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Comm-Unity, Inc. v. Division of Medical Assistance and Health Services

January 5, 2010

COMM-UNITY, INC., PETITIONER-APPELLANT,
v.
DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES, RESPONDENT-RESPONDENT.



On appeal from a Final Agency Decision of the Director of the Division of Medical Assistance and Health Services.

Per curiam.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

Argued November 4, 2009

Before Judges Skillman and Simonelli.

Appellant Comm-Unity, Inc. (Comm-Unity) appeals from the final decision of respondent Division of Medical Assistance and Health Services (DMAHS) adopting the initial decision of an Administrative Law Judge (ALJ) granting summary decision in DMAHS's favor sustaining the termination Comm-Unity's Medicaid provider agreement pursuant to N.J.A.C. 10:49-11.1(d)22. We affirm.

Comm-Unity is a New Jersey corporation, which operated a partial care facility for patients suffering from serious mental disabilities. Because Comm-Unity received Medicaid funding, it was required to periodically submit a re-enrollment application. N.J.A.C. 10:49-3.2(b)1.

i.

Comm-Unity does not deny that Harold Katz and Robert Lieberman are officers of the corporation. Lieberman was also Comm-Unity's program director. On March 24, 2006, Lieberman submitted a re-enrollment application to DMAHS on Comm-Unity's behalf (the application). Section I, Question 23 requested the following information:

Have any of the entities named in the response to questions 1 or 7,*fn1 or their officers or partners, or any individuals named in response to question 15, ever been the subject of any license suspension, revocation, fine, reprimand, probation or other adverse licensure action in this State or any other jurisdiction?

[(Emphasis added.)]

Question 25 requested the following information:

Have any of the entities named in response to questions 1 or 7, or their officers or partners, or any of the individuals named in the response to question 15, ever been the subject of any suspension, debarment, disqualification or recovery action involving Medicaid (Title XIX), Medicare (Title XVIII), any other federally or state-funded health care program, or any private or non-profit health insurance plan or any of the other programs administered in whole or in part by DMAHS in this state or any other jurisdiction? [(Emphasis added.)]

Lieberman answered "No" to both questions.

Katz and Lieberman do not deny that they were also officers of Eden House Residential Health Care Facility (Eden House). In November 2004, the New Jersey Department of Health and Senior Services (DHSS) penalized Eden House $33,250 ...


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