Group Health Plan, Inc. v. State Bd. of Registration for the Healing Arts, 56642
| Decision Date | 02 January 1990 |
| Docket Number | No. 56642,56642 |
| Citation | 787 S.W.2d 745 |
| Parties | GROUP HEALTH PLAN, INC., Margarethe Hagemann, M.D., Melvin Burton, M.D., John Williams, M.D., Paul Steinbicker, M.D., Joseph Seria, M.D., Timothy J. Murphy, R.PH., Mary Beckemeier, R.N., and Roger Young, R.N., and, Catherine Weibel, M.D., Joseph Hazan, M.D., Alvora Mora, M.D., Plaintiffs-Appellants, v. STATE BOARD OF REGISTRATION FOR THE HEALING ARTS, Frank I. Clark, M.D., C.C. Reynolds, M.D., Mary K. Bruns, D.O., Mike Conoyer, M.D., Clem E. Haggerty, M.D., Darrel Domann, M.D., David L. Wilkinson, M.D., and Patricia B. Kemp, personally and individually, and officially as the membership of State Board of Registration for the Healing Arts, and, Board of Pharmacy, Donald Brown, James A. Cordes, Janet L. Crawford, James F. Dille, George L. Oesteich, Sheila L. Schmidt, and Jean Stanford, personally and individually, and officially as the membership of the Board of Pharmacy, and, Missouri Department of Health-Bureau of Narcotics and Dangerous Drugs and Robert G. Harmon, Defendants-Respondents. |
| Court | Missouri Court of Appeals |
Richard Donald Watters, Valerie Goodwin Lloyd, Lashly, Baer & Hamel, St. Louis, for plaintiffs-appellants.
Curtis Frank Thompson, Government Counsel, Asst. Atty. Gen., Jefferson City, for defendants-respondents.
Plaintiffs, Group Health Plan, Inc. et al., appeal from the trial court's order dismissing their two-count petition for declaratory judgment, injunction and damages. We affirm in part and reverse and remand in part.
Initially we note the multiple parties as described in plaintiffs' petition. The named plaintiffs are Group Health Plan, Inc. (G.H.P.), a corporation and a federally qualified health maintenance organization, with its principal offices in St. Louis County, Missouri; Margarethe Hagemann, M.D., et al., duly licensed physicians employed by and on the staff of G.H.P. (G.H.P. physicians); Mary Beckemeier, R.N., et al., duly licensed registered nurses employed by and on the staff of G.H.P. (G.H.P. nurses); and Timothy J. Murphy, R.Ph., a duly licensed pharmacist employed by and on the staff of G.H.P. (G.H.P. pharmacist).
The named defendants are the State Board of Registration for the Healing Arts (Board of Healing Arts), a Missouri agency, and its individual members; the Board of Pharmacy, a Missouri agency, and its individual members; and the Missouri Department of Health--Bureau of Narcotics and Dangerous Drugs (Bureau), a Missouri agency, and its director, Robert G. Harmon.
Our review of the trial court's dismissal requires an examination of the pleadings, allowing them their broadest intendment, treating all facts alleged as true, construing allegations as favorable to plaintiffs and determining whether the petition invokes principles of substantive law upon which relief can be granted. Rosatone v. GTE Sprint Communications, 761 S.W.2d 670, 671 (Mo.App.1988). The facts on appeal are gleaned from plaintiffs' petition.
G.H.P., its physicians and nurses have staff policies and operational procedures (hereinafter collectively referred to as "protocols"). Pursuant to the protocols, G.H.P. nurses are allowed to examine and assess certain G.H.P. members without the presence of a physician. G.H.P. physicians supply a G.H.P. nurse with pre-signed prescriptions for "routine medications" which she is allowed to fill out. G.H.P. physicians also consult with and authorize another G.H.P. nurse to provide prescriptions under the physician's name per his own name. A G.H.P. pharmacist then fills the prescription.
Board of Healing Arts threatened to bring actions, "civil and/or criminal and/or administrative," against each of the G.H.P. physicians, claiming the implementation of the protocols involved the unauthorized practice of medicine. Board of Pharmacy also threatened actions against G.H.P. pharmacist. Finally, Bureau and its director threatened to seek an investigative warrant to search G.H.P.'s premises and to bring actions against all the named plaintiffs.
Plaintiffs filed their two-count petition. Count I asked for a declaratory judgment that plaintiffs' actions, as described above, are consistent with Missouri and federal law and that the defendants' actions deprived plaintiffs of equal protection of the law as guaranteed by the Fourteenth Amendment to the United States Constitution; and (2) an injunction permanently restraining defendants from proceeding with complaints or charges against plaintiffs for violation of Chapters 195, 334, and 338, RSMo (1986). 1 Count II prayed for damages and attorneys' fees for violation of 42 U.S.C. Section 1983.
The trial court sustained defendants' motion to dismiss Count I of plaintiffs' petition on the following grounds:
(1) the court lacked jurisdiction under State ex rel. Missouri State Board of Registration for the Healing Arts v. Hartenbach et al., 768 S.W.2d 657 (Mo.App.1989); Schierding v. Missouri Dental Board, 705 S.W.2d 484 (Mo.App.1985); and State ex rel. State Board of Registration for the Healing Arts v. Elliott, 387 S.W.2d 489 (Mo.1965); (2) plaintiffs G.H.P., G.H.P. nurses, and G.H.P. pharmacist lack standing to request relief against the Board of Healing Arts; (3) plaintiffs G.H.P., G.H.P. physicians and G.H.P. nurses lack standing to request relief against the Board of Pharmacy; and (4) all plaintiffs lack standing to request relief against the Bureau and its director.
The trial court also sustained defendants' motion to dismiss Count II of plaintiffs' petition for failure to state a claim upon which relief could be granted.
We first consider the issue of jurisdiction as it relates to Count I. The issue, more precisely defined, is whether there was subject-matter jurisdiction. Subject-matter jurisdiction involves the nature of the cause of action or the relief sought and exists only when the tribunal has the right to proceed to determine the controversy at issue or grant the relief requested. State Tax Commission v. Administrative Hearing Commission, 641 S.W.2d 69, 72 (Mo. banc 1982); In re Marriage of Neal, 699 S.W.2d 92, 94 (Mo.App.1985).
In its order, the trial court cited Hartenbach, Schierding and Elliott as authority to dismiss for lack of jurisdiction. In each of those cases, contested administrative proceedings were commenced before suit, and the plaintiff was attempting to bring a separate court action to stop the administrative proceeding. Under those circumstances it is clear that the charges brought against a plaintiff should be resolved first in the administrative proceeding, and, until that resolution occurs, the circuit court generally lacks jurisdiction over the subject matter. Hartenbach, at 659. The reason for this rule is to prevent "premature interference with agency processes, so that the agency may function efficiently and so that it may have an opportunity to correct its own errors, to afford the parties and the courts the benefit of its experience and expertise, and to compile a record which is adequate for judicial review...." Id., citing Weinberger v. Salfi, 422 U.S. 749, 95 S.Ct. 2457, 45 L.Ed.2d 522 (1975).
Defendants concede that there were no administrative proceedings against plaintiffs pending at the time of the filing of plaintiffs' petition. Defendants argue, however, that because the filing of charges against some of the plaintiffs was imminent, the rationale of Hartenbach et al. is applicable and mandates dismissal of plaintiffs' petition. They argue that otherwise the issue of jurisdiction would be resolved by whether a plaintiff wins the race to the courthouse. We disagree.
Here, there were no administrative remedies to be exhausted by plaintiffs because no charges had been initiated. There simply was no decision by the administrative agency to be heard or appealed. Nicolai v. City of St. Louis, 762 S.W.2d 423, 425 (Mo. banc 1988). Further, there were no statutory or administrative provisions that would have allowed plaintiffs to initiate an action within the administrative agency. See State Tax Commission, at 76. A declaratory judgment action is an appropriate method of determining controversies concerning the construction of statutes and powers and duties of governmental agencies thereunder. Id., at 75.
Sermchief v. Gonzales, 660 S.W.2d 683 (Mo. banc 1983) involved an appeal of an adjudication on the merits of a declaratory judgment action by nurses and physicians against Board of Healing Arts. In that action, plaintiffs sought a declaration that the practices of the nurses were authorized under nursing law and did not constitute the unlawful practice of medicine.
In Nicolai, plaintiff brought a declaratory judgment action to determine whether the City of St. Louis had the authority to tax his premises as a kennel. The trial court dismissed his action, inter alia, for failure to exhaust his administrative remedies. On appeal, the Supreme Court reversed and remanded holding that plaintiff properly sought judicial determination of his claim. Nicolai, at 425.
Both Sermchief and Nicolai involved declaratory judgment actions where the action by the administrative agency was threatened but not yet initiated. In the present case, action by the administrative agency has been threatened but not initiated. The courts have jurisdiction to render declaratory judgments questioning the validity of a rule or the threatened application thereof. See Section 536.050.1, RSMo (1986). Certainly, if jurisdiction lies to consider the threatened application of rules, it lies to consider the threatened application of statutes. In the absence of a pending administrative action, the trial court has subject-matter jurisdiction to adjudicate plaintiffs' action. Plaintiffs' point is granted.
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