{
  "id": 3143013,
  "name": "Pinckneyville Medical Group, Claimant, v. The State of Illinois, Respondent",
  "name_abbreviation": "Pinckneyville Medical Group v. State",
  "decision_date": "1988-07-21",
  "docket_number": "No. 87-CC-0962",
  "first_page": "176",
  "last_page": "180",
  "citations": [
    {
      "type": "official",
      "cite": "41 Ill. Ct. Cl. 176"
    }
  ],
  "court": {
    "name_abbreviation": "Ill. Ct. Cl.",
    "id": 8793,
    "name": "Illinois Court of Claims"
  },
  "jurisdiction": {
    "id": 29,
    "name_long": "Illinois",
    "name": "Ill."
  },
  "cites_to": [
    {
      "cite": "39 Ill. Ct. Cl. 150",
      "category": "reporters:state",
      "reporter": "Ill. Ct. Cl.",
      "case_ids": [
        5493847
      ],
      "opinion_index": 0,
      "case_paths": [
        "/ill-ct-cl/39/0150-01"
      ]
    }
  ],
  "analysis": {
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  "last_updated": "2023-07-14T21:56:46.892024+00:00",
  "provenance": {
    "date_added": "2019-08-29",
    "source": "Harvard",
    "batch": "2018"
  },
  "casebody": {
    "judges": [],
    "parties": [
      "Pinckneyville Medical Group, Claimant, v. The State of Illinois, Respondent."
    ],
    "opinions": [
      {
        "text": "Patchett, J.\nThis cause coming on for the Court\u2019s consideration on Respondent\u2019s motion to dismiss, due notice having been given and the Court, being fully advised, makes the following findings:\nThis claim, the caption of which identifies the Claimant as Pinckneyville Medical Group, a medical group practice, in fact presents the vendor-payment claims of Dr. Fozard and Dr. Shanbhag, who are affiliated with that group. In its departmental report, the Illinois Department of Public Aid (IDPA) notes that the individual physicians, rather than the medical group, were enrolled participants in the Department\u2019s Medical Assistance Program (MAP) when the subject services were rendered; and the claim was therefore investigated and reported by IDPA as if filed by the two physician-participants. Because only the individual physicians, and not the group practice, are MAP enrollees, and because group practices as such are not permitted to enroll in IDPA\u2019s program, only the two physicians would have standing to bring the instant action under section 11 \u2014 13 of the Public Aid Code (Ill. Rev. Stat. 1985, ch. 23, par. 11 \u2014 13). See this Court\u2019s opinion filed in Canlas v. State (1987), 39 Ill. Ct. Cl. 150.\nAs indicated in IDPA\u2019s report, the claim seeks section 11 \u2014 13 vendor payments by the two physicians on four patient accounts, namely, Dr. Fozard\u2019s services for patients Hammond and Huggins, and Dr. Shanbhag\u2019s services for the same two patients. The Department has accepted liability, to the extent of the maximum dollar amounts authorized by its pricing schedules and policy, for patient Hammond\u2019s services; and denies all payment liability for patient Huggins\u2019 services.\nThis claim was filed on November 14,1986. Patient Huggins\u2019 services, for which Claimants seek payment, were rendered on June 6, 1983, more than three years prior to Claimants\u2019 commencement of this action. In fact, Claimants initially billed Huggins\u2019 services to IDPA in invoices received by the Department on September 18, 1986, more than three years after they had rendered such services. Their invoices were disallowed, and payment, refused by IDPA, due to the tardiness of these invoices.\nIn responding, IDPA challenges Claimants\u2019 claim for payment of Huggins\u2019 services on the ground, inter alia, that Claimants\u2019 individual causes of action in respect to such services had already been barred, when filed with this Court, under the provisions of section 11 \u2014 13, and of section 22(b) of the Court of Claims Act. (Ill. Rev. Stat., ch. 37, par. 439.22(b).) We find that challenge to be valid.\nSection 11 \u2014 13 establishes a one-year limitation on the filing of claims by vendors seeking State payment for goods and services furnished to or on behalf of IDPA recipients. A vendor\u2019s cause of action \u201caccrues\u201d and the running of the one-year limitation period begins on the date of specified events; and the statute provides for alternate accrual dates, depending upon when IDPA received the vendor\u2019s initial invoice. If the vendor proves that its initial invoice was received by IDPA within six months following the date of service, and if IDPA refused payment of that invoice, then the one-year limitation period begins to run on the date of IDPA\u2019s notice to the vendor of such refusal. If, on the other hand, the vendor cannot prove that IDPA received its invoice within six months after the date on which the services were rendered, then the cause of action as to such services accrues six months following the date of service, and the limitation period runs from that date. Under this alternate situation, the vendor must commenee its action in this Court within 18 months following the date of service, i.e., within one year following the date of accrual, if it is to avoid the bar of the limitation period in section 11 \u2014 13.\nIn this case, although Claimants provided patient Huggins\u2019 services in June 1983, the record which they present indicates that their initial invoices were not submitted to IDPA for over three years thereafter. While Claimants attempt to attribute their delay to the patient\u2019s tardiness in supplying them with information that she was an IDPA recipient, that fact cannot excuse Claimants\u2019 own inaction. As IDPA notes, Claimants do not allege that they themselves made any effort, from June 1983 through September 1986, to contact the local IDPA office in an attempt to determine whether Huggins may in fact have been eligible, as of June 1983, for MAP benefits under IDPA\u2019s program. Such lack of diligence by Claimants cannot excuse them from complying with the deadlines imposed by IDPA Rule 140.20 (89 Ill. Adm. Code 140.20) and by Federal regulations (see Title 42, Code of Federal Regulations, \u00a7447.45(d)(1)). See Rock Island Franciscan Hospital v. State (1987), No. 83-CC-1956, and prior decisions therein cited.\nThis Court has previously observed\n\u201cthat the Federal government\u2019s continuing participation in the funding of Illinois MAP program is dependent upon IDPA\u2019s regular enforcement of these regulatory requirements. Applicable here are the requirements: 000 that correctly-prepared invoices be timely received by IDPA.\u201d Methodist Medical Center v. State (1986), No. 83-CC-1572.\nIt is apparent here that Claimants could have complied with the above regulatory deadlines as to Huggins\u2019 patient accounts, and thereby helped avoid the risk of a denial of Federal government funding in IDPA\u2019s payments for such services.\nWith respect to Huggins\u2019 June 6,1983, services, we find that Claimants\u2019 causes of action accrued, within the meaning of section 11 \u2014 13, on December 7, 1983; and that said causes were barred as of December 8,1984, one year following such accrual.\nIt is therefore hereby ordered:\nThat Claimants receive and be awarded the following sums in full payment of patient Hammond\u2019s medical services: $76.00 to J. Gregg Fozard, M.D. (SSN [ XXX-XX-XXXX ]), and $412.00 to Madhukar Shanbhag, M.D. (SSN [ XXX-XX-XXXX ]), in accordance with IDPA\u2019s acceptance of liability for said services; and\nThat Respondent\u2019s motion to dismiss the complaint and the underlying action herein as to patient Huggins\u2019 services, pursuant to paragraph 2 \u2014 619 of the Illinois Code of Civil Procedure, on the ground that Claimants\u2019 causes of action as to said s\u00e9rvices were already barred by section 11 \u2014 13 of the Public Aid Code (Ill. Rev. Stat. 1985, ch. 23, par. 11 \u2014 13) and by section 22(b) of the Court of Claims Act (Ill. Rev. Stat., ch. 37, par. 439.22(b)) when this action was commenced, is hereby granted; and this action, as to Huggins\u2019 services, is dismissed with prejudice.",
        "type": "majority",
        "author": "Patchett, J."
      }
    ],
    "attorneys": [
      "Don Johnson, for Claimant.",
      "Neil F. Hartigan, Attorney General (Suzanne Schmitz, Assistant Attorney General, of counsel), for Respondent."
    ],
    "corrections": "",
    "head_matter": "(No. 87-CC-0962\nPinckneyville Medical Group, Claimant, v. The State of Illinois, Respondent.\nOpinion filed July 21, 1988.\nDon Johnson, for Claimant.\nNeil F. Hartigan, Attorney General (Suzanne Schmitz, Assistant Attorney General, of counsel), for Respondent."
  },
  "file_name": "0176-01",
  "first_page_order": 266,
  "last_page_order": 270
}