Victoria Leet, Individually and on behalf of all others similarly situated v. Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center; Alegis Revenue Solutions, LLC; and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana

CourtLouisiana Court of Appeal
DecidedFebruary 25, 2021
Docket2020CA0745
StatusUnknown

This text of Victoria Leet, Individually and on behalf of all others similarly situated v. Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center; Alegis Revenue Solutions, LLC; and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana (Victoria Leet, Individually and on behalf of all others similarly situated v. Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center; Alegis Revenue Solutions, LLC; and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana) 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.

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Victoria Leet, Individually and on behalf of all others similarly situated v. Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center; Alegis Revenue Solutions, LLC; and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana, (La. Ct. App. 2021).

Opinion

STATE OF LOUISIANA

COURT OF APPEAL

FIRST CIRCUIT

NO. 2020 CA 0745

VICTORIA LEFT, INDIVIDUALLY AND ON BEHALF OF ALL OTHERS SIMILARLY SITUATED

VERSUS

HOSPITAL SERVICE DISTRICT NO. 1 OF EAST BATON ROUGE COA PARISH, LOUISIANA D/ B/ A LANE REGIONAL MEDICAL CENTER; ALEGIS REVENUE SOLUTIONS, LLC; AND LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY D/ B/ A BLUE CROSS AND BLUE SHIELD OF LOUISIANA

Judgment Rendered: FEB 2 5 202'

On Appeal from the 191 Judicial District Court In and for the Parish of East Baton Rouge State of Louisiana Trial Court No. 639818

Honorable Donald R. Johnson, Judge Presiding

J. Lee Hoffoss, Jr. Attorneys for Plaintiff A - ppellant Donald W. McKnight Victoria Leet, Individually and on Lake Charles, LA behalf of all others similarly situated

Derrick G. Earles Lafayette, LA

Scott R. Bickford Lawrence J. Centola, III New Orleans, LA

Andrew J. D' Aquilla St. Francisville, LA Thomas R. Temple, Jr. Attorneys for Defendant -Appellee,

David R. Kelly Hospital Service District No. I of East Joseph J. Cefalu Baton Rouge Parish, Louisiana d/ b/ a Baton Rouge, LA Lane Regional Medical Center

BEFORE: THERIOT, WOLFE, AND HESTER, Ji.

0) HESTER, J.

Plaintiff, Victoria Leet, appeals a judgment granting a motion for

reconsideration and a motion for summary judgment filed by defendant, Hospital

Service District No. 1 of East Baton Rouge Parish, Louisiana d/ b/ a Lane Regional

Medical Center, thereby dismissing all of plaintiffs claims, with prejudice. For the

reasons that follow, we affirm.

FACTUAL AND PROCEDURAL HISTORY

This matter initially came before this court on appeal filed by plaintiff. Leet

v. Hospital Service District No. 1 of East Baton Rouge Parish, 2018- 1148 ( La.

App. 1 st Cir. 2/ 28/ 19), 274 So. 3d 583 (" Leet I"). The applicable prior factual and

procedural history, as set forth in Leet I, is as follows:

On May 29, 2014, Victoria Leet was injured in an automobile accident and received treatment at Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/ a Lane Regional Medical Center ( referred to herein as " Lane Regional"). At the time of the accident, Leet was insured under the comprehensive medical benefit plan of her husband' s employer, Louisiana Machinery Company, LLC. Through a contract between Louisiana Machinery and Louisiana Health Service & Indemnity Company d/b/ a Blue Cross and Blue Shield of Louisiana (" Blue Cross"), Louisiana Machinery' s self-funded plan was administered by Blue Cross, and Louisiana Machinery purchased access to the Blue Cross contracted healthcare provider network, which allows its insureds to seek treatment from network providers at the contracted reimbursement rate. Thus, as a covered beneficiary of a plan participant, Leet was able to obtain treatment from specific providers within the Blue Cross preferred provider network for a reduced rate, with her only responsibility being the applicable copay, deductible, or coinsurance. Lane Regional is a contracted health care provider with Blue Cross. Pursuant to its provider agreement with Blue Cross, Lane Regional contractually agreed to accept these reduced rates as payment in full for services provided to Blue Cross insureds.

At the time of treatment, Leet presented her Blue Cross insurance card to Lane Regional. However, on June 24, 2014, prior to submitting a claim for its services to Blue Cross, Lane Regional, through its accounts receivable contractor, asserted a lien, by sending medical lien letters to Leet and her attorney, for the full, undiscounted amount of 8, 789. 35 against any tort recovery Leet may receive from a third party as a result of the automobile accident. By check dated August 21, 2014, USAgencies Casualty Insurance Company (" USAgencies"), the third -

party automobile liability insurer, issued a payment to Lane Regional for $8, 789. 35, the full amount of the lien.

3 Meanwhile, on July 15, 2014, several weeks after asserting the lien, Lane Regional filed an insurance claim with Blue Cross, seeking reimbursement for the services provided to Leet. Thereafter, on

September 16, 2014, initially " pend/ denying" the claim while after

awaiting additional information, Blue Cross paid Lane Regional for the claim at the reduced, contracted reimbursement rate of $ 1, 477. 74.

Despite efforts by Leet' s attorney to have Lane Regional reimburse Leet the full amount of any payment over the reduced, contracted rate for the services provided, Lane Regional retained the full, undiscounted payment from USAgencies. With regard to the payment of the reduced, contracted rate from Blue Cross, Lane Regional, after first attempting to return the $ 1, 477. 74 payment to Blue Cross, issued a refund to Leet

on December 1, 2014, in the amount of $1, 477. 74, as reimbursement of the overpayment on her account.

Thereafter, on December 10, 2014, Leet filed a petition styled Class Action Petition for Payment of a Thing Not Due, for Damages, for Declaratory Relief, and for Injunctive Relief' in the Twentieth Judicial District Court. Through original and amending petitions, Leet named as defendants Lane Regional; Alegis Revenue Group, LLC,' Lane Regional' s accounts receivable contractor; and Blue Cross.

Alegis Revenue Group, LLC was at times improperly referred to as " Alegis Revenue Solutions, LLC" and " Alegis Corporation" in the petitions.

Regarding the claims against Lane Regional, Leet, individually and on behalf of the class, alleged that Lane Regional, in filing a lien and collecting the full, undiscounted rate for services provided to Leet, violated LSA-R.S. 22: 1874 of the Balance Billing Act and that, as a result of these allegedly illegal billing practices by Lane Regional, she and those similarly situated were entitled to repayment of all

overpayments, damages for mental anguish and emotional distress, loss of profits or use, out- of-pocket expenses, and all other damages allowed by law, as well as attorney' s fees, costs, and expenses. Leet, individually and on behalf of all others similarly situated, also sought declaratory judgment, declaring that the practices of Lane Regional were in violation of law and in breach of contract and that all actions at law asserted by Lane Regional be deemed unenforceable and cancelled, and preliminary and permanent injunctive enjoining Lane relief,

Regional from refusing to accept a patient' s health insurance when a patient has been involved in a liability accident and from maintaining actions at law in violation of LSA-R.S. 22: 1874.

Subsequently, on December 15, 2014, five days after Leet filed suit, but before service was perfected on Lane Regional, Lane Regional issued a second payment to Leet in the amount of $ 7, 211. 61,

representing the remaining sums it had retained over the contractually reduced reimbursement rate less Leet' s $ 100. 00 copayment.

After transfer of the suit from the Twentieth Judicial District Court to the Nineteenth Judicial District Court, removal of the suit to federal court, and a remand back to the state district court, Lane

Regional filed a motion for summary judgment on February 23, 2018, rd contending that it was entitled to judgment in its favor as a matter of law, dismissing plaintiffs claims against it. Specifically, Lane Regional contended that: ( 1) as aentity, it was entitled to public

immunity pursuant to LSA- R. S. 9: 2798.

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Victoria Leet, Individually and on behalf of all others similarly situated v. Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center; Alegis Revenue Solutions, LLC; and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana, Counsel Stack Legal Research, https://law.counselstack.com/opinion/victoria-leet-individually-and-on-behalf-of-all-others-similarly-situated-lactapp-2021.