Marquette General Hospital, Inc v. Chosa

770 N.W.2d 920, 284 Mich. App. 80
CourtMichigan Court of Appeals
DecidedMay 26, 2009
DocketDocket 285697
StatusPublished

This text of 770 N.W.2d 920 (Marquette General Hospital, Inc v. Chosa) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marquette General Hospital, Inc v. Chosa, 770 N.W.2d 920, 284 Mich. App. 80 (Mich. Ct. App. 2009).

Opinion

DAVIS, J.

Plaintiff, Marquette General Hospital, Inc. (the Hospital), appeals as of right the Baraga Circuit Court’s order granting summary disposition in favor of defendants. At issue is defendant Baraga County’s liability for the cost of medical services provided by the Hospital to defendant Bryan Keith Chosa, who was an inmate at the Baraga County Jail at the time. Although the general legal principles involved were well-established by statute in the earliest days of Michigan’s statehood, this case presents an issue of first impression regarding a procedural requirement added to the statute by the Legislature in 2006. We reverse and remand.

The general facts in this case are simple and undisputed. On July 15, 2006, Chosa was admitted at the Hospital for in-patient medical services. The record does not specify precisely what those services were. But from reading the medical billing summary, several cop *82 ies of which are found in the lower court record, it is clear that the services related to cardiac problems. Furthermore, his admission was apparently an emergency, and counsel for Baraga County would later tell the trial court that “we actually [had] to modify a bond at one point to get [Chosa] out of jail because of precisely the type of issues that brought us here.” Chosa was, in any event, discharged on July 19, 2006, and was returned to the Baraga County Jail.

The medical bill for Chosa’s care came to $31,305.42, and an account for that sum was stated between the parties. Miki Wipfli, the Hospital’s business office manager stated in an affidavit that the only medical coverage that it was aware of at the time was “ABW Medicaid or Adult Medical Program,” which only covered outpatient services and therefore would not apply to Chosa’s in-patient services. He further stated that, after verifying the accuracy of that belief, the Hospital informed the Baraga Department of Human Services on August 7, 2006, that Chosa was not eligible for Medicaid. On August 16, 2006, the Hospital sent a bill to the Baraga County Jail.

According to a copy of an Application Eligibility Notice from the Michigan Family Independence Agency, Chosa applied for state assistance — specifically, disability and Medicaid — on August 23, 2006. On September 26, 2006, Baraga Undersheriff Bob Teddy wrote a letter to the Hospital stating his assumption that the Hospital had already explored Medicaid eligibility and advising the Hospital for the first time that Chosa was a member of the Keweenaw Bay Indian Community and possibly eligible for medical services through the Indian Health Service. Teddy also wrote that “MCL 801.4 mandates that you explore this source of payment as well as any other possible sources of payment before resubmitting *83 you [sic] invoice to my Office.” Wipfli stated in his affidavit that the Hospital did not receive Teddy’s letter until October 23, 2006. 1 He farther stated that this was the first time the Hospital was made aware that Chosa might be eligible for Indian health care.

Wipfli stated that the Hospital “accordingly” billed the Keweenaw Bay Indian Community’s Health Association on October 4, 2006. 2 On January 29, 2007, the Keweenaw Bay Indian Tribal Health Fund sent a letter to the Hospital denying payment because “[a]pproval was not obtained from an IHS authorizing official within 72 hours following receipt of this EMERGENCY SERVICE.” In the meantime, on November 8, 2006, the Family Independence Agency denied disability and Medicaid to Chosa because he was “not disabled per MRT.” (The record does not disclose what the acronym stands for.) Wipfli’s affidavit states that various individuals employed by Baraga County were apprised of the ongoing attempts to obtain payment for Chosa. Those communications appear to be the only items of material fact in dispute, although given that those communications were apparently only verbal, it is additionally disputed whether they are even relevant under the applicable statute.

The instant suit was commenced on January 18, 2008, in the general posture of bill collection. Baraga *84 County admitted that the medical services were rendered, that an account stated for $31,305.42 existed between the parties, and that, as a general statutory matter, defendant Baraga County is responsible for the payment of that money for Chosa’s medical services. MCL 801.4(1). Baraga County contends, however, that the Hospital failed to comply with certain statutory prerequisites to payment.

Under MCL 801.4(1), with some listed exceptions, “all charges and expenses of safekeeping and maintaining prisoners and persons charged with an offense[ ] shall be paid from the county treasury, the accounts therefor being first settled and allowed by the county board of commissioners.” The substance of MCL 801.4(1) has literally always been “on the books” in Michigan, a substantially identical provision being found in the 1838 Rev Stat, part 4, tit 2, ch 10, § 3; later found in the 1846 Rev Stat, ch 171, § 4. Other than the more recent insertion by the Legislature of the mentioned exceptions, counsel for Baraga County accurately conceded that, traditionally, “it’s always been done this way.”

The exceptions to MCL 801.4(1) are at issue in this case. 2006 PA 20 added subsection 2, which became effective on February 9, 2006 — approximately five months before the medical services were rendered in this case. Specifically, MCL 801.4(2) provides:

If medical care or treatment is provided to an individual described in subsection (1), the health care provider shall make a reasonable effort to determine whether that individual is covered by a health care policy, a certificate of insurance, or other source for the payment of medical expenses. If the county sheriff who has custody over the individual is aware that the individual is covered by any health care policy, certificate of insurance, or other source of payment, the sheriff shall provide that information to *85 the health care provider. If the health care provider determines that the individual, at the time of admission or treatment, is a medicaid recipient or a beneficiary of any health care policy, certificate of insurance, or other source for the payment of some or all of those expenses, the health care provider shall first seek reimbursement from that source, subject to the terms and conditions of the applicable health care policy, certificate of insurance, or medicaid contract, before submitting those expenses to the county. When submitting an invoice to the county for the payment of medical expenses under this section, a health care provider shall provide a statement that the health care provider has made a reasonable effort to determine whether the individual was covered by a health care policy, certificate of insurance, or other source for the payment of medical expenses. A county may enter into agreements with health care providers to establish procedures for the submission of invoices for medical expenses under this section and the payment of those invoices.

This Court reviews a trial court’s ruling on a motion for summary disposition de novo. Coblentz v City of Novi, 475 Mich 558, 567-568; 719 NW2d 73 (2006).

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Coblentz v. City of Novi
719 N.W.2d 73 (Michigan Supreme Court, 2006)
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468 Mich. 1216 (Michigan Supreme Court, 2003)

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Bluebook (online)
770 N.W.2d 920, 284 Mich. App. 80, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marquette-general-hospital-inc-v-chosa-michctapp-2009.