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Ladieux v. Jefferson Parish Hosp. Serv. Dist. No. 2

Court of Appeals of Louisiana, Fifth Circuit

November 25, 2014

NELL LADIEUX AND RONALD LEE, INDIVIDUALLY AND ON BEHALF OF, A CLASS OF PERSONS SIMILARLY SITUATED
v.
JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 2 D/B/A EAST JEFFERSON GENERAL HOSPITAL

ON APPEAL FROM THE TWENTY-FOURTH JUDICIAL DISTRICT COURT, PARISH OF JEFFERSON, STATE OF LOUISIANA. NO. 711-046, DIVISION " I" . HONORABLE NANCY A. MILLER, JUDGE PRESIDING.

SIDNEY D. TORRES, III, ROBERTA L. BURNS, BEAU F. CAMEL, ATTORNEYS AT LAW, Chalmette, Louisiana, COUNSEL FOR PLAINTIFF/APPELLANT.

TIMOTHY R. RICHARDSON, ATTORNEY AT LAW, New Orleans, Louisiana, COUNSEL FOR PLAINTIFF/APPELLANT.

P. J. STAKELUM, III, GLENN S. NEWBAUER, ATTORNEYS AT LAW, Metairie, Louisiana, COUNSEL FOR DEFENDANT/APPELLEE.

Panel composed of Judges Fredericka Homberg Wicker, Robert M. Murphy, and Hans J. Liljeberg.

OPINION

ROBERT M. MURPHY, J.

Page 110

[14-449 La.App. 5 Cir. 3] Plaintiffs-appellants, Nell Ladieu[1] and Ronald Lee, individually and on behalf of a class of persons similarly situated, appeal the trial court's December 19, 2013 judgment granting the motion for involuntary dismissal of Plaintiffs' motion for class certification filed by Defendant-appellee, Jefferson Parish Hospital Service District No. 2, d/b/a East Jefferson General Hospital (" EJGH" ), and the trial court's January 3, 2014 judgment denying Plaintiff's motion for class certification. Plaintiffs also seek review of the trial court's May 7, 2013 judgment granting EJGH's partial motion for summary judgment, which dismissed with prejudice the claims of the proposed class representatives, Ladieu and Lee, based upon the Health Care Consumer Billing and Disclosure Protection Act (" Billing Act" ), La. R.S. 22:1871, et seq., after finding that there is no private right or cause of action under the Billing Act.

For the reasons that follow, we reverse the trial court's May 7, 2013 judgment dismissing Ladieu and Lee's claims under the Billing Act in light of the Louisiana Supreme Court's opinion in Anderson v. Ochsner Health System and Ochsner Clinic Foundation, 13-2970 (La. 7/1/14), ___ So.3d ___, [14-449 La.App. 5 Cir. 4] . We vacate the trial court's December 19, 2013 judgment granting EJGH's motion for involuntary dismissal and its January 3, 2014 judgment denying Plaintiffs' motion for class certification. We further remand the case to the trial court and order a rehearing of Plaintiffs' motion for class certification in light of the Anderson case. Id.

FACTS AND PROCEDURAL HISTORY

On February 3, 2012, Ladieu and Lee filed a class action petition for damages

Page 111

alleging that they were both involved in separate car accidents involving third parties and received treatment for their injuries at EJGH. At the time of their accidents, both Ladieu and Lee were insured by health insurance policies -- Ladieu was insured by Blue Cross Blue Shield and Lee was insured by United Healthcare, in addition to Medicare. The petition alleged that despite having health insurance, EJGH billed Ladieu and Lee personally for the covered services rendered by EJGH at amounts in excess of the reimbursement rates contracted between EJGH and Ladieu and Lee's medical insurers. Specifically, EJGH billed Ladieu in the amount of $1,391 and billed Lee in the amount of $1,876.60.

Both Ladieu and Lee, through their counsel of record in their respective car accident lawsuits, sent EJGH correspondence advising EJGH that they had in place health insurance plans and requesting that EJGH remit the claims for the services rendered to their insurers. Instead of remitting their claims to their insurers, Plaintiffs alleged that EJGH sent their attorney medical lien letters asserting its privilege under La. R.S. 9:4751-4755 for the full amount of services rendered at undiscounted rates on any recovery received by Plaintiffs in connection with their underlying car accident claims. Ladieu ultimately paid EJGH a total of $1,043.25 for the services rendered to her, whereas Lee has not yet paid EJGH any amount for the services rendered to him.

[14-449 La.App. 5 Cir. 5] Plaintiffs alleged that based on the foregoing, EJGH violated the Billing Act, La. R.S. 9:4752, and La C.C. art. 2299. La. R.S. 9:4752 provides that a health care provider, hospital, or ambulance service that furnishes services to any injured person shall have a privilege for their reasonable charges or fees on the net amount payable to the injured person out of the total amount of any recovery or sum collected from another person or insurance company on account of such injuries. Article 2299 provides that a person who has received a payment not owed to him is bound to restore it to the person from whom he received it. La. C.C. art. 2299. Plaintiffs brought the action on their own behalf, and on behalf of a similarly situated class consisting of the following individuals:

All persons who received " covered healthcare services" as defined by La. R.S. 22:1872(8) provided by [EJGH], and at the time of the covered healthcare services had " health insurance coverage" as defined by La. R.S. 22:1872(18); and from whom [EJGH] attempted to recover any amount in excess of the " contracted reimbursement rate" as defined by La. R.S. 22:1872(7) and/or who paid [EJGH] in any manner including, but not limited to, liability insurance proceeds and/or from proceeds of a settlement or judgment, an amount in excess of the contracted reimbursement rate either directly and/or through their attorney [14-449 La.App. 5 Cir. 6] and/or through a liability insurance carrier and/or any third party in violation of La. R.S. 22:1872, et seq.

Plaintiffs' petition further alleged that the proposed class consisted of two sub-classes:

(A) " Attempt to recover" sub-class: [a] sub-class of persons who received covered healthcare services and who had health insurance coverage, and from whom, [EJGH] attempted to recover any amount in excess of the " contracted reimbursement rate" since January 1, 2004. The members of this sub-class seek a judgment declaring that [EJGH] violated La. R.S. 9:4751 by not billing the injured parties' health insurers, and enjoining [EJGH] from continuing that practice.

Page 112

(B) " Payor" sub-class: [a] sub-class of persons who received covered healthcare services and who had health insurance coverage, and/or who paid [EJGH] in any manner including but not limited to [sic] liability insurance proceeds and/or from proceeds of a settlement or judgment, an amount in excess of the " contracted reimbursement rate" either directly and/or through their attorney and/or ...

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