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Rabun v. St. Francis Medical Center, Inc.

Court of Appeals of Louisiana, Second Circuit

June 26, 2019

IRMA RABUN, INDIVIDUALLY AND ON BEHALF OF ALL OTHERS SIMILARLY SITUATED Plaintiffs-Appellees
v.
ST. FRANCIS MEDICAL CENTER, INC. Defendant-Appellant

          Appealed from the Fourth Judicial District Court for the Parish of Ouachita, Louisiana Trial Court No. 20141389. Honorable Daniel Joseph Ellender, Judge

          BREAZEALE, SACHSE & WILSON, LLP By: David R. Kelly Thomas R. Temple, Jr. Chris D. Billings Joseph J. Cefalu, III Counsel for Appellant

          HOFFOSS DEVALL, LLC By: J. Lee Hoffoss, Jr. Claude P. Devall, Jr. Donald W. McKnight MARTZELL, BICKFORD & CENTOLA, PC By: Scott R. Bickford Lawrence J. Centola, III LABORDE EARLES LAW FIRM By: Derrick G. Earles PARKER ALEXANDER, LLC By: Kevin D. Alexander HAROLD D. LUCIUS, JR. KIRBY D. KELLY Counsel for Appellees

          Before WILLIAMS, GARRETT, and COX, JJ.

          COX, J.

         This case reaches our Court on appeal for the second time from the Fourth Judicial District Court, Ouachita Parish, Louisiana.[1] In the current appeal, St. Francis Medical Center, Inc. ("St. Francis") is appealing the trial court's judgment granting Irma Rabun's motion to certify the matter as a class action. For the following reasons, we affirm.

         FACTS

         On February 1, 2013, Ms. Rabun was involved in a automobile accident and subsequently treated at St. Francis. Ms. Rabun filed a suit for damages against the other driver in the accident. St. Francis filed a medical lien for the full cost of her medical treatment against the settlement Ms. Rabun would receive in connection with the underlying accident. Ms. Rabun had health insurance and St. Francis was a contracted health care provider, which would have allowed for a discounted rate on medical services. However, St. Francis did not file a claim with Ms. Rabun's insurer, only filing the medical lien against Ms. Rabun's judgment. Ms. Rabun filed suit against St. Francis claiming St. Francis was required to submit all claims for medical bills to her health insurer for the contracted rate, in accordance with the Health Care Consumer Billing Disclosure Protection Act, La R.S. 22:1871, et seq. (hereinafter referred to as the "Balance Billing Act").

         This appeal does not encompass the merits of Ms. Rabun's claim, but is limited to a review of the trial court's certification of the class action. Ms. Rabun defined the class to be certified as follows:

         All persons currently and/or formerly residing in the State of Louisiana during the relevant time period:

(1) Having "Health Insurance Coverage" [as defined by La. R.S. 22:1872(18)] provided coverage for themselves or for others for whom they are legally responsible, with any "Health Insurance Issuer" [as defined by La. R.S. 22:1872(19)] at the time "covered health care services" [as defined by La. R.S. 22:1872(8)] were provided by any company owned and/or operated by St. Francis Medical Center; and,
(2) With which "Health Insurance Issuer" any company owned and/or operated by St. Francis Medical Center was a "contracted health care provider" at the time of service [as defined by La. R.S. 22:1872(6); and,
(3) From whom St. Francis Medical Center and/or any company owned and/or operated by St. Francis Medical Center collected, and/or attempted to collect, the "Health Insurance Issuer's Liability" [as defined by La. R.S. 22:1872(20)], including, but not limited to, any collection or attempt to collect from any settlement, judgment or claim made against any third person or insurer who may have been liable for any injuries sustained by the patient (which insurers include those providing liability coverage to third persons, uninsured/underinsured coverage, and/or medical payments coverage); and/or,
(4) From whom St. Francis Medical Center and/or any company owned and/or operated by St. Francis Medical Center, collected, and/or attempted to collect, any amount in excess of the "Contracted Reimbursement Rate" [as defined by La. R.S. 22:1872(7)], including but not limited to, any collection or attempt to collect from any settlement, judgment, or claim made against any third person or any insurer which may have been liable for any injuries sustained by the patient (which insurers include those providing liability coverage to third persons, uninsured/underinsured coverage, and/or medical payments coverage); and or
(5) From whom St. Francis Medical Center and/or any company owned and/or operated by St. Francis Medical Center, collected, and/or attempted to collect, any amount without first receiving any explanation of benefits or other information from the Health Insurance Issuer setting forth the liability of the insured as required by La. R.S. 22:1874(A)(2) and (3).

         She requested the class extend back to January 1, 2004, the effective date of the Balance Billing Act.

         Ms. Rabun argued before the trial court that she met the requirements of a class action-numerosity, commonality, typicality, superiority, and predominance. In proving numerosity, Ms. Rabun claimed there are well over 100 patients affected by the liability accident billing procedure. She argued that because there are over 100 patients effected, it would be a strain and undue burden on the court to adjudicate such a large number of suits. She argued that for this reason, the class action procedure would be more useful and judicially expedient than mere joinder.

         As to commonality, Ms. Rabun stated that each claim shares a common issue that is central to the validity of each claim. She argued it is uncontested that St. Francis had a special policy for attempting to collect and collecting from insured patients involved in a motor vehicle crash. She argued that all persons sought to be made class members received services at St. Francis; St. Francis was a contracted healthcare provider of their health insurers; all were subject to St. Francis's policy to collect or attempt to collect amounts in excess of the contracted reimbursement rate; and, all were subject to these collection attempts before St. Francis received an explanation of benefits from any health insurer.

         Ms. Rabun argued typicality was met because her claim arises from the same course of conduct that gives rise to the claims of other class members, and her claims are based on the same legal theory. Ms. Rabun claimed her case is also subjected to St. Francis's policy of attempting to collect from patients with health insurance amounts in excess of the contracted reimbursement rate.

         As to the adequacy of representation, Ms. Rabun claimed there is no evidence of conflicting or antagonistic claims between herself and the class members; she and the class members have the same interest in the outcome; and, she is willing to see this matter to the end and is dedicated to the prosecution of the case. She further argued that her counsel is experienced in class action litigation and have all been appointed as class action counsel in many Balance Billing Act actions.

         Ms. Rabun argued she meets the requirements of La. C.C.P. art. 591. She argued that this is not a case involving multiple causation elements or alleged liability and damages, but the case fundamentally revolves around the interplay of St. Francis's billing policy with the Balance Billing Act. She also argued the management of this class action would not be overly complex or unduly burdensome on either party. Finally, she maintained that the vindication of public policies and rights of patients justifies the time, costs, and expenses of pursuing class certification.

         St. Francis opposed the class action certification, arguing Ms. Rabun's claims are inappropriate for class certification. First, St. Francis pointed out that Ms. Rabun filed a class action petition for damages, for breach of contract, for declaratory relief, and for injunctive relief, but made no mention of certifying the breach of contract claims in her motion to certify. St. Francis also argued that Ms. Rabun was unable to show that there is a "definable group of aggrieved persons" with plausible claims sufficient to satisfy numerosity; she is an inadequate representative for the proposed class that she purports to ...


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