In Re Hospital Pricing Litigation

659 S.E.2d 131, 377 S.C. 48
CourtSupreme Court of South Carolina
DecidedMarch 10, 2008
Docket26457
StatusPublished

This text of 659 S.E.2d 131 (In Re Hospital Pricing Litigation) is published on Counsel Stack Legal Research, covering Supreme Court of South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Hospital Pricing Litigation, 659 S.E.2d 131, 377 S.C. 48 (S.C. 2008).

Opinion

377 S.C. 48 (2008)
659 S.E.2d 131

In re HOSPITAL PRICING LITIGATION.
Teresa Lynn KING, Respondent,
v.
ANMED HEALTH, Appellant.
David Blair and all others similarly situated, Respondents,
v.
Medical University Hospital Authority, Appellant.
Kathy and Franklin Kinard and all others similarly situated, Respondents,
v.
Medical University Hospital Authority, Appellant.
David Blair and all others similarly situated, Respondents,
v.
CareAlliance Health Services, Inc., d/b/a Roper Hospital, Inc., and Bon Secours St. Francis Xavier Hospital, Inc., Appellant.
Deborah Wilson and all others similarly situated, Respondents,
v.
CareAlliance Health Services, Inc., d/b/a Roper Hospital, Inc., and Bon Secours St. Francis Xavier Hospital, Inc., Appellant.
Greenville Hospital System, Appellant,
v.
Kellie Jean Paulson and Michael A. Paulson, Respondents.
William S. Robertson, as Personal Representative for the Estate of Mildred Driggers Robertson, Deceased, and all others similarly situated, Respondents,
v.
Greenville Hospital System, Appellant.
Joshua L. Boyd, Respondent,
v.
Self Regional Healthcare, Appellant.
Alexis Sams and all others similarly situated, Respondents,
v.
Palmetto Health Alliance d/b/a Palmetto Richland *49 & Palmetto Baptist, Appellants.
Frances Bonetto, Respondent,
v.
Palmetto Health Alliance d/b/a Palmetto Richland & Palmetto Baptist, Appellants.
Kathy Green and all those similarly situated, Respondents,
v.
Sisters of Charity Providence Hospitals, Appellant.

No. 26457.

Supreme Court of South Carolina.

Heard January 10, 2008.
Decided March 10, 2008.
Rehearing Denied April 16, 2008.

*51 Manton M. Grier and R. David Proffitt, both of Haynsworth Sinkler Boyd, of Columbia, and Ellis M. Johnson, II, H. Sam Mabry, III and Courtney C. Atkinson, all of Haynsworth Sinkler Boyd, of Greenville, for Appellant Palmetto Health Alliance d/b/a Palmetto Richland & Palmetto Baptist.

Marguerite S. Willis, Nikole Setzler Mergo, and Daniel C. Leonardi, all of Nexsen Pruet, of Columbia, for Appellant Sisters of Charity Providence Hospitals.

Thomas S. White and Lydia Blessing Applegate, both of Haynsworth Sinkler Boyd, of Charleston, for Appellant Care-Alliance Health Services Corporation d/b/a Roper St. Francis Healthcare, Roper Hospital, Bon Secours St. Francis Hospital.

Robert L. Widener, Celeste T. Jones, Jane W. Trinkley, and Kelly M. Jolley, all of McNair Law Firm, of Columbia, for Appellant Medical University Hospital Authority.

Wm. Douglas Gray, of McNair Law Firm, of Anderson, for Appellant AnMed Health.

H. Sam Mabry, III and Charles M. Sprinkle III, both of Haynsworth Sinkler Boyd, of Greenville, for Appellant The Greenville Hospital System.

Stephen D. Baggett and Steven M. Pruitt, both of McDonald Patrick Baggett Poston & Hemphill, of Greenwood, for Appellant Self Regional Healthcare.

A. Camden Lewis, Ariail E. King, and Peter D. Protopapas, all of Lewis & Babcock, of Columbia, Richard A. Harpootlian, of Columbia, Gedney M. Howe III, of Charleston, and Robert D. Dodson, of Columbia, and Michael E. Spears, of Spartanburg, for Respondents.

Acting Chief Justice MOORE.

In this case, Appellants appeal the circuit court's order granting partial summary judgment in favor of Respondents regarding the meaning of a statute that requires hospitals to *52 offer certain discounts to an insurer who provides a specific type of health insurance contract. The circuit court held that Appellants violated the statute. We disagree and reverse.

FACTUAL/PROCEDURAL BACKGROUND

Respondents[1] (hereinafter "Patients") filed an action against Appellants (hereinafter "Hospitals") for failing to comply with S.C.Code Ann. § 38-71-120 (2002) (repealed by Act No. 332, § 31, 2006 S.C. Acts 2624, 2661) (hereinafter "the Discount Statute"), which provides:

Whenever an insurer contracts with a hospital to provide full hospital service and medical care service contracts for its policy owners in the same manner as described in Chapters 13 and 14 of Title 37 of the 1962 Code and arranges with the hospital for payment of claims under procedures described in Chapters 13 and 14 of Title 37 of the 1962 Code, the insurer is entitled to the same discounts allowed to any insurer. Any person making full payment for hospital services within seven days from receipt of a bill for such services shall be entitled to the same discount allowed to any insurer.

Hospitals currently bill their patients the same amount for identical procedures based on a Charge Master,[2] but Hospitals give different discounts on these procedures depending on Hospitals' contracts with a patient's insurance company. Patients filed the instant action against Hospitals, arguing that these current billing practices violated the Discount Statute. In response, Hospitals contended that the Discount Statute was an outdated statute that had no application because insurance companies do not currently offer "full hospital service and medical care service contracts" to which the Discount Statute applies and that no insurer contracts with Hospitals "in the same manner as described in Chapters 13 and 14 of *53 Title 37 of the 1962 Code." The parties filed cross motions for summary judgment, and after a hearing, the circuit court granted partial summary judgment in favor of Patients.

The circuit court first noted that the manner in which insurance companies provide health insurance to their policyholders has changed since the Discount Statute was first enacted. However, the circuit court rejected Hospitals' argument that full service contracts no longer exist. Rather, the circuit court held that all of the contracts involved in this litigation were service contracts, as opposed to indemnity contracts, and thus, under a progressive reading of the statute, the Discount Statute applied to the current contracts utilized by Hospitals. Additionally, the circuit court held that the requirement that an insurer must contract "in the same manner as described in Chapters 13 and 14 of Title 37 of the South Carolina Code" simply meant that the insurer must contract directly with Hospitals and determined that insurers currently contract with Hospitals in this same manner. Accordingly, the circuit court ruled that the Discount Statute required the Hospitals to offer uniform discounts to all insured Patients. Additionally, the circuit court held that the second sentence of the Discount Statute required Hospitals to provide uninsured Patients with a bill reflecting the lowest discount offered to any insurer. Because Hospitals admitted that they failed to do so, the circuit court ruled that Hospitals violated the Discount Statute.[3]

Hospitals appealed and we certified this case pursuant to 204(b), SCACR. Hospitals present the following issue for review:

Is the circuit court's interpretation of the Discount Statute erroneous as a matter of law because it is against the legislative intent and ignores the plain meaning of the terms?[4]

*54 STANDARD OF REVIEW

The issue of interpretation of a statute is a question of law for the court. Catawba Indian Tribe of South Carolina v. State, 372 S.C.

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Cite This Page — Counsel Stack

Bluebook (online)
659 S.E.2d 131, 377 S.C. 48, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-hospital-pricing-litigation-sc-2008.