King County Public Hospital District No. 2 v. Department of Health

275 P.3d 1141, 167 Wash. App. 740
Court of Appeals of Washington·Decided May 4, 2012·No. 66304-6-I·Published·Cited by 9 cases

Opinion

*742 Spearman, J.

¶1 We are asked to determine whether a health law judge (HLJ) acted arbitrarily and capriciously in entering a final order approving a settlement between the Department of Health (Department) and Odyssey Healthcare. The central component of the settlement was the Department’s approval of Odyssey’s 2006 certificate of need (CN) application to provide hospice care in King County. Evergreen and other competing providers filed a petition for review of the HLJ’s order in superior court. The superior court reversed the HLJ’s order on the grounds that (1) Evergreen had not received a full adjudicative hearing, (2) the Department acted arbitrarily and capriciously in settling Odyssey’s federal lawsuit by granting Odyssey’s 2006 CN application based on evidence obtained long after the record for that application was closed, and (3) the HLJ acted arbitrarily and capriciously in adopting the settlement without finding that Odyssey had met all four of the CN criteria. The court revoked the CN and remanded to the HLJ. Odyssey appeals. We hold that the HLJ’s approval of the settlement was not arbitrary and capricious for the reasons asserted by Evergreen on appeal. We reverse and remand.

FACTS

¶2 In Washington, hospice care can be offered only by holders of CNs, which are nonexclusive licenses. RCW 70.38.025(6); RCW 70.38.105. To obtain a CN, a provider’s proposal must meet four criteria: (1) need for the proposed program, (2) financial feasibility of the program, (3) structure and process of care, and (4) cost containment. WAC 246-310-210 through -.240. The CN process involves an application by a provider; notification to certain interested parties, such as competitors, and an opportunity for public comment (including a hearing, if requested); and a decision by the Department. See RCW 70.38.115. An applicant denied a CN has the right to an adjudicative proceeding. RCW 70.38.115(10)(a). If the Department wishes to settle *743 with an applicant prior to the conclusion of the adjudicative proceeding, the Department must inform competitors and afford them an opportunity to comment, in advance, on the proposed settlement. RCW 70.38.115(10)(c).

¶3 In October 2006, Odyssey filed ON applications to offer hospice services in King, Snohomish, and Pierce Counties. This was Odyssey’s second attempt to obtain CNs for these counties; its 2003 applications had been denied. 1 The Department denied the 2006 applications in August 2007. Odyssey requested adjudicative proceedings to appeal the denials before an HLJ. Evergreen’s request to intervene was granted. The HLJ, John F. Kuntz, granted various stays, one due to Odyssey’s plan to file a federal lawsuit. On April 7, 2009, Odyssey filed a lawsuit against the Department in federal district court, alleging violations of the Sherman Anti-Trust Act, 15 U.S.C. § 1; the dormant commerce clause, U.S. Const, art. I, § 8, cl. 3; and 42 U.S.C. § 1983. 2

¶4 The Department and Odyssey entered into settlement negotiations to resolve the federal lawsuit and the adjudicative proceedings. On September 25, 2009 they reached an agreement, memorialized in two documents: (1) *744 a settlement to resolve the federal lawsuit and (2) a proposed settlement and stipulation to resolve the adjudicative proceeding. The settlement in the federal lawsuit required the parties to enter into the settlement and stipulation in the adjudicative proceeding. 3 The settlement also contained a release provision to ensure that the Department would act in good faith in deciding whether to present the proposed settlement in the adjudicative proceeding to the HLJ and support the HLJ’s approval of it. 4

¶5 Under the proposed settlement in the adjudicative proceeding, the parties proposed approval of Odyssey’s CN application based on more recent data showing that need now existed for a new hospice in King County (2008 methodology). 5 The Department agreed to provide appropriate entities notice and an opportunity to comment on the *745 proposed settlement. The proposed settlement stated that the Department would then “(i) present the Stipulation to the Health Law Judge for entry of an Order approving the proposed settlement and granting the King County application ... , or (ii) notify Odyssey of its decision not to present the Stipulation to the Health Law Judge . . . .” Odyssey agreed to withdraw its request for adjudicative proceedings to appeal the denials for CNs for Pierce and Snohomish Counties.

*744 Nothing in this Agreement prohibits Odyssey from bringing a new lawsuit against the State of Washington, the Department of Health, or any of its employees or former employees, related to the denial of a Certificate of Need application, including a denial by the Health Law Judge of the King County Certificate of Need awarded under paragraph 2 of the proposed Settlement and Stipulation in the pending adjudicative proceeding before the Department of Health. However, in such case, with one exception, Odyssey is precluded from seeking damages, costs, or attorneys’ fees related to any event allegedly occurring prior to the date of signing of this Settlement. This preclusion will not apply if the Certificate of Need Program, pursuant to Paragraph 4 of the attached Stipulation and Settlement, makes a decision not to present the Stipulation and Settlement to the Health Law Judge for approval of the King County application, and in subsequent litigation, Odyssey proves that the decision was made in bad faith. No showing of bad faith is required in order for Odyssey to seek prospective injunctive relief in any future lawsuit.

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King County Public Hospital District No. 2 v. Department of Health, 275 P.3d 1141, 167 Wash. App. 740 (Wash. Ct. App. 2012).

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