Park Place Surgery Center D/B/A Park Place Surgical Hospital (Brian Armstead) v. National Oilwell Varco, Lp

CourtLouisiana Court of Appeal
DecidedSeptember 6, 2017
DocketWCW-0017-0483
StatusUnknown

This text of Park Place Surgery Center D/B/A Park Place Surgical Hospital (Brian Armstead) v. National Oilwell Varco, Lp (Park Place Surgery Center D/B/A Park Place Surgical Hospital (Brian Armstead) v. National Oilwell Varco, Lp) 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
Park Place Surgery Center D/B/A Park Place Surgical Hospital (Brian Armstead) v. National Oilwell Varco, Lp, (La. Ct. App. 2017).

Opinion

STATE OF LOUISIANA COURT OF APPEAL, THIRD CIRCUIT

17-483

PARK PLACE SURGERY CENTER, LLC DBA PARK PLACE SURGICAL HOSPITAL

VERSUS

NATIONAL OILWELL VARCO, L.P. AND NEW HAMPSHIRE INSURANCE COMPANY

**********

SUPERVISORY WRIT FROM A RULING OF THE OFFICE OF WORKERS’ COMPENSATION, DISTRICT 04, LAFAYETTE PARISH, STATE OF LOUISIANA, DOCKET NO. 17-01205 HONORABLE ADAM JOHNSON, PRESIDING JUDGE

JOHN E. CONERY JUDGE

Court composed of John D. Saunders, Shannon J. Gremillion, and John E. Conery, Judges.

WRIT DENIED. Gerald A. Melchiode Kevin A. Marks Renée S. Melchiode Benjamin M. Pri-tal Melchiode Marks King, L.L.C. 639 Loyola Avenue, Suite 2550 New Orleans, Louisiana 70113 (504) 336-2880 COUNSEL FOR DEFENDANTS/ APPLICANTS/RELATORS NATIONAL OILWELL VARCO, L.P. AND NEW HAMPSHIRE INSURANCE COMPANY

Thomas A. Filo Somer G. Brown Cox, Cox, Filo, Camel & Wilson, L.L.C. 723 Broad Street Lake Charles, Louisiana 70601 (337) 436-6611 COUNSEL FOR PLAINTIFF/RESPONDENT: Park Place SurgeryCenter, LLC, D/B/A Park Place Surgical Hospital CONERY, Judge.

The defendants-relators, National Oilwell Varco, L.P., and New Hampshire

Insurance Company, seek supervisory writs from the judgment of the Office of

Workers’ Compensation, District 04, the Honorable Adam Johnson presiding,

which denied the relators’ exceptions of res judicata, lis pendens, lack of subject

matter jurisdiction, and nonjoinder of indispensable party. For the following

reasons, the motion to seal the record is granted, except as to this opinion, and the

writ is denied at relators’ cost.

STATEMENT OF THE CASE

The instant case arises from a workers’ compensation form 1008 claim filed

by the plaintiff-respondent, Park Place Surgery Center, LLC d/b/a Park Place

Surgical Hospital (Park Place), for underpayment of a workers’ compensation

medical bill by the relators (the employer and employer’s insurer) pursuant to

La.R.S. 23:1034.2(F) in connection with medical treatment provided for on-the job

injuries sustained by employee Brian Armstead. Park Place also seeks statutory

penalties and attorney fees under La. R.S. 23:1201(F)(4) for the arbitrary and

capricious handling of the workers’ compensation claim by relators.

The relators filed exceptions of prematurity, vagueness, res judicata, lis

pendens, lack of subject matter jurisdiction, and nonjoinder of indispensable party,

all of which were denied following a hearing on April 25, 2017. A written

judgment was signed on May 1, 2017. The relators are now before this court on

writs seeking review of the trial court’s rulings on the exceptions. The relators also

filed a motion to seal the record, briefs, exhibits, and any issued opinion or other

pleading if confidential and proprietary information is included. SUPERVISORY RELIEF

The requirement of irreparable injury is met in this case in light of Herlitz

Construction Company, Inc. v. Hotel Investors of New Iberia, Inc., 396 So.2d 878

(La.1981). When the overruling of an exception is arguably incorrect, when a

reversal will terminate the litigation, and when there is no dispute of fact to be

resolved, judicial efficiency and fundamental fairness to the litigants dictate that

the merits of the application for supervisory writs should be decided in an attempt

to avoid the waste of time and expense of a possibly useless future trial on the

merits.

ON THE MERITS

The relators argue that the medical bill that forms the basis of the dispute

was initially reviewed by FairPay Solutions, Inc. (FairPay). FairPay provides

review services of workers’ compensation bills to employers and their respective

insurers. The relators add that the payment made to the plaintiffs was in keeping

with FairPay’s recommendation and in accordance with a Settlement Agreement

confected several years ago in a class action suit, Opelousas General Hospital

Authority, a Public Trust d/b/a Opelousas General Health System and ArkLaMiss

Surgery Center, LLC v. FairPay Solutions, Inc., No. 12-C-1599-C, 27th Judicial

District Court, St. Landry Parish (Class Action), and signed by the trial court on

August 17, 2012.1

The Class therein was defined as follows:

All Louisiana hospitals and ambulatory surgical centers that have provided outpatient services to workers’ compensation patients pursuant to the Louisiana Workers’ Compensation Act, LSA-R.S. 23:1021[,] et seq., and whose bills have been discounted, adjusted,

1 Part of the record was sealed in Opelousas General Hosp. Authority v. FairPay Solutions, Inc., docket number 17-42, which is at issue herein, but not this court’s opinion issued in that matter, cited infra. 2 paid on a reduced basis, or otherwise paid at less than the billed amount after October 21, 2003[,] as a result of a reduction recommended by FairPay.

Pursuant to the Settlement Agreement, FairPay paid about seven million

dollars to the members of the class for the dismissal of their claims. A permanent

injunction was entered against any future claims involving FairPay’s

recommendation for payment on a medical bill made pursuant to the Future

FairPay Pricing Methodology (FPPM). The Settlement Agreement also contained

a mechanism for dispute resolution for a Class Member to seek additional

reimbursement from a released party under the agreement. Additionally, the Class

Members agreed to a safe haven for FairPay wherein they agreed to waive and

release all claims and liability pertaining to bills paid pursuant to FairPay’s

recommendation in keeping with the FPPM. Once a Class Member exhausts the

delineated procedure for dispute resolution and FairPay and its clients have

allegedly failed to follow the Methodology, the Class Member may file an action

in district court or in the Office of Workers’ Compensation (OWC). The issue of

whether FairPay adhered to the Methodology was the sole issue in the prior

litigation.

After the Settlement Agreement was approved, Qmedtrix, a competing bill

review company, appealed on numerous grounds, including the assertion that the

class action claims arose under the exclusive jurisdiction of the OWC. A panel of

this court affirmed the district court’s approval of the settlement and the adoption

of a new methodology for pricing. Opelousas General Hosp. Authority v. FairPay

Solutions, Inc., 13-17 (La.App. 3 Cir. 7/13/13), 118 So.3d 1269. Further, that

panel concluded that the class action claims did not arise under the Workers’

3 Compensation Act (WCA); thus, the claims did not fall within the exclusive

jurisdiction of the OWC.

The Settlement Agreement provides for a Reconsideration Period which

requires the Class Member to submit to FairPay for review and reconsideration the

amount recommended to be paid and the amount actually paid on a bill or bills.

FairPay then reviews the bill or bills to determine if it erred in the application of

the pre-approved Methodology. FairPay then has thirty days to seek a mediation

of future disputes. Only after these procedural remedies have been exhausted may

a healthcare provider bring an action alleging FairPay has not properly applied the

Methodology under the Settlement Agreement.

Park Place maintains, however, that it complied with the Initial

Reconsideration Period and submitted the subject claim to FairPay before the

thirty-day period required prior to filing the workers’ compensation form 1008

claim.

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Park Place Surgery Center D/B/A Park Place Surgical Hospital (Brian Armstead) v. National Oilwell Varco, Lp, Counsel Stack Legal Research, https://law.counselstack.com/opinion/park-place-surgery-center-dba-park-place-surgical-hospital-brian-lactapp-2017.