Jo Ann Blackwell v. Mary Black Health System, LLC

CourtCourt of Appeals of South Carolina
DecidedSeptember 18, 2024
Docket2020-001613
StatusPublished

This text of Jo Ann Blackwell v. Mary Black Health System, LLC (Jo Ann Blackwell v. Mary Black Health System, LLC) is published on Counsel Stack Legal Research, covering Court of Appeals of South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jo Ann Blackwell v. Mary Black Health System, LLC, (S.C. Ct. App. 2024).

Opinion

THE STATE OF SOUTH CAROLINA In The Court of Appeals

Jo Ann Blackwell, Michelene Brooks, and Samuel H. Owens, Jr., individually and on behalf of all others similarly situated, Respondents,

v.

Mary Black Health System, LLC, d/b/a Mary Black Memorial Hospital; CHSPSC, LLC; and Professional Account Services, Inc., Appellants.

Appellate Case No. 2020-001613

Appeal From Spartanburg County J. Mark Hayes, II, Circuit Court Judge

Opinion No. 6088 Heard March 4, 2024 – Filed September 18, 2024

AFFIRMED

James Lynn Werner and Katon Edwards Dawson, Jr., both of Parker Poe Adams & Bernstein, LLP, of Columbia, for Appellants.

Rachel Gottlieb Peavy, of Simmons Law Firm, LLC, of Columbia, for Respondents Michelene Brooks and Samuel H. Owens, Jr.

John S. Simmons and Rachel Gottlieb Peavy, of Simmons Law Firm, LLC, of Columbia; John Belton White, Jr., Griffin Littlejohn Lynch, and Marghretta Hagood Shisko, all of John B. White, Jr., P.A., of Spartanburg; and Wes A. Kissinger, Thomas A. Killoren, Jr., and Ryan Frederick McCarty, of Spartanburg, all for Respondent Jo Ann Blackwell.

VINSON, J.: Mary Black Health System, LLC, d/b/a Mary Black Memorial Hospital (Mary Black); CHSPSC, LLC; and Professional Account Services, Inc. (PASI) (collectively, Providers) appeal the circuit court's denial of their motions to dismiss the amended complaint of Jo Ann Blackwell, Michelene Brooks, and Samuel Owens, Jr. (collectively, Insureds). Providers argue the circuit court erred by denying their motions to dismiss when Owens's claims were barred by the statute of limitations; Blackwell failed to state a claim for unjust enrichment and could not enforce the agreement between MedCost, Blackwell's insurance carrier, and Mary Black as a third-party beneficiary; Brooks's claims fell under the Medicare Act, which required them to initially seek payment from applicable auto or liability policy coverage; Brooks's and Owens's claims were barred by the voluntary payment doctrine; and the complaint failed to state sufficient facts to constitute a tortious interference with a contract claim or any viable cause of action against PASI or CHSPSC. Providers also appeal the circuit court's denial of their motion to stay the case and compel arbitration against Owens, arguing Owens's claims must be resolved through arbitration because he was attempting to enforce the agreement between Mary Black and CIGNA, Owens's insurance carrier. We affirm.

FACTS AND PROCUDURAL HISTORY In this case, Insureds received medical treatment at Mary Black for injuries they sustained in automobile accidents. Insureds allege Providers sought payment for their services by submitting medical bills to Insureds and asserting liens against their third-party automobile accident claims instead of submitting medical bills to Insureds' health insurance carriers.

Blackwell originally filed the complaint as a class action against Providers on January 20, 2017. After obtaining leave from the circuit court, Blackwell amended the complaint in April 2020 to add Owens and Brooks as plaintiffs. Blackwell, who stated she had valid health insurance through MedCost at the time of her accident, received treatment at Mary Black that resulted in $33,093.65 in medical bills. She alleged Providers refused to submit the medical bills to MedCost and instead sought collection by asserting liens against her potential third-party automobile accident claim. Brooks alleged she had valid health insurance through Medicare at the time that she received treatment at Mary Black, and her treatment resulted in $9,982.44 in medical bills. Brooks further alleged Providers asserted liens against her third-party automobile claim instead of turning the medical bills over to Medicare for payment. Brooks stated Providers agreed to settle Brooks's account if she paid fifty percent of the medical bills, or $4,991.22. Brooks alleged Providers agreed to accept only the reduced payment after asserting a lien against her third-party recovery in her personal injury case and reviewing the settlement offer in that case. Similarly, Owens alleged he had valid health insurance coverage through CIGNA when he received medical treatment at Mary Black that resulted in a bill for $9,086.76. He alleged Providers refused to submit his medical bills to CIGNA and agreed to settle for fifty percent of the original bill after asserting a lien against his third-party recovery in his personal injury case and reviewing the settlement offer in that case. All Insureds alleged their health insurance carriers would have paid their medical bills had Providers submitted those bills to their respective carriers. Insureds' amended complaint included claims for tortious interference with a contractual relationship, unjust enrichment, and injunctive relief. In their tortious interference with a contractual relationship claim, Insureds alleged they had "a valid business expectancy and/or contractual relationship" with their health insurance carriers that Providers knew or should have known about. They alleged Providers "intentionally and improperly inferred [sic] with and caused a disruption of the business expectancies and/or contractual relationships" between Insureds and their health insurance carriers. Insureds alleged Providers acted without justification and caused damages to Insureds, who paid premiums for health insurance but received no benefit. In their unjust enrichment cause of action, Insureds alleged Providers were unjustly enriched when they received "the benefits of proceeds to which they were not entitled" after billing Insureds for their medical expenses instead of their health insurance carriers. They alleged payment should have been made by the health insurance carriers and the amount paid should have been determined by the contracts between the carriers and Providers.

Insureds' cause of action for injunctive relief alleged Providers were required to send medical bills directly to the Insureds' health insurance carriers and to honor the carriers' contractual discounts for Mary Black's services. They allege Providers failed to honor the contractual discounts or its commitment to send Insureds' bills to the health insurance carriers. Insureds stated Providers attempted to increase their profit by seeking payment from Insureds directly despite the fact that they were "precluded from seeking payment for covered services from [sources other than Insureds' health insurance carriers]." Insureds requested the circuit court find Providers violated the terms of Providers' agreements with the health insurance carriers, declare the practice invalid and void as a matter of law, and enter a permanent injunction enjoining Providers from continuing the practice.

In June 2020, Providers moved to dismiss the amended complaint or, in the alternative, to stay the case and compel arbitration. Providers argued the amended complaint failed to allege sufficient facts to constitute a tortious interference with contractual relationship claim; Brooks's claims fell under the Medicare Act, which required them to initially seek payment from any applicable auto or liability policy coverage; Blackwell failed to state a claim for unjust enrichment and was barred from enforcing the agreement between MedCost and Mary Black (the MedCost Agreement) as a third-party beneficiary; Owens's claims were barred by the statute of limitations; and Brooks's and Owens's claims were barred by the voluntary payment doctrine. In addition, Providers argued Owens's claims against CHSPSC must be resolved through arbitration because he was attempting to enforce the agreement between Mary Black and CIGNA (the CIGNA Agreement), which included an arbitration clause.

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Bluebook (online)
Jo Ann Blackwell v. Mary Black Health System, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jo-ann-blackwell-v-mary-black-health-system-llc-scctapp-2024.