State Ex Rel. Blue Cross & Blue Shield Mutual v. Carroll

487 N.E.2d 576, 21 Ohio App. 3d 263, 21 Ohio B. 307, 1985 Ohio App. LEXIS 9875
CourtOhio Court of Appeals
DecidedJanuary 23, 1985
Docket49614
StatusPublished
Cited by5 cases

This text of 487 N.E.2d 576 (State Ex Rel. Blue Cross & Blue Shield Mutual v. Carroll) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Ex Rel. Blue Cross & Blue Shield Mutual v. Carroll, 487 N.E.2d 576, 21 Ohio App. 3d 263, 21 Ohio B. 307, 1985 Ohio App. LEXIS 9875 (Ohio Ct. App. 1985).

Opinions

Markus, P. J.

Relator’s complaint in this court seeks prohibition or mandamus to prevent the respondent judge from enforcing a preliminary injunction in pending common pleas court case Nos. 83968 and 83993. In those cases, the city of Lakewood, d.b.a. Lakewood Hospital, and Brentwood Hospital ask for equitable relief from allegedly unfair and deceptive trade practices. More specifically, the two hospitals complain there about public advertising by Blue Cross and Blue Shield regarding its new *264 cost containment plan for hospital insurance.

Relator (Blue Cross and Blue Shield) has moved for summary judgment in its favor on its complaint in this court. The respondent judge has moved to dismiss that complaint or for summary judgment denying any relief. The parties, and the two hospitals which appear as amici curiae, have submitted extensive evidentiary materials supporting their respective positions. Those materials include the original record and a transcript of the oral proceedings in the underlying common pleas cases, as well as affidavits from counsel and others.

These materials establish the following undisputed facts:

(1) In its common pleas court case, Lakewood Hospital seeks an order that Blue Cross and Blue Shield and those participating with it “be enjoined from further advertising of any nature or the publication of any statements by any means which are designed to promote [its] selection of member hospitals for 1985 until such time as the Superintendent of Insurance expressly approves [its] selection of member hospitals and all appeals are exhausted concerning such approval, should such approval occur.”

(2) In its common pleas court case, Brentwood Hospital seeks an order to enjoin Blue Cross and Blue Shield and those participating with it “from making any representation or claim which expressly or by implication, inference or innuendo” asserts certain facts and conclusions that Brentwood claims are false and harmful.

(3) On the day these two actions were filed, they were assigned to the same judge who telephoned the office of the anticipated counsel for Blue Cross and Blue Shield. The judge requested counsel from that office to attend proceedings forthwith. On that day and the following day, . the judge heard oral arguments from counsel for the parties regarding the hospitals’ requests for a temporary restraining order. On the day following the filing of those cases, the judge advised counsel that he would treat the proceedings as a hearing on motions for preliminary injunctions.

(4) No witnesses testified at the hearings in the trial court. No exhibits were formally authenticated, offered or received. The parties made no relevant factual stipulations. The hospitals relied upon their verified complaints, together with purported copies of miscellaneous documents and an attorney’s affidavit attached to their pleadings and memo-randa.

(5) Two days after the cases were filed, the judge issued a preliminary injunction “until judicial resolution of the [hospitals’] appeals to the Superintendent of Insurance of the state of Ohio of contract termination notices, or until the trial of the merits of the issues and claims arising from these causes, or until further order of this court.”

(6) The judge’s preliminary injunction restrained Blue Cross and Blue Shield and those participating with it from:

“1. The repetition or further publication of advertisements of the same kind, nature and content as those described in [the hospitals’] exhibits; and
“2. Further advertising of any nature or the publication of any statements by any means directly or indirectly, affirmatively or by omission, that:
“(a) [Blue Cross and Blue Shield] has certified, selected or designated any specific hospital or hospitals, or any specific number of hospitals as ‘winners’ or ‘losers’, members or non-members, or included or excluded members of its 1985 Member Hospital Network Plan.
“(b) any specific hospital or list of *265 hospitals offers the best quality of care or the lowest price or cost, or, singularly or together with any other hospital or hospitals, offers better care or lower prices or costs than any other hospital; or
“(c) either Lakewood Hospital or Brentwood Hospital offers lower quality care, or care at a higher price or cost than any other hospital or hospitals.

“Nothing in this order shall be construed to prohibit the otherwise lawful advertisement or cost-containment measures undertaken by [Blue Cross and Blue Shield] or of its general information relative to its network plan of providing health care, or direct communication with its subscribers concerning its cost-containment program generally and/or its efforts or intent to provide quality coverage with respect to medical and related services and treatment at a reasonable cost to the subscriber; nor is [Blue Cross and Blue Shield] limited or restrained from the promotion or encouragement of public self-education as to the thrust and contemplated effect of the efforts of [Blue Cross and Blue Shield] to accomplish cost containment respecting quality medical and surgical care and services. Nothing in this provision is to be considered as in any manner limiting or diminishing the efficacy of the equitable and statutorily-authorized restraints hereinabove imposed on [Blue Cross and Blue Shield.]”

(7) The present controversy in the common pleas court and in this court relates solely to the ability of Blue Cross and Blue Shield to make future comments about its Hospital Network Plan. We are not here determining whether any previous statement or advertisement by Blue Cross and Blue Shield was fair or accurate. Nor are we determining whether the Hospital Network Plan is fair, appropriate, or lawful. All parties to this action apparently agree that no part of the Blue Cross and Blue Shield Hospital Network Plan will affect the payment to any subscriber, policyholder, or hospital unless or until the plan survives presently pending challenges. Presumably those issues will be resolved by the Insurance Department or a court reviewing that agency’s decision.

From these and other undisputed facts, we conclude as a matter of law:

A. The common pleas court and the assigned judge had no jurisdiction to issue the above-described preliminary injunction.

B. The court failed to give sufficient notice of its intention to consider a motion for a preliminary injunction. See Civ. R. 6(D) and 65(B).

C. The court issued a preliminary injunction without conducting an eviden-tiary hearing and without receiving any legally competent evidence to support its issuance.

D. The court premised its authority to issue an equitable order on the provisions in R.C. Chapter 4165, and more particularly R.C. 4165.03 (the Deceptive Trade Practices Act). That Act is not intended to replace established administrative supervision over advertising by regulated industries. The Ohio Department of Insurance and the Superintendent of Insurance have primary and initial regulatory jurisdiction over an insurer’s allegedly misleading or deceptive advertising. Cf. Ohio Academy of Trial Lawyers v. Dept. of Ins.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

State Ex Rel. Dental Care Plus, Inc. v. Sunderland
735 N.E.2d 19 (Ohio Court of Appeals, 1999)
State ex rel. Banc One Corp. v. Walker
1999 Ohio 151 (Ohio Supreme Court, 1999)
Salvation Army v. Blue Cross & Blue Shield
636 N.E.2d 399 (Ohio Court of Appeals, 1993)

Cite This Page — Counsel Stack

Bluebook (online)
487 N.E.2d 576, 21 Ohio App. 3d 263, 21 Ohio B. 307, 1985 Ohio App. LEXIS 9875, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-blue-cross-blue-shield-mutual-v-carroll-ohioctapp-1985.