Nosser v. Health Care Trust Fund Bd.

666 So. 2d 1272, 1996 La. App. LEXIS 26, 1996 WL 23446
CourtLouisiana Court of Appeal
DecidedJanuary 24, 1996
Docket27619-CA
StatusPublished
Cited by3 cases

This text of 666 So. 2d 1272 (Nosser v. Health Care Trust Fund Bd.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nosser v. Health Care Trust Fund Bd., 666 So. 2d 1272, 1996 La. App. LEXIS 26, 1996 WL 23446 (La. Ct. App. 1996).

Opinion

666 So.2d 1272 (1996)

Dr. Thomas M. NOSSER, et al., Plaintiffs-Appellees,
v.
HEALTH CARE TRUST FUND BOARD OF the CITY OF SHREVEPORT, Defendant-Appellant.

No. 27619-CA.

Court of Appeal of Louisiana, Second Circuit.

January 24, 1996.

*1273 Ramona N. Wallis, Shreveport, for Defendant-Appellant.

Michael H. Wainwright, Shreveport, for Plaintiffs-Appellees.

Before NORRIS, BROWN, and WILLIAMS, JJ.

NORRIS, Judge.

Dr. Thomas M. Nosser and the Chiropractic Association of Louisiana filed suit in February 1994 against the Health Care Trust Fund Board of the City of Shreveport, seeking a declaratory judgment that a certain limitation in the health care plan provided to participating employees of the City of Shreveport violated La.R.S. 22:668 and 40:1299.65. Essentially, plaintiffs asserted the city's plan discouraged participants from selecting chiropractic treatment methods, and discriminated against practitioners of the chiropractic profession in violation of statutory law. The Board filed an answer and reconventional demand generally denying the allegations of plaintiffs' petition and praying for declaratory judgment that the city's plan did not violate statutory law. Alternatively, if it was found that the plan did violate statutory law, then the Board prayed for a declaration that the statutes as applied are an unconstitutional increase of financial burden on a political subdivision.

Plaintiffs subsequently filed a motion for summary judgment that the trial court granted on November 18, 1994. Currently before us is the Board's appeal of that judgment. For the following reasons, we affirm.

The Coverage limitation

The city's health care plan limits to $500.00 the maximum annual benefit payable for "spinal manipulative therapy and any physical therapy type modalities rendered in connection therewith by an osteopathic physician, chiropractor or medical doctor." Furthermore, "spinal manipulative therapy" is defined in the city's plan as meaning:

*1274 The practice or procedure by which the hands or any instrument or device [are] used to adjust, mobilize, manipulate, massage, stimulate or influence the spine and the adjacent or nearby muscles, ligaments, nerves and tissues, for the purpose of diagnosis, treatment or otherwise improving a Covered Person's physical or mental condition.

The question before the trial court on summary judgment, and before this Court on appeal, is whether this limitation violates La. R.S. 22:668 and 40:1299.65 quoted in pertinent part below:

22:668. Selection of Type of Treatment; Reimbursement

A. (1) Notwithstanding any provision of any policy or contract of insurance or health benefits issued after the effective date of this Section, whenever such policy or contract provides for payment or reimbursement for any service and such service may be legally performed by chiropractor licensed in this state, such payment or reimbursement under such policy or contract shall not be denied when such service is rendered by a person so licensed. Terminology in such policy or contract deemed discriminatory against such person or method of practice shall be void.
40:1299.65. Chiropractic Care; Freedom of Choice
No agency of the state, parish or municipality, under the laws of the State of Louisiana, shall deny to the recipients or beneficiaries of their aid or services the freedom to choose a duly licensed chiropractor as the provider of care or services which are within the scope of practice of the profession of chiropractic as defined in R.S. 37:2801(3).

The provisions of La.R.S. 37:2801(3) define the "practice of chiropractic" in pertinent part, as follows:

Holding one's self out to the public as a chiropractor and as being engaged in the business of, or the actual engagement in, the diagnosing of conditions associated with the functional integrity of the spine and treating by adjustment, manipulation, and the use of the physical or other properties of heat, light, water, electricity, sound, massage, therapeutic exercise, mobilization, mechanical devices, and other physical rehabilitation measures for the purpose of correcting interference with normal nerve transmission and expression.

A comparison of the type of treatment/therapy employed in the practice of chiropractic, as defined by statute, and the type of treatment/therapy limited under the city's health care plan, leaves no reasonable doubt that the city's plan effectively limits payment for the type of treatment/therapy provided by chiropractors. Further, the uncontradicted summary judgment evidence clearly shows that the city's plan has had precisely that effect.

Discussion: Validity of the limitation

On appeal, the Board points out that the city's plan does not exclude payment for chiropractic services, but rather requires payment for "spinal manipulative therapy and any physical therapy-type modalities rendered in connection therewith by an osteopathic physician, chiropractor or medical doctor[.]" The Board asserts that the city's plan merely limits payment for spinal manipulative therapy regardless of the health care provider, just as the plan limits the amounts paid for other covered medical expenses. The Board further argues that the city's plan can limit liability by setting policy limitations, and that the participants in the plan are free to choose spinal manipulative therapy. Citing Guarantee Trust Life Ins. Co. v. Gavin, 882 F.2d 178 (5th Cir.1989), the Board argues that the sole purpose of La. 22:668 and 40:1299.65 is to assure equal treatment of medical doctors and chiropractors performing the same kinds of services for patients. We disagree with the Board's arguments for several reasons.

First, we again emphasize that the limitation of the plan on its face is a limitation on the type of treatment/therapy utilized in the practice of chiropractic, as defined by statute. The fact that the limitation also mentions osteopathic physicians and medical doctors does nothing to change the scope of the limitation vis-à-vis chiropractors, and this is true regardless of any actual intent to discriminate *1275 on the part of the drafters of the plan's limiting language. Put another way, it is not necessary for the plan to limit therapy/treatment performed exclusively by chiropractors; it is enough that the scope of the limitation, whether accidentally or intentionally, closely corresponds with the scope of the practice of chiropractic.

Next, we note that the Board minutes in question were furnished to appellants as answers to interrogatories by the Board. Considering La.C.C.P. art. 966 B, we find the Board's objection to "uncertified copies" of the minutes to be meritless. We also note that all the copies of minutes bore both the signature of the Mayor as Chairman of the Board, and of the Executive Secretary of the Board. These minutes repeatedly refer to the Plan's annual limit on "chiropractic care," and in one instance even refer to "chiropractic care (spinal/manipulative therapy)." There also was discussion on more than one occasion concerning the legality of the limit on "chiropractic care." Thus, even if the law required intentional discrimination against chiropractors, the minutes in question would be sufficient to carry the plaintiffs' burden on summary judgment and shift the burden to the Board.

Under La.C.C.P. art.

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Bluebook (online)
666 So. 2d 1272, 1996 La. App. LEXIS 26, 1996 WL 23446, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nosser-v-health-care-trust-fund-bd-lactapp-1996.