Galvan v. Northwestern Memorial Hospital

888 N.E.2d 529, 382 Ill. App. 3d 259
CourtAppellate Court of Illinois
DecidedApril 14, 2008
Docket1—05—3620, 1—05—4083 cons.
StatusPublished
Cited by28 cases

This text of 888 N.E.2d 529 (Galvan v. Northwestern Memorial Hospital) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Galvan v. Northwestern Memorial Hospital, 888 N.E.2d 529, 382 Ill. App. 3d 259 (Ill. Ct. App. 2008).

Opinions

JUSTICE GARCIA

delivered the opinion of the court:

The plaintiff, Antonio Galvan, brought a class action lawsuit against the defendant, Northwestern Memorial Hospital, and other similarly situated not-for-profit hospitals in Illinois to challenge their practices of charging uninsured patients more for services than they charged insured patients. Following a motion by the defendant, the trial court dismissed the plaintiffs complaint with prejudice pursuant to section 2—615 of the Code of Civil Procedure (Code) (735 ILCS 5/2 — 615 (West 2004)). The plaintiff appeals, arguing he sufficiently pleaded a cause of action under the Illinois Consumer Fraud and Deceptive Business Practices Act (Consumer Fraud Act) (815 ILCS 505/1 et seq. (West 2004)) and for unjust enrichment.

BACKGROUND

On August 27, 2003, the plaintiff was involved in an automobile accident and suffered serious injuries. He was taken to the emergency room at Northwestern where he underwent surgery. The plaintiff remained at Northwestern for 15 days. After he was released, Northwestern billed the plaintiff $87,033.99 for the health care services it provided. At the time of his hospitalization, the plaintiff was uninsured.

In an action to recover for his injuries, the plaintiff was awarded $240,000 in a settlement agreement with the tortfeasor. Northwestern asserted a lien on the proceeds of the settlement in the amount of $87,033.99.

On January 27, 2005, the plaintiff, individually and on behalf of “all uninsured persons who were treated at or were admitted to Northwestern Memorial Hospital and similar not-for-profit hospitals throughout the state of Illinois from 2001 to the present and who have been billed list or gross hospital charges by Northwestern Memorial Hospital and similar not-for-profit hospitals,” filed a two-count complaint against Northwestern “and similarly situated not-for-profit hospitals operating in the state of Illinois that have charged or are charging their uninsured patients gross or list hospital charges.” Count I alleged violations of the Consumer Fraud Act. Specifically, it alleged Northwestern’s practice of billing uninsured patients gross or list hospital charges, which was more than 50% what it charged insured patients, was unfair and deceptive. In count II, the plaintiff alleged Northwestern was unjustly enriched by its imposition of the lien on the plaintiff’s settlement.

The Illinois Hospital Association, in its amicus brief, explained the federal government mandates, through Medicare regulations, all hospitals maintain a charge master list, which outlines customary charges for each of a hospital’s services and supplies. The plaintiff alleged when Northwestern billed him for his health care expenses, he was billed based on this list. He maintains this violated the Consumer Fraud Act because insured patients are generally charged significantly lower rates for the same services. The Hospital Association explained that, in general, insured patients are billed less than the price set in the charge master list because their insurance companies have contracted with the hospital.

In May 2005, Northwestern moved to dismiss the plaintiff’s complaint, arguing the plaintiff failed to state a claim upon which relief could be granted. On November 11, 2005, the trial court granted Northwestern’s motion. The court held because the plaintiff was taken to Northwestern in an emergency, he could not allege any damages proximately caused by a deceptive act. Further, the plaintiff could not allege unfairness because Northwestern’s policy did not violate public policy, the plaintiff was free to challenge the amount he was charged, and the imposition of the lien was a benign act. The court also held the plaintiff failed to state a claim for unjust enrichment because he did not pay any money to Northwestern and thus could not allege Northwestern retained a benefit to his detriment.

The November 11, 2005, order contained the wrong case number. On December 12, 2005, the trial court granted the plaintiffs motion for the entry of an order bearing the correct case number. This appeal followed.

AMICI BRIEFS

The Service Employees International Union (SEIU) was granted leave to file an amicus brief in support of the plaintiff. The Illinois Hospital Association submitted an amicus brief in support of Northwestern. These briefs outline hospital billing procedures and policies and the effect of these policies on workers. The amici briefs also disclose challenges to hospital billing practices raised in different lawsuits in Illinois and throughout the country.

ANALYSIS

The plaintiff argues the trial court erred when it granted Northwestern’s section 2 — 615 motion to dismiss because he sufficiently stated a cause of action for violations of the Consumer Fraud Act and unjust enrichment. In the alternative, the plaintiff argues in his reply brief he should have been granted leave to amend his complaint.1 A section 2 — 615 motion to dismiss challenges the legal sufficiency of a complaint. 735 ILCS 5/2 — 615 (West 2004); First Midwest Bank, N.A. v. Stewart Title Guaranty Co., 218 Ill. 2d 326, 334, 843 N.E.2d 327 (2006). In the context of a section 2 — 615 motion, “[t]he central inquiry is whether the allegations of the complaint, when considered in the light most favorable to the plaintiff, are sufficient to state a cause of action relief may be granted on.” Hill v. PS Illinois Trust, 368 Ill. App. 3d 310, 312, 856 N.E.2d 560 (2006). A court should not dismiss a complaint on the pleadings “unless it clearly appears that no set of facts can be proved under the pleadings which will entitle the plaintiff to recover.” Bryson v. News America Publications, Inc., 174 Ill. 2d 77, 86-87, 672 N.E.2d 1207 (1996). We review the trial court’s dismissal of a complaint de novo. First Midwest Bank, 218 Ill. 2d at 334.

In order to state a claim, a plaintiff must allege facts sufficient to bring a claim within a legally cognizable cause of action. City of Chicago v. Beretta U.S.A. Corp., 213 Ill. 2d 351, 368, 821 N.E.2d 1099 (2004). A court considering a motion to dismiss for failure to state a claim will “disregard the conclusions that are pleaded and look only to well-pleaded facts to determine whether they are sufficient to state a cause of action against the defendant.” Beretta, 213 Ill. 2d at 368. If the facts are not sufficient, a court will grant a defendant’s motion to dismiss. Beretta, 213 Ill. 2d at 368.

A. Consumer Fraud Act

The plaintiff maintains he adequately pleaded Northwestern’s practice of billing uninsured patients at its list or gross rate, which was more than 50% what it charged insured patients, was unfair and deceptive.

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Cite This Page — Counsel Stack

Bluebook (online)
888 N.E.2d 529, 382 Ill. App. 3d 259, Counsel Stack Legal Research, https://law.counselstack.com/opinion/galvan-v-northwestern-memorial-hospital-illappct-2008.