized Representative. That application was pending in the
Superior Court, Chancery Division. After the Chancery judge denied
the motion, FCC requested the OAL grant its motion to intervene.
FCC also filed for guardianship of B.L. in the Chancery Court.
An Administrative Law Judge (ALJ) ordered OPG to file its
opposition to the motion to intervene by March 1. The ALJ advised
he would hear the motion on March 9, the same date as the scheduled
fair hearing.
OPG did not file opposition but instead advised the OAL and
FCC's counsel on March 3 that it was withdrawing the request for
a fair hearing. FCC's motion for guardianship of B.L. had been
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denied by the Chancery judge and after a "careful review," OPG
determined there was no basis to move forward with the hearing.
Despite OPG's withdrawal of its appeal, FCC nevertheless
asked the ALJ to rule on its motion to intervene so that the appeal
might continue to a determination. OPG opposed the motion.
On March 8, 2017, ALJ Morejon determined he could not rule
on FCC's motion as OPG had withdrawn its request for a fair hearing
prior to the return date scheduled for the motion. Therefore, the
motion to intervene was moot.
Upon receipt of the ALJ's ruling, FCC requested DMAHS re-open
the administrative appeal. DMAHS did not respond.
On appeal, FCC does not dispute the ALJ's ruling that the
motion to intervene was moot; instead, it asserts that DMAHS must
re-open the appeal and transfer it to the OAL.
Our review of an administrative agency's determination is a
limited one. We will "not disturb an administrative agency's
determinations or findings unless there is a clear showing that
(1) the agency did not follow the law; (2) the decision was
arbitrary, capricious, or unreasonable; or (3) the decision was
not supported by substantial evidence." In re Virtua-West Jersey
Hosp. Voorhees for a Certificate of Need, 194 N.J. 413, 422 (2008).
The burden is upon the appellant to demonstrate grounds for
reversal. McGowan v. N.J. State Parole Bd., 347 N.J. Super. 544,
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563 (App. Div. 2002); see also Bowden v. Bayside State Prison, 268
N.J. Super. 301, 304 (App. Div. 1993) (holding that "[t]he burden
of showing the agency's action was arbitrary, unreasonable[,] or
capricious rests upon the appellant.").
We are satisfied DMAHS was not arbitrary or capricious in not
accommodating FCC's request to re-open the appeal. OPG was the
lawfully appointed plenary guardian of B.L. It alone had the
statutory power to pursue or defend litigation on her behalf. See
N.J.S.A. 3B:12-25. FCC's application to assume guardianship of
B.L. was denied by the Chancery judge. Therefore, it had no
authority to bring any claim in her name. Once OPG withdrew its
request for a fair hearing prior to a determination of FCC's
intervention motion, the motion was rendered moot. Only OPG had
the authority to continue the claim before the OAL. As a result,
DMAHS properly declined to respond to FCC's request to re-open the
case.
Appeal is dismissed.
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