IHC v. HCFI

IN THE UTAH COURT OF APPEALS
 

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IHC Health Systems, Inc. dba LDS Hospital,

Petitioner and Appellant,

v.

Department of Health, Division of Healthcare Financing,

Respondent and Appellee.

MEMORANDUM DECISION
(Not For Official Publication)
 

Case No. 20040487-CA
 

F I L E D
(June 9, 2005)
 

2005 UT App 263

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Original Proceeding in this Court

Attorneys: Douglas Turek, The Woodlands, Texas, for Petitioner

Rex Olsen, Salt Lake City, for Respondent

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Before Judges Billings, Greenwood, and Jackson.

GREENWOOD, Judge:

    Petitioner IHC Health Systems dba LDS Hospital seeks review of a final agency decision by Respondent Department of Health, Division of Health Care Financing, denying Medicaid reimbursement, through Molina Health Care of Utah, Inc. (Molina), for the treatment of Keyontae Pittman from August 19, 2002 through October 29, 2002.

    Petitioner argues that Respondent erred, abused its discretion, and acted arbitrarily and capriciously in upholding Molina's decision to withhold Medicaid reimbursement by erroneously interpreting and applying the law relating to reimbursement and determining facts not supported by substantial evidence. We decline to consider Petitioner's arguments, however, because they are inadequately briefed.

    "It is well established that a reviewing court will not address arguments that are not adequately briefed." State v. Thomas, 961 P.2d 299, 304 (Utah 1998). "Implicitly, rule 24(a)(9) [of the Utah Rules of Appellate Procedure] requires not just bald citation to authority but development of that authority and reasoned analysis based on that authority." Id. at 305.

    Petitioner's brief is deficient because: (1) Petitioner incorrectly states the standard of review; (2) Petitioner cites Administrative Rule R414-1-13 and the Medicaid Provider Manual as the dispositive legal authority in its table of authorities and conclusion, but fails to analyze, apply, or even cite to this authority, or any other authority, in its argument, let alone describe how Respondent improperly interpreted or applied it; (3) Petitioner hints at possible estoppel or waiver theories as reasons for overturning Respondent's decision, but never mentions these terms or develops them into actual theories as to how Respondent erred;(1) and (4) Petitioner claims that Respondent made factual findings not supported by substantial evidence, but fails to articulate which findings are erroneous, and does not "marshal all [of] the evidence that supports the finding and then demonstrate that despite this evidence the finding is so lacking in support as to be against the clear weight of the evidence." Davis v. Davis, 2003 UT App 282,¶10, 76 P.3d 716 (alteration in original) (quotations and citations omitted); see also Utah R. App. P. 24(a)(9) ("A party challenging a fact finding must first marshal all record evidence that supports the challenged finding."). In sum, Petitioner fails to articulate any legal basis for overturning Respondent's decision.

    Accordingly, Respondent's decision is affirmed.

______________________________

Pamela T. Greenwood, Judge

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WE CONCUR:

______________________________

Judge Judith M. Billings,

Presiding Judge

______________________________

Norman H. Jackson, Judge

1. For example, Petitioner argues that it reasonably treated Pittman as having IHC Health Plus insurance coverage because Pittman did not lose his IHC Health Plus coverage until October 24, 2002--four days before the end of the hospital stay at issue, and Petitioner took all proper steps to authorize Pittman through IHC Health Plus. Because IHC Health Plus is not a party to this suit, this information is only relevant to an estoppel or waiver argument. However, Petitioner does not argue estoppel or waiver, let alone demonstrate how an erroneous reliance on IHC Health Plus coverage estopps Molina from denying reimbursement or excuses Petitioner from following the required procedures for Medicaid reimbursement.