RMI v. Southdown Care Center

747 So. 2d 809, 1999 WL 1268036
CourtLouisiana Court of Appeal
DecidedDecember 28, 1999
Docket98 CA 2430
StatusPublished
Cited by3 cases

This text of 747 So. 2d 809 (RMI v. Southdown Care Center) 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
RMI v. Southdown Care Center, 747 So. 2d 809, 1999 WL 1268036 (La. Ct. App. 1999).

Opinion

747 So.2d 809 (1999)

RMI
v.
SOUTHDOWN CARE CENTER.

No. 98 CA 2430.

Court of Appeal of Louisiana, First Circuit.

December 28, 1999.

Jerry W. Lindig, Gregory D. Frost, Baton Rouge, Louisiana, for defendant/appellant, Southdown Care Center.

Delbert G. Talley, Covington, Louisiana, for plaintiff/appellee, RMI.

John J. Rabalais, Covington, Louisiana, Janice B. Unland, Metairie, Louisiana, for amicus curiae, Louisiana Nursing Home Association.

BEFORE: GONZALES, FITZSIMMONS and WEIMER, JJ.

GONZALES, J.

On August 28, 1991, Ruby Lewis, a meter reader for the City of Thibodaux, was struck by lightning while in the course and scope of her employment. She was left comatose and, after eight months of hospitalization, she was placed in a skilled nursing facility, Southdown Care Center. In April of 1992, Risk Management Inc. (RMI), the workers' compensation carrier for the city of Thibodaux, and Southdown Care Center signed a contract agreeing to the amount charged for the ongoing care of Ms. Lewis.

On August 11, 1997, RMI filed a disputed claim for compensation with the Office of Workers' Compensation, alleging that RMI and Southdown Care Center signed an agreement for the care of Ms. Lewis in April of 1992, but that the Louisiana Fee Schedule, which went into effect in November of 1992, took precedence over the contractual agreement; therefore, RMI believed it had overpaid Southdown Care Center.

Southdown Care Center filed exceptions of vagueness, no "cause and/or right" of action, and lack of subject matter jurisdiction. Southdown Care Center's exceptions of vagueness and no cause of action were dismissed, and the exception of lack of subject matter jurisdiction was denied. In its reasons for judgment denying the lack of subject matter jurisdiction exception, the workers' compensation judge relied upon La.R.S. 23:1034.2, finding that "the *810 legislature has provided for the Office of Workers' Compensation to determine disputes involving the reimbursement schedule by statutory authority."

Thereafter, the case proceeded to trial by the workers' compensation judge. After trial, the workers' compensation judge rendered judgment in favor of RMI, finding that the fee schedule which was implemented on November 1, 1992, superceded the April 21, 1992 contract and that the fees charged by Southdown Care Center under the contract were in excess of the reimbursement schedule for November 1, 1992, through September of 1997, in violation of La.R.S. 23:1034.2. The workers' compensation judge further ruled that the reimbursement schedule was constitutional and was not an ex post facto law. The workers' compensation judge rendered judgment in favor of RMI for overpayment in excess of the fee schedule in the amount of $221,156.68.

Southdown Care Center appealed that judgment and urges the following assignments of error:

1. The OWC Hearing Officer erred in denying Southdown's exception of Lack of Jurisdiction over the Subject Matter.
2. The OWC Hearing Officer erred in allowing the plaintiff to supplement the record after the evidence was closed.
3. The OWC Hearing Officer erred in determining that the contract between the parties was null and void.
4. The OWC Hearing Officer erred by finding that the workers' compensation reimbursement schedule (sometimes hereinafter referred to as "fee schedule") implemented November 1, 1992 superseded the April 21, 1992 contract between Plaintiff and Defendant.
5. The OWC Hearing Officer erred in finding that the plaintiff's cause of action was not barred by payment, collateral or equitable estoppel or detrimental reliance.
6. The OWC Hearing Officer erred in determining that the care provided to Ms. Lewis in this case was limited to the fee schedule with regards to skilled nursing facilities under the Louisiana Workers' Compensation reimbursement schedule.
7. The OWC Hearing Officer erred in finding that the fees charged by Southdown in their contract were in excess of the reimbursement schedule during the period from November 1, 1992 through September, 1997 and, therefore, were in violation of LSA-R .S. 23:1034.2.
8. The OWC Hearing Officer erred in finding that the Defendant failed to prove that it was entitled to special reimbursement consideration or outlier relief under Section 2519 of Title 40.

ASSIGNMENT OF ERROR NO. 1 THE JURISDICTION ISSUE

The judicial power is vested in a supreme court, courts of appeal, district courts, and other courts, as authorized by the Louisiana Constitution, article V, § 1. The Louisiana Constitution, article V, § 16, provides that except as otherwise authorized by the constitution or except as provided by law for administrative agency determinations in workers' compensation matters, a district court shall have original jurisdiction of all civil and criminal matters.

In Albe v. Louisiana Workers' Compensation Corporation, 97-0581, 97-0014 (La.10/21/97), 700 So.2d 824, 828, the court pointed out that:

The determination whether a statute is unconstitutional is a purely judicial function. State v. Board of Sup'rs of Elections, 186 La. 949, 173 So. 726 (La.1937). The judicial power of the state is constitutionally vested in the courts. La. Const. Art. 5 Sec. 1. The Commission is not a court but is an administrative agency in the executive branch of state government. See Bagert v. Bd. Of Ethics for Elected Officials, 594 So.2d 922 (La.App. 1 Cir.1992). An administrative agency does not have the authority to determine the constitutionality of statutes. *811 See Church Point Wholesale Beverage v. Tarver, 614 So.2d 697, 702 n. 8 (La.1993), and Red River Coors, Inc. v. McNamara, 577 So.2d 187 (La.App. 1 Cir.), writ denied, 582 So.2d 1306 (La. 1991) (Board of Tax Appeals does not have authority to decide the constitutionality of statutes); Bell v. Dept. of Health and Human Resources, 483 So.2d 945, 947 n. 1 (La.1986), cert. denied, 479 U.S. 827, 107 S.Ct. 105, 93 L.Ed.2d 55 (1986), and Appeal of Brisset, 436 So.2d 654 (La.App. 1 Cir.), writ denied, 441 So.2d 749 (La.1983) (Civil Service Commission does not have the authority to decide the constitutionality of statutes). Thus, the district court, and not the Commission, had jurisdiction to rule on the constitutionality of the statutes.
. . . .
The Office of Workers' Compensation Administration was created within the Department of Labor for the purpose of administering the provisions of the Workers' Compensation Act. La.R.S. 23:1291. The administrative hearing officers are appointed by the director of the Office of Workers' Compensation Administration, who is in turn subject to the general administrative authority of the secretary of the Department of Labor. La.R.S. 23:1310.1 and La.R.S. 23:1310.2. There is no doubt that the Office of Workers' Compensation, like the Commission on Ethics for Public Employees in Midboe [v. Commission on Ethics for Public Employees, 94-2270 (La.11/30/94), 646 So.2d 351], is an administrative agency.
. . . .
Administrative agencies are a governmental hybrid, exercising powers similar to those exercised by all three branches of government.

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Bluebook (online)
747 So. 2d 809, 1999 WL 1268036, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rmi-v-southdown-care-center-lactapp-1999.