Schneberger v. Air Evac EMS

Court of Appeals for the Tenth Circuit·Decided August 31, 2018·No. 17-6154·Unpublished

Opinion

FILED

United States Court of Appeals Tenth Circuit

UNITED STATES COURT OF APPEALS August 31, 2018 Elisabeth A. Shumaker

TENTH CIRCUIT Clerk of Court

SUSAN SCHNEBERGER; LACY STIDMAN; JOHNNY TRENT, individually and as class representatives,

Plaintiffs - Appellants,

v. No. 17-6154 (D.C. No. 5:16-CV-00843-R)

AIR EVAC EMS, INC., d/b/a Air Evac (W.D. Okla.) Lifeteam; EAGLEMED, LLC,

Defendants - Appellees.

ORDER AND JUDGMENT *

Before HOLMES, MATHESON, and MORITZ, Circuit Judges.

Susan Schneberger, Lacy Stidman, and Johnny Trent brought claims on behalf of themselves and a putative class of similarly situated individuals against air-ambulance operators in Oklahoma, alleging that the defendants charged exorbitant rates for air-ambulance services. They claimed breach of implied contract because the parties did not agree on a particular price before services

*

This order and judgment is not binding precedent except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.

were provided; therefore, the plaintiffs argued, the defendants agreed to transport the plaintiffs and their family members for a reasonable price. They also brought claims, inter alia, for unjust enrichment and money had and received. The district court dismissed these claims as preempted by the Airline Deregulation Act (“ADA”), 49 U.S.C. § 41713. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm.

I1

A

Defendants EagleMed, LLC (“EagleMed”) and Air Evac EMS, Inc. (“Air Evac”) operate air-ambulance services in several states, including Oklahoma. They do not dispatch their own services, but instead respond to third-party dispatch requests and requests from medical professionals or first responders.

The plaintiffs claim that they or their family members were transported by the defendants “without entering into written agreements specifying a price prior to transport.” Aplts.’ Opening Br. at 3. No price or schedule of prices was disclosed at the time of service. The plaintiffs claim that the defendants “do not negotiate rates with patients” or “publish their pricing model in any available platform.” Aplts.’ App. at 27 (Pet., dated July 26, 2016). The plaintiffs further

1 In reviewing a judgment on a motion to dismiss, “[w]e accept as true all well-pleaded factual allegations in the complaint.” S.E.C. v. Shields, 744 F.3d 633, 640 (10th Cir. 2014) (quoting Burnett v. Mortg. Elec. Registration Sys., Inc., 706 F.3d 1231, 1235 (10th Cir. 2013)).

argue that the emergency conditions under which the transportation here took place precluded any “meaningful opportunity to consent” to the terms of service. Aplts.’ Opening Br. at 4. 2 Ms. Schneberger’s husband was transported 416 miles by EagleMed from Norman Regional Hospital in Norman, Oklahoma, to MD Anderson Hospital in Houston, Texas. Mr. Schneberger was insured by Blue Cross Blue Shield Association (“BCBS”), but BCBS refused to pay for EagleMed’s service because it concluded that his transportation was not medically necessary. EagleMed reduced Mr. Schneberger’s bill from $63,564.71 to $53,133.83. Ms. Stidman was

2 In EagleMed LLC v. Cox, 868 F.3d 893 (10th Cir. 2017), we detailed a similar description of “the market for air-ambulance services” offered by an amicus and, notably, did not quarrel with its accuracy:

Unlike the typical commercial airline flights that were the focus of the [ADA], air-ambulance flights generally are not chosen by their passengers, are not paid in advance at an agreed-to rate, and do not have prices that are determined in a free market of individual consumer choice. As a general rule, air-ambulance services are not requested or arranged by either the individuals who will receive the services or by the insurance companies, governmental entities, or individuals who will ultimately pay for them. Rather, air ambulances are called by medical professionals and emergency first-responders who will neither receive nor pay for their services. Their prices are determined only after the service has already been rendered—in cases paid through Medicare or Medicaid, at prices established by government rate schedules, and in cases paid through private insurance, usually at a price negotiated between the air ambulance and the insurer.

Id. at 902–03.

transported sixty-seven miles by EagleMed from Pittsburg County, Oklahoma, to St. John Medical Center in Tulsa, Oklahoma. Ms. Stidman’s insurance paid $15,180.53 of EagleMed’s charges, leaving her with a bill for $19,516.26. Mr. Trent was transported 106 miles by Air Evac from Elk City, Oklahoma, to Oklahoma City after an oilfield accident. Air Evac charged Mr. Trent $45,101.94.

The plaintiffs argue that they were charged for transportation “in an amount that vastly exceeded both the cost to provide the transport and the fair market value of the transport.” Aplts.’ Opening Br. at 4. The plaintiffs proffered statements by “[a]n executive of the largest air ambulance company in the industry admitt[ing] that the fair charge for an average transport would be $12,000” and claimed that they were charged between four and eight times that amount. Id. (emphasis added) (citing Aplts.’ App. at 131 (Pls.’ Joint Resp. to Defs.’ Mot. to Dismiss, dated Dec. 20, 2016)). When the plaintiffs were unable to pay, the defendants began collection efforts that exposed the plaintiffs to “adverse judgments and damage to their credit ratings.” Id. at 5. The defendants do not contest that the written agreements between the parties lacked an agreed-upon price. The defendants argue, however, that they are required by law to transport patients who require services regardless of their insurance coverage or ability to pay. Providing these services is expensive—requiring the defendants to maintain customized aircraft and twenty-four-hour crews—and payments received from

uninsured patients or patients covered by Medicaid or Medicare are, in general, “substantially below air ambulance providers’ per-transport costs.” Aplees.’ Resp. Br. at 9. “Such underpayments contribute to escalating prices for emergency air ambulance transportation.” Id. And in order “[t]o continue to provide air ambulance service for everyone regardless of insurance status . . . [the defendants] must receive their billed charges for a sufficient portion of their flights to offset the losses they incur when they transport uninsured or underinsured patients.” Id. at 10.

B

The plaintiffs filed claims in the state District Court for Oklahoma County, Oklahoma, seeking damages and injunctive relief prohibiting the defendants from charging or attempting to collect “unreasonable rates” for their services. Aplts.’ App. at 48–51. The plaintiffs presented several claims under Oklahoma law, including claims for breach of an implied contract (including breach of the implied covenant of good faith and fair dealing), unjust enrichment, and money had and received. 3 The plaintiffs argued that, due to the lack of a specified price term, the parties entered into implied contracts for services to be provided at a

3 The plaintiffs also brought a claim alleging violations of the Oklahoma Consumer Protection Act, O KLA . S TAT . A NN . tit. 15, § 751, but they voluntarily conceded that this claim should not go forward in their briefing responding to the defendants’ motion to dismiss, discussed infra, and the federal district court acknowledged the concession and did not address the claim further in its dismissal order.

reasonable price, and the defendants breached those contracts. In the alternative, the plaintiffs sought a declaratory judgment that the contracts between the parties were “unenforceable . . . because of the lack of mutuality.” Aplts.’ App. at 50. The defendants removed the case to the U.S. District Court for the Western District of Oklahoma.

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