{
  "id": 3175120,
  "name": "Capitol Claim Service, Inc., as Assignee or Agent for S. B. Rawls Mortuary et al., Claimant, v. The State of Illinois, Respondent",
  "name_abbreviation": "Capitol Claim Service, Inc. v. State",
  "decision_date": "1988-02-25",
  "docket_number": "Nos. 83-CC-2353, 83-CC-2354, 83-CC-2355 cons.",
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    "judges": [],
    "parties": [
      "Capitol Claim Service, Inc., as Assignee or Agent for S. B. Rawls Mortuary et al., Claimant, v. The State of Illinois, Respondent."
    ],
    "opinions": [
      {
        "text": "Patchett, J.\nThese three consolidated causes are before the Court on Respondent\u2019s motion to dismiss, filed in April 1986. Due notice having been given, and the Court, being fully advised, finds as follows:\nThe three actions present common issues of law and fact, relating to vendor-payment claims, filed pursuant to section 11 \u2014 13 of the Public Aid Code (Ill. Rev. Stat., ch. 23, par. 11 \u2014 13), by Capitol Claims Service, Inc., as assignee of accounts-receivable of certain funeral home and cemetery vendors. Together, these actions present 25 accounts, each for funeral or burial services (and related goods) furnished in behalf of persons who, at the time of their deaths, were public aid recipients. The Illinois Department of Public Aid (IDPA), in its departmental report filed herein pursuant to sections 790.100 and 790.140 of the rules of this Court (74 Ill. Adm. Code 790.100, 790.140) denies all payment liability with respect to these 25 accounts.\nThe Public Aid Code includes certain provisions, e.g., sections 3 \u2014 8, 5 \u2014 12, 6 \u2014 6 and 7 \u2014 5, relating to Respondent\u2019s, and IDPA\u2019s, obligation to provide funerals, burial space and interment for deceased IDPA recipients. (Ill. Rev. Stat. 1979, ch. 23, pars. 3 \u2014 8, 5 \u2014 12, 6 \u2014 6, 7 \u2014 5.) Section 5 \u2014 12 is an example of such provisions:\n\u201cFuneral and Burial. Upon the death of a recipient * * *, if his estate is insufficient to pay his funeral and burial expenses and if no other resources, including assistance from legally responsible relatives, are available for such purposes, there shall be paid, in accordance with the standards, rules and regulations of the Illinois Department, such reasonable amounts as may be necessary to meet costs of the funeral, burial space, and cemetery charges, or to reimburse any person not financially responsible for the deceased who have voluntarily made expenditures for such costs.\u201d\nIn its report, IDPA emphasizes that Respondent\u2019s payment obligations are contingent, in each instance, upon the vendor\u2019s complying with the Department\u2019s \u201cstandards, rules and regulations\u201d and the other conditions referred to in the statutes. This opinion addresses the merits of these vendors\u2019 25 accounts, and the extent of the vendors\u2019 compliance with such statutory and regulatory requirements. In considering these accounts, we refer to them by use of the account numbers assigned by IDPA in its March 5,1986, report.\nRequired Exhaustion Of Third-Party Resources\nAs previously noted, IDPA\u2019s payment obligation for funeral and burial expenses is contingent, under applicable statutes, upon a determination by the Department that \u201cno other resources, including assistance from legally responsible relatives, are available\u201d to pay such expenses. (Ill. Rev. Stat. 1979, ch. 23, par. 5\u2014 12.) When such resources exist, IDPA Rules 117.53 and 117.54 require that reductions be made against vendors\u2019 charges (subject to \u201cmaximum allowable\u201d charges established in section 117.50) for the value of decedent\u2019s assets, available resources including both insurance proceeds and any other anticipated death benefits available to the estate, and amounts paid or arranged to be paid by the decedent\u2019s legally responsible relatives. (89 Ill. Adm. Code 117.53, 117.54; formerly Rule 7.13). The resulting policy is analogous to the requirement of this Court in section 25 of the Court of Claims Act (Ill. Rev. Stat., ch. 37, par. 439.24 \u2014 5) and section 790.60 of the rules of this Court (74 Ill. Adm. Code 790.60), that all administrative remedies and sources of recovery be exhausted before any State liability can be determined to exist. Boe v. State (1984), 37 Ill. Ct. Cl. 72; Lyons v. State (1981), 34 Ill. Ct. Cl. 268.\nIDPA identifies five accounts (nos. 17,18,19, 20 and 21 as listed in its departmental report) for which it had denied payment liability due to the availability of life insurance on the decedents\u2019 lives, the proceeds of which were in excess of the maximum allowable amounts otherwise available (under IDPA Rule 117.50) under the Department\u2019s allowance for funeral and burial expenses of deceased public aid recipients. In each instance, the insurance policy or policies would have produced benefit payments sufficient to pay the charges as submitted by the funeral home and cemetery vendors to IDPA.\nIn five instances, account nos. 14, 20, 21, 22 and 25, IDPA made payment to the vendors in amounts less than their charges, as a result of having reduced such charges by the amount of a lump-sum death benefit which the decedents\u2019 estates were entitled to receive under the Federal Social Security Act. In another instance, account no. 13, the decedent had been a nursing home resident and had left a personal fund trust account balance with the nursing home which, when combined with IDPA\u2019s payment, would equal the vendors\u2019 charges for the decedent\u2019s funeral and burial.\nWith respect to account 9, a person (other than a legally responsible relative of the decedent) had filed a claim with IDPA for reimbursement for funds expended by that person for the costs of the decedent\u2019s funeral and burial, pursuant to IDPA Rule 117.54 (89 Ill. Adm. Code 117.54). The vendor was so notified by IDPA, and did not thereafter pursue payment from the Department. In another case (account 11), the same vendor invoiced its entire charge to IDPA, without crediting the payment which it had received from the decedent\u2019s legally responsible relative. IDPA rejected its claim for that reason in July 1982, and the vendor failed thereafter to submit a corrected bill of its charges within the time permitted by IDPA Rule 117.55(c) (2) (89 Ill. Adm. Code 117.55(c)(2), formerly Rule 7.13). The vendor had been paid in full for account 5, over two months prior to the filing of the claim in No. 83-CC-2353.\nIn each case where existing resources were available (nos. 13,14,17,18, 19, 20, 21, 22 and 25), such resources were sufficient, alone or when combined with IDPA\u2019s payments, to make available the maximum allowable amounts authorized by IDPA\u2019s program.\nProper Claim-Form Preparation\nFuneral home, cemetery and other vendors are instructed to invoice their funeral and burial claims to IDPA, using Department invoices (here, form DPA 29) designed specifically for that purpose. In doing so, they are to complete the claim form in accordance with instructions appearing on the reverse side of the form. Accounts 1, 4, 6, 7, 12 through 15, and 16 (no claim was ever received by IDPA for the latter account) are among the examples cited by the Department of claim forms not prepared by the vendors in compliance with such instructions.\nThese instructions require the vendor who actually rendered the services to be identified by name, address and Federal employer identification number, and for such vendor to sign and date the claim form being submitted. Vendors are not free to disregard these instructions by omitting required entries on the form, by substituting as vendor the name of a person or firm who did not render the service, or otherwise by failing clearly to identify the person or firm who actually rendered the service and is entitled to payment for it. Each entry is to be completed as instructed, so that Respondent\u2019s officials may be assured that the proper vendor will be paid for that vendor\u2019s services.\nDetails of these vendors\u2019 departures from the instructions are noted in IDPA\u2019s report. For example, the purported assignments of ownership of these accounts could have been accomplished by a separate document submitted with the claim, and did not excuse the preparer from fully identifying the vendor on the form itself, in compliance with related instructions. As to each of the nine accounts referenced above, we find that the vendors failed to comply with such instructions and IDPA Rule 117.55.\nVendor Disqualified From Rendering Services\nIDPA denies all liability for the funeral and embalming services as represented in accounts 1 through 8 (except account 5 which was paid), because the vendor\u2019s licenses to perform such survices had been suspended for cause, effective July 21,1982, pursuant to sections 1 \u2014 14 and 2 \u2014 10 of the Funeral Directors and Embalmers Licensing Act of 1935 (Ill. Rev. Stat. 1981, ch. Ill, pars. 2813, 2824). All of these services, as invoiced, were performed during the six-month period when this vendor\u2019s licenses were under suspension. The vendor was thus prohibited by law from engaging in the occupations of funeral directing and embalming during this period.\nThe Court agrees with the Department\u2019s refusal of payment for these services, and finds the denial of liability to be mandated by law. Respondent\u2019s suspension of the vendor\u2019s licenses meant that he had no certificate of State registration to engage in these occupations during the suspension period. His continued practice of such activities without State authority was thus unlawful. (Ill. Rev. Stat. 1981, ch. Ill, pars. 2803, 2816.) Moreover, the vendor, having failed to comply with licensing requirements applicable to his occupations, may not maintain an action for payment of his services rendered while his licenses were under suspension. Tovar v. Paxton Community Memorial Hospital (1975), 29 Ill. App. 3d 218, 330 N.E.2d 247.\nNoncompliance With IDPA\u2019s Invoicing Deadlines\nIDPA Rule 117.55 (89 Ill. Adm. Code 117.55) requires that vendors\u2019 funeral and burial claims be received by the Department within 180 days following a decedent\u2019s death in order to be entitled to payment consideration. IDPA denies liability as to accounts 1, 10, 16, 23 and 24, by reason of the vendors\u2019 failures to comply with this invoicing deadline. Account 23 involves funeral services performed in 1974 and account 24 presents a claim for 1975 funeral services. Yet the vendor\u2019s Court complaint allegations indicate that these two accounts were first invoiced to IDPA in 1982.\nIDPA Rule 117.55 also provides that, for payment consideration, the rebill invoice of a previously invoiced account must be received within 90 days after the vendor\u2019s initial invoice was disallowed and returned for correction or completion. IDPA denies liability as to accounts 9, 10, 11, 12, 15, 16, and 18 through 22, due to vendors\u2019 failures to comply with this rebill deadline.\nSection 11 \u2014 13 of the Public Aid Code (Ill. Rev. Stat. 1983, ch. 23, par. 11 \u2014 13) provides that a vendor\u2019s right to a vendor payment may be \u201climited by [IDPA\u2019s] regulations.\u201d We have previously recognized such limitations. See, e.g., Riverside Medical Center v. State (1986), 39 Ill. Ct. Cl. 301, and the decisions therein referred to, as they relate to the initial invoice and rebill deadlines imposed by IDPA\u2019s rules upon another category of vendors. We find that Rule 117.55\u2019s deadlines, applicable to funeral and burial vendors\u2019 claims in behalf of deceased public aid recipients, are entitled to similar recognition and enforcement. And we find that IDPA was correct in refusing payment to those vendors whose accounts are identified as nos. 1, 9,10,11, 12, 15, 16, and 18 through 24.\nCourt Actions Barred by Section 439.22\u2019s Time Limitation\nSection 11 \u2014 13 of the Public Aid Code also imposes limits on the time within which those seeking vendor payments must commence their actions before this Court, in order to avoid the one-year bar provided for in section 22 of the Court of Claims Act. (Ill. Rev. Stat., ch. 37, par. 439.22; Methodist Medical Center v. State (1983), 35 Ill. Ct. Cl. 871, 872.) IDPA contends that vendor Rawls Mortuary\u2019s actions on account nos. 10 and 12 (a part of No. 83-CC-2353) were barred by this statutory limitation.\nThe dates pertinent to these accounts are as follows:\nThe Court claim which included these accounts was not commenced until May 16, 1983, more than one year following IDPA\u2019s initial disallowance of the vendor\u2019s administrative claims.\nAt the time No. 83-CC-2353 was filed, section 11\u2014 13 of the Public Aid Code provided as follows:\n\u201c[vjendors seeking to enforce obligations of \u00b0 \" [IDPA] for goods or services (I) furnished to or in behalf of recipients and (2) subject to a vendor payment as defined in Section 2 \u2014 5, shall commence their actions 0 \u00b0 \u201c within one year next after the cause of action accrued.\u201d (Ill. Rev. Stat. 1983, ch. 23, par. 11 \u2014 13.)\nA vendor\u2019s cause of action accrued upon IDPA\u2019s written notification to him that his claim (invoice seeking an administrative payment) had been disallowed for payment by the Department. The date of IDPA\u2019s notice, the accrual date, initiated the running of the one-year limitation period during which the vendor was obligated to commence his Court action in respect to the previously invoiced services. Such accrual did not preclude the vendor from correcting his prior invoice errors or omissions by preparing a rebill invoice to IDPA within the time permitted by subsection (c)(2) of IDPA Rule 117.55; however, it is IDPA\u2019s position that the running of the one-year limitation period was not suspended, nor was the period extended in duration, as a result of the vendor\u2019s submittal of one or more rebill invoices.\nUpon applying these statutory limitations to the accounts here challenged, the Court finds that the Court action had already been barred as to each of these two accounts when it was filed on May 16, 1983. In each instance, the vendor commenced his Court action more than one year following the respective dates on which IDPA had given written notice of its refusal to pay his administrative claims.\nIt is therefore hereby ordered that Respondent\u2019s motion to dismiss each of the accounts presented in Nos. 83-CC-2353, 83-CC-2354 and 83-CC-2356, on the grounds as addressed above in this opinion, is hereby granted and said 25 accounts are each hereby dismissed with prejudice.",
        "type": "majority",
        "author": "Patchett, J."
      }
    ],
    "attorneys": [
      "Samuel J. Cahnman, for Claimant.",
      "James Radar, for Respondent."
    ],
    "corrections": "",
    "head_matter": "(Nos. 83-CC-2353, 83-CC-2354, 83-CC-2355 cons.\nCapitol Claim Service, Inc., as Assignee or Agent for S. B. Rawls Mortuary et al., Claimant, v. The State of Illinois, Respondent.\nOpinion filed February 25, 1988.\nSamuel J. Cahnman, for Claimant.\nJames Radar, for Respondent."
  },
  "file_name": "0097-01",
  "first_page_order": 187,
  "last_page_order": 196
}