[District of Columbia Payments]

The Superintendent of St. Elizabeths Hospital asked for a decision concerning four questions which arose as a result of the hospital's financial relationship with the District of Columbia. The Superintendent asked whether: (1) there will be an Antideficiency Act violation if the hospital provides unreimbursed services to District patients that result in the hospital's exceeding its appropriation cap; (2) the legislative mandate requiring the hospital to provide care to those eligible satisfies the Act provision excepting obligations authorized by law; (3) moneys appropriated as part of the Federal payment to the District can be withheld as an offset to the District's indebtedness to the hospital; and (4) the Comptroller General can require the District Government to adjust its account with the Department of the Treasury regarding the difference between its actual payment and the amounts due and payable by virtue of their appropriations. GAO held that: (1) if the hospital incurs obligations exceeding any cap on its appropriation, it will be in violation of the Act; (2) although the Act requires the Superintendent to admit qualifying patients to the hospital, it does not authorize him to incur obligations in excess of the available appropriations; (3) the Office of Management and Budget apportions the Federal payment and pays it to the District before the end of the second quarter of the fiscal year so that offset is an effective remedy for the hospital with respect to claims for patient care already provided during the first half of the fiscal year; (4) the Comptroller General has the statutory authority to determine the legal status of an account and take exception to unauthorized payments, but this authority does not extend to transferring funds between accounts.