Associated Hospital Service of Maine v. Mahoney

213 A.2d 712, 161 Me. 391
CourtSupreme Judicial Court of Maine
DecidedOctober 13, 1965
StatusPublished
Cited by21 cases

This text of 213 A.2d 712 (Associated Hospital Service of Maine v. Mahoney) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Associated Hospital Service of Maine v. Mahoney, 213 A.2d 712, 161 Me. 391 (Me. 1965).

Opinion

*393 Marden, J.

On report. Associated Hospital Service of Maine (AHS) was incorporated by Chapter 24, Private and Special Laws, 1939 (Charter), for the purpose of establishing, maintaining and operating a nonprofit hospital service plan whereby hospital care might be provided by hospitals with which the corporation might have a contract to such of the public as might become subscribers under a contract with AHS. 1 The act provided that it could qualify for operation by submitting, among other things, copies of its proposed contracts and table of rates to be charged to the Insurance Commissioner (Commissioner) of the State and that the Commissioner should annually issue a license to AHS upon being satisfied, among other things, that the proposed program be a non-profit *394 program and that the rates charged and benefits provided be fair and reasonable. The Commissioner was authorized to examine the affairs of the corporation; was to serve as an arbiter in controversies arising between the corporation and any hospital, and was empowered to supervise dissolution as in cases involving insurance companies. The act declared AHS a charitable institution and exempted it from taxation. This service of the corporation has become known as “Blue Cross” service. This special act was approved March 2, 1939.

At the same session of the Legislature Chapter 149, Public Laws 1939, an enabling act, with essential terms the same as Chapter 24 of the Private and Special Laws, permitted the organization of non-profit hospital service corporations under the general law. The supervisory responsibility of the Commissioner was expanded to the licensing of selling agents for the corporation. This general act was approved March 30, 1939.

By Chapter 21, Private and Special Laws 1943, permissible operation of AHS was extended to cover contracts for medical and surgical service. 2 This service of the corporation has become known as “Blue Shield” service.

*395 By Chapter 47, Public Laws 1951, the permissible operation of non-profit hospital service corporations was likewise extended under the general law.

By Chapter 175, Private and Special Laws 1955, the permissible operation of AHS was extended to group contracts and reciprocal arrangements with similar corporations in other states.

The general law was not co-extended.

By Chapter 47, Private and Special Laws 1957, the authority of AHS was extended to issue non-profit contracts under which it assumed liability (responding by cash indemnity) on the whole or part of the expenses incurred by a subscriber as a result of injury or disease not covered by the corporation’s regular contracts for hospital or medical service (hereinafter referred to as “extended benefits”) provided, however, that such liability was reinsured and further, that, subject to the prior approval of the Commissioner, AHS might, on a non-profit basis, perform services for the State or United States Governments. The phase of the 1957 extension authorizing extended benefits not covered by AHS’s regular contracts is in Section 3 C of the plaintiff’s charter and is the source of the present controversy.

By Chapter 135, Private and Special Laws 1963, Charter, Section 3 C was amended to authorize AHS to offer the extended benefits without reinsurance, provided that a deposit was made with the Treasurer of State as security for the payment of “said additional benefits,” which shall be limited to health care services and supplies, but not include indemnity for loss of time, incapacity or death. 3

*396 At this point, and after AHS had deposited the required security, it submitted to the Commissioner a copy of the proposed extended benefits contract (Extended Benefits Endorsement BC-BS-63) and offered the new contract to the public.

After some intervening negotiations, and an opinion rendered to the Commissioner by the office of the Attorney General, the Commissioner disapproved the proposed contract as being in conflict with R. S., 1954, Chapter 60, §§ 244-257, inclusive, “Non-profit Hospital or Medical Service Organizations” (now 24 M.R.S.A., §§ 2301-2315), which statute embodied the 1939 and 1951 public laws referred to above, with changes not here pertinent.

The conflict arises between Section 3 C of the AHS charter which authorizes the extended benefits contract and §§ 244 and 246, of Chapter 60, R. S., 1954 (now 24 M.R.S.A., §§ 2301 and 2303) which defines the scope of such organizations under the general law and which scope is confined to the Blue Cross and Blue Shield programs.

Associated Hospital Service sought a declaratory judgment as to the Commissioner’s authority to so disapprove and as to the validity of Section 3 C of its charter, and sought an injunction pendente lite against interference by the Attorney General and the Commissioner. While the complaint was pending before the single justice, the Health Insurance Association of America, et al., sought permission to intervene under Rule 24 M.R.C.P. and were per *397 mitted to do so. The complaint was discontinued as against the Attorney General. After hearing, introduction of exhibits and recording of stipulations, preliminary injunction was granted and by agreement the case was reported.

The following questions of law are stipulated:

1. The extent of the Insurance Commissioner’s jurisdiction over issue of contracts by plaintiff.
2. Whether Chapter 135, Private and Special Laws 1963 (and Chapter 47, Private and Special Laws 1957), conflicts with Chapter 60, § 244, R. S., 1954, as amended (and if so with what effect), and
3. Whether (exercise of rights granted plaintiff under) Chapter 135, Private and Special Laws, 1963, denies the intervenors the equal protection of the law (constitutionally guaranteed).

Within the stipulated questions plaintiff contends:

1. That the Insurance Commissioner has no standing to question the constitutionality of Charter, Section 3 C, and
2. That the intervenors have no standing to question the constitutionality of Charter, Section 3 C.

Although not stipulated, it is established that AHS is the only non-profit hospital or medical service organization existing in Maine.

Standing of Commissioner and Intervenors.

The standing of the Insurance Commissioner and the intervenors is first considered.

Conceding that the weight of authority does not permit a ministerial public officer to challenge the constitutional validity of the law under which he is enjoined to act *398 through a writ of mandamus, State ex rel. Atlantic Coast Line R. Co. v.

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213 A.2d 712, 161 Me. 391, Counsel Stack Legal Research, https://law.counselstack.com/opinion/associated-hospital-service-of-maine-v-mahoney-me-1965.