Swla Hospital Association D/B/A Lake Charles Memorial Hospital v. Superior Carriers, Inc.

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

06-807

SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION
D/B/A LAKE CHARLES MEMORIAL HOSPITAL

VERSUS

SUPERIOR CARRIERS, INC.

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APPEAL FROM THE
FOURTEENTH JUDICIAL DISTRICT COURT
PARISH OF CALCASIEU, NO. 2006-1020
HONORABLE WILFORD D. CARTER, DISTRICT JUDGE

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OSWALD A. DECUIR
JUDGE

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Court composed of Oswald A. Decuir, Jimmie C. Peters, and Glenn B. Gremillion,
Judges.

REVERSED.

John Stanton Bradford
Stockwell, Sievert, Viccellio, Clements
& Shaddock, L.L.P.
P. O. Box 2900
Lake Charles, LA 70602
(337) 436-9491
Counsel for Plaintiff/Appellee:
Southwest Louisiana Hospital Association

Perry R. Staub, Jr.
Mark Van Horn
Larry E. Demmons
Taggart, Morton, Ogden, Staub,
Rougelot & O’Brien, L.L.C
2100 Energy Centre
1100 Poydras Street
New Orleans, LA 70163-2100
(504) 599-8500
Counsel for Intervenor/Appellee:
CCN, Inc.

Thomas A. Filo
Cox, Cox, Filo, Camel & Wilson
723 Broad Street
Lake Charles, LA 70601
(337) 436-6611
Counsel for Plaintiff/Appellee:
Southwest Louisiana Hospital Association

H. Clay Ward, III
Attorney at Law
1111 Ryan Street
Lake Charles, LA 70601
(337) 433-9320
Counsel for Defendant/Appellant:
Superior Carriers, Inc.

DECUIR, Judge.

This is a claim filed in district court by a provider to recover payment for

medical services rendered to a workers’ compensation claimant. The defendant

appeals a grant of summary judgment in favor of the provider finding that PPO

network discounts are invalid under workers’ compensation law.

FACTS

On December 8, 2003, Southwest Louisiana Hospital Association, d/b/a Lake

Charles Memorial Hospital (LCMH), rendered medical services to Steven G. Hollie,

an employee of defendant, Superior Carriers, Inc. LCMH billed $4,605.00 for these

services. Instead of reimbursing LCMH the workers’ compensation schedule rate of

$4,144.50, Superior’s workers’ compensation carrier, Great West Casualty Company,

paid the PPO network discount amount of $3,914.29.

LCMH filed this petition for declaratory relief asking the court to declare this

discount invalid and unenforceable for failing to comply with the Louisiana Preferred

Provider Organization Act (La.R.S. 40:2203.1) and for discounting this workers’

compensation bill below the lesser of LCMH’s actual charge or the fee schedule

amount in violation of La.R.S. 23:1033. The trial court granted the relief sought in

both instances. Superior lodged this appeal. CCN, Inc., the administrator of the PPO

network, filed a motion to intervene, which this court referred to the merits.

DISCUSSION

Superior first argues that this case should be reversed based on the en banc

opinion of this court in Beutler-England Chiropractic Clinic v. Mermentau Rice, Inc.

05-942 (La.App. 3 Cir. 5/31/06), 931 So2d 553. We agree. In Beutler-England, the

court held that La.R.S. 23:1310.3(E), as amended, applies retroactively and grants

original and exclusive jurisdiction over contractual and coverage disputes like the

ones in the case at bar to workers’ compensation judges. LCMH argues that, even if

that is the case, the district court had jurisdiction over the claim for violation of

La.R.S. 40:2203.1 and that part of the judgment should stand. We are unpersuaded

by this argument. Aside from the court’s interest in avoiding piecemeal litigation, the

resolution of that dispute affects the payment of benefits under the workers’

compensation act and, therefore, the Office of Workers’ Compensation had exclusive

jurisdiction. Accordingly, the district court lacked subject matter jurisdiction in this

case.

We need not discuss the remaining issues raised by the parties because this

finding is dispositive. Likewise, the motion to intervene filed by CCN, Inc. is denied.

DECREE

For the foregoing reasons, the judgment of the district court is reversed for

want of subject matter jurisdiction. All costs of this appeal are taxed to appellant,

Superior Carriers, Inc.

REVERSED.

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