SVETLANA KARASINA v. STATE OF NEW JERSEY
Annotate this CaseNOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-6338-08T1
SVETLANA KARASINA, C.R.N.F.A.;
RUBEN RAMOS, C.R.N.F.A.;
CATHERINE DIRR, C.R.N.F.A.;
ROSANN RIKER, R.N.F.A.;
JOANNE WENTZELL, C.R.N.F.A.;
FRANK MARTUCCI, C.R.N.F.A.;
NANCY CONLEY, C.R.N.F.A.;
DANETTE ARBOLEDA-MARIN, C.R.N.F.A.;
JANETTE PARSONS, R.N.F.A.;
CORINNE E. REAMER, R.N., B.S.N., C.R.N.F.A.;
DONNA GINSBERG, R.N.F.A.;
ANDREA LANGAN, C.R.N.F.A.;
JO BROWNA, C.R.N.F.A.;
SHAWN DOUCETTE, R.N.F.A.;
SUSAN SARKOS, A.P.N., R.N.F.A.;
ROSEMARY FOX, R.N.F.A.;
SUZANNE ROSTOUSKIS, R.N.F.A.;
MICHELLE BRENNER, A.P.N., R.N.F.A.;
HEIDI BENNETT, R.N.F.A.;
ROSANNE PARENTE, R.N.F.A.;
PAT HEISLER, R.N.F.A.;
PAMELA CALIMER, R.N., B.S.N., C.R.N.F.A.;
and COLLEEN DEVITA, C.R.N.F.A.,
Plaintiffs-Appellants,
v.
STATE OF NEW JERSEY, STATE HEALTH
BENEFITS PLAN, AND STATE HEALTH
BENEFITS COMMISSION,
Defendants-Respondents.
___________________________________
Argued May 11, 2010 - Decided September 8, 2010
Before Judges Skillman, Fuentes and Gilroy.
On appeal from the Superior Court of New
Jersey, Law Division, Mercer County, Docket
No. L-1039-09.
Steven I. Kern argued the cause for
appellants (Kern Augustine Conroy &
Schoppmann, P.C., attorneys; Mr. Kern, of
counsel; R. Bruce Crelin and Mr. Kern, on
the brief).
Kellie L. Kiefer Pushko, Deputy Attorney
General, argued the cause for respondents
(Paula T. Dow, Attorney General, attorney;
Melissa H. Raksa, Assistant Attorney General,
of counsel; Ms. Pushko, on the brief).
PER CURIAM
Plaintiffs appeal from the July 17, 2009 Law Division order
that dismissed their complaint for failure to state a claim upon
which relief could be granted. R. 4:6-2(e). We affirm.
Plaintiffs are Registered Nurse First Assistants (RNFAs)
and/or Certified Registered Nurse First Assistants (CRNFAs) who
act as surgical assistants during surgeries in lieu of assistant
surgeons. On April 16, 2009, plaintiffs filed a complaint
against the State, the State Health Benefits Program (SHBP)
(improperly pled as State Health Benefits Plan), and the State
Health Benefits Commission (the Commission), seeking a
declaratory judgment determining that defendants are required to
pay plaintiffs for health services rendered to state employees
covered by SHBP's Traditional Plan to the same extent as if the
A-6338-08T1
2
services were performed by licensed physicians. Plaintiffs seek
payment for services provided, retroactive to February 2004.
On June 5, 2009, in lieu of filing an answer, defendants
filed a motion seeking to dismiss the complaint for failure to
state a claim upon which relief could be granted, contending
plaintiffs had failed to exhaust their administrative remedies.
On July 17, 2009, the court entered an order supported by an
oral opinion granting the motion. It is from this order that
plaintiffs appeal.1 Notwithstanding the filing of their notice
of appeal on August 20, 2009, plaintiffs filed an administrative
petition with the Commission seeking the same declaratory relief
1
Plaintiffs' complaint was improperly filed in the Law
Division. The Commission is a State agency established pursuant
to the New Jersey State Health Benefits Program Act, N.J.S.A.
52:14-17.25 to -17.46a. The Appellate Division's jurisdiction
extends not only to challenges to a State agency's action, but
also to a State agency's inaction. In re Failure by Dep't. of
Banking,
336 N.J. Super. 253, 261 (App. Div.), certif. denied,
168 N.J. 292 (2001); Hosp. Ctr. at Orange v. Guhl,
331 N.J.
Super. 322, 329-30 (App. Div. 2000); Pressler, Current N.J.
Court Rules, comment 3.1 on R. 2:2-3 (2010). Accordingly,
plaintiffs should have sought review of the Commission's alleged
inaction "by direct appeal to us, pursuant to R. 2:2-3(a)(2)."
In re Failure by Dep't. of Banking, supra,
336 N.J. Super. at 261 (quoting Trantino v. N.J. State Parole Bd.,
296 N.J. Super. 437, 459-60 (App. Div. 1997), aff'd. and modified on other
grounds,
154 N.J. 19 (1998)).
A-6338-08T1
3
sought in the Law Division. Plaintiffs also sought a stay of
that petition pending this appeal.2
On appeal, plaintiffs argue the trial court erroneously
granted the motion to dismiss their complaint because no viable
administrative remedy is available to them, asserting that the
administrative appeal procedure established by N.J.A.C. 17:9-1.3
only applies to members of the SHBP and plaintiffs are not
members, but medical providers. We disagree.
The Administrative Procedure Act (APA), N.J.S.A. 52:14B-1
to -25, provides plaintiffs with an administrative remedy to
challenge defendants' denial of payment for the services
rendered as surgical assistants. N.J.S.A. 52:14B-8 provides in
relevant part:
[A]n agency upon the request of any
interested person may in its discretion make
a declaratory ruling with respect to the
applicability to any person, property or
state of facts of any statute or rule
enforced or administered by that agency. A
declaratory ruling shall bind the agency and
all parties to the proceedings on the state
of facts alleged. Full opportunity for
hearing shall be afforded to the interested
parties. Such ruling shall be deemed a final
decision or action subject to review in the
Appellate Division of the Superior Court.
Nothing herein shall affect the right or
2
We were advised at oral argument that the Commission has
deferred ruling on plaintiffs' petition pending the outcome of
this appeal.
A-6338-08T1
4
practice of every agency in its sole
discretion to render advisory opinions.
[(Emphasis added).]
Because plaintiffs have a financial interest in receiving
payment for their services, they are interested persons under
the statute. See In re Camden County,
170 N.J. 439, 448 (2002)
(holding that "the existence of a financial interest that is
affected directly by the agency action will confer standing on a
governing body" seeking to review such action). Furthermore,
the APA requires liberal application of criteria to determine
standing. Ridgewood Educ. Ass'n v. Ridgewood Bd. of Educ.,
284 N.J. Super. 427, 431 (App. Div. 1995).
The Commission is responsible for interpretation of the
SHBP. See Murray v. State Health Benefits Comm'n,
337 N.J.
Super. 435, 439 (App. Div. 2001) ("[t]he Commission retains
final authority and financial responsibility for the State
Plan"). If the Commission declines to hear plaintiffs' petition
for declaratory relief, or renders a decision adverse to
plaintiffs, plaintiffs may seek review in the Appellate
Division. R. 2:2-3(a)(2). Accordingly, plaintiffs have an
administrative remedy to obtain the relief sought.
Alternatively, plaintiffs contend that they are not
required to exhaust their administrative remedy as the issue
involves only a matter of law. Not so.
A-6338-08T1
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The exhaustion of the administrative remedies doctrine
requires that before a party files a direct appeal to the
Appellate Division challenging a State agency's action or
inaction, the party must first seek review of such action or
inaction "before [the] administrative agency or officer, unless
the interest of justice requires otherwise." R. 2:2-3(a)(2).
The rationale behind the doctrine is that "interruption of the
administrative process is not justifiable to any greater extent
than interference with the trial process by interlocutory
appeals. The expertise of an administrative agency may not be
exercised or known until it renders its final decision and
usually due deference is accorded such expertise upon judicial
Triano v. Div. of State Lottery,
306 N.J. Super. 114,
review."
121 (App. Div. 1997) (quoting Magliochetti v. State,
276 N.J.
Super. 361, 374-75 (Law Div.1994)).
We acknowledge that the doctrine is discretionary rather
than jurisdictional, Abbott v. Burke,
100 N.J. 269, 297 (1985),
and that the doctrine is generally not applied "when only a
question of law exists," see Brunetti v. New Milford,
68 N.J.
576, 591 (1975), or "administrative remedies would be futile."
Triano, supra, 306 N.J. Super. at 121-22. However, the
exhaustion doctrine "is a rule of practice designed to allow
administrative bodies to perform their statutory functions in an
A-6338-08T1
6
orderly manner without preliminary interference from the courts.
Therefore, while it is neither a jurisdictional nor an absolute
requirement, there is nonetheless a strong presumption favoring
the requirement of exhaustion of remedies." Brunetti, supra,
68 N.J. at 588 (internal citation omitted). Additionally, "where
the court perceives the agency to be in a special position to
interpret its enabling legislation," a court may still require
administrative remedies to be exhausted, despite a question of
law being the only dispute. Abbott, supra,
100 N.J. at 298.
The Commission is uniquely suited to interpret the statute
upon which plaintiffs rely. See N.J.S.A. 52:14-
17.29(A)(1)(e)(v)(2) ("[T]he commission may, by regulation,
determine what types of services and supplies shall be included
as 'eligible medical services' under the major medical expense
benefits coverage as well as those which shall be excluded from
or limited under such coverage."). Accordingly, we affirm the
dismissal of plaintiffs' complaint without prejudice for failure
to state a claim upon which relief can be granted for failure to
exhaust their administrative remedies.
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