Ex parte University of South Alabama

• Decision Date: 03 December 1999
• Citation: 761 So.2d 240
• Parties: Ex parte UNIVERSITY OF SOUTH ALABAMA d/b/a the University of South Alabama Medical Center. (Re University of South Alabama, d/b/a the University of South Alabama Medical Center v. Angela Garrick).
• Court: Alabama Supreme Court

761 So.2d 240

Ex parte UNIVERSITY OF SOUTH ALABAMA d/b/a the University of South Alabama Medical Center.

(Re University of South Alabama, d/b/a the University of South Alabama Medical Center v. Angela Garrick).

1980370.

Supreme Court of Alabama.

December 3, 1999.

Thomas R. Boller, Mobile, for petitioner.

John C. Brutkiewicz, Mobile, for respondent.

William Kent Upshaw of Holt, Cooper & Upshaw, Birmingham, for amicus curiae Healthcare Financial Management Ass'n.

Gregg Brantley Everett, general counsel, Alabama Hospital Ass'n, Montgomery, for amicus curiae Alabama Hospital Ass'n.

David G. Wirtes, Jr., and George M. Dent of Cunningham, Bounds, Yance, Crowder & Brown, L.L.C., Mobile, for amicus curiae Alabama Trial Lawyers Ass'n.

SEE, Justice.

We issued the writ of certiorari to review an issue of first impression, the interpretation of Alabama's hospital-lien statute, § 35-11-370, Ala.Code 1975. Specifically, the question is whether § 35-11-370 grants a hospital a lien for charges for subsequent care and treatment of an injured person who had previously entered the hospital within one week after receiving an injury, if the subsequent care and treatment are related to that injury.

I.

On April 11, 1996, Angela Garrick was injured in an automobile accident. She was taken to the University of South Alabama Medical Center ("USA Medical Center"), operated by the University of South Alabama. Doctors there treated her for injuries sustained in the accident. Garrick was released from the hospital on May 1, 1996. USA Medical Center claims that Garrick incurred approximately $50,035.25 in medical charges as a result of that first admission. The Alabama Medicaid Agency paid almost half those charges.¹

On May 13, 1996, Garrick was readmitted to USA Medical Center.² She was discharged on May 20. USA Medical Center claims that Garrick incurred $33,857.75 in medical charges during that second admission. The Alabama Medicaid Agency paid none of these charges.

Garrick received a financial settlement based on the injuries she had suffered in the accident. Pursuant to Ala.Code 1975, § 35-11-371, USA Medical Center filed two hospital liens against that settlement—one lien for the charges resulting from her first hospital admission and the other lien for the charges resulting from her second admission.³ Garrick filed a complaint for declaratory relief against USA Medical Center, paying in the $55,000 she had received in the settlement of her automobile-accident claim, and requesting that the trial court declare USA Medical Center's "lien" invalid, but not indicating which lien she contended was invalid and unenforceable. USA Medical Center counterclaimed, alleging that Garrick owed a total of $36,935 for medical services it had provided her.⁴

Garrick and USA Medical Center each moved for a summary judgment. The trial court granted Garrick's motion, declaring that "the proposed lien [was] defective in that it violates the requirements of [Ala. Code 1975,] § 35-11-370, with respect to the time within which a patient must have been admitted to, or treated by, the hospital following injuries,"⁵ and it denied USA Medical Center's motion. The trial court made Garrick's summary judgment final, pursuant to Rule 54(b), Ala. R. Civ. P.

The Court of Civil Appeals affirmed the trial court's judgment, concluding that the language of § 35-11-370 clearly and unambiguously states that a hospital is granted a lien only in cases where the injured party enters a hospital within one week following the accident giving rise to the injury. See University of South Alabama v. Garrick, 761 So.2d 237 (Ala.Civ.App. 1998).⁶ Thus, the Court of Civil Appeals held, USA Medical Center "was not entitled to a statutory lien for the medical charges incurred as a result of Garrick's second hospitalization," because that hospitalization occurred more than one week after the accident that had caused her injuries. 761 So.2d at 240.

II.

Ala.Code 1975, § 35-11-370, provides in pertinent part:

"Any person, firm, hospital authority or corporation operating a hospital in this state shall have a lien for all reasonable charges for hospital care, treatment and maintenance of an injured person who entered such hospital within one week after receiving such injuries, upon any and all actions, claims, counterclaims and demands accruing to the person to whom such care, treatment or maintenance was furnished, or accruing to the legal representatives of such person, and upon all judgments, settlements and settlement agreements entered into by virtue thereof on account of injuries giving rise to such actions, claims, counterclaims, demands, judgments, settlements or settlement agreements and which necessitated such hospital care, subject, however, to any attorney's lien."

(Emphasis added.)

USA Medical Center argues that the Court of Civil Appeals' interpretation of § 35-11-370 is contrary to both the plain language of the statute and the intent of the Legislature in passing it. Garrick argues that the language of the statute is plain, obvious, and unambiguous, and, therefore, that there is no room for construction.

Both Garrick and USA Medical Center note this principle:

"The cardinal rule of statutory interpretation is to determine and give effect to the intent of the legislature as manifested in the language of the statute. Gholston v. State, 620 So.2d 719 (Ala. 1993). Absent a clearly expressed legislative intent to the contrary, the language of the statute is conclusive. Words must be given their natural, ordinary, commonly understood meaning, and where plain language is used, the court is bound to interpret that language to mean exactly what it says. IMED Corp. v. Systems Engineering Associates Corp., 602 So.2d 344 (Ala.1992)."

Ex parte State Dep't of Revenue, 683 So.2d 980, 983 (Ala.1996). Where the language of a statute is clear and "there remains no room for judicial construction[,] ... the clearly expressed intent of the legislature must be given effect." Ex parte Holladay, 466 So.2d 956, 960 (Ala.1985) (citing Dumas Bros. Mfg. Co. v. Southern Guar. Ins. Co., 431 So.2d 534 (Ala.1983)). When construing a statute, this Court "has a duty to ascertain and effectuate legislative intent expressed in the statute, which may be gleaned from the language used, the reason and necessity for the act, and the purpose sought to be obtained." Ex parte Holladay, 466 So.2d at 960 (citing Shelton v. Wright, 439 So.2d 55 (Ala.1983)).

Section 35-11-370 lends itself to either of two readings. It may be read to entitle a hospital to a lien for charges for all treatment that is related to the injury, whenever the treatment occurs, as long as the patient is initially admitted to the hospital within one week of the injury. Alternatively, it can be read to entitle a hospital to a lien only for charges for treatment a patient receives during the patient's initial admission, and then only if the patient is admitted within one week of the injury. In light of the ambiguity, we must look to the purpose of the statute to discern the legislative intent. See Dennis v. Pendley, 518 So.2d 688, 690 (Ala.1987) ("It is the court's function to make clear the intent of the legislature when some degree of ambiguity is found in a statute.") (citing Sutherland Stat. Constr., § 45.02 (4th ed.1984)).

This Court has recognized that the hospital-lien statute is to be construed broadly in order not to defeat a just hospital claim. Guin v. Carraway Methodist Med. Ctr., 583 So.2d 1317, 1319 (Ala.1991). This Court in Guin quoted from J.F. Rydstrom, Annotation, Construction, Operation, and Effect of Statute Giving Hospital Lien Against Recovery From Tortfeasor Causing Patient's Injuries, 25 A.L.R.3d 858, 874 § 5(b) (1969) (stating that "it has generally been held or recognized" that the requirements of hospitallien statutes "should not be technically applied so as to defeat just hospital claims, and that such statutes are to be liberally construed in this respect"). The purpose of Alabama's hospital-lien statute is, by giving a hospital an automatic lien for the reasonable value of its services, to induce it to receive a patient injured in an accident, without first considering whether the patient will be able to pay the medical bills incurred. See Guin, supra, 583 So.2d at 1319-20; see also J.F. Rydstrom, supra, 25 A.L.R.3d at 862 (stating that the purpose of a hospital-lien statute is to lessen the burden imposed on a hospital by nonpaying accident victims). The statute creates an incentive for a hospital to accept a patient who needs medical services but who may be either uninsured or unable to pay for such services. To interpret § 35-11-370 as applying only to the period of a patient's initial admission would create a disincentive for the hospital to provide the patient proper follow-up medical treatment.

The Texas Court of Civil Appeals addressed a similar issue in Baylor University Medical Center v. Travelers Insurance Co., 587 S.W.2d 501 (Tex.Civ.App.1979, writ ref'd n.r.e.), a case involving the Texas hospital-lien statute.⁷ Although the Texas statute does differ from the Alabama statute, the interpretation and analysis of the Texas court is still instructive. The Texas court held that the Texas hospital-lien statute, entitling a hospital to a lien only if the patient was admitted to the hospital within 72 hours of the injury, required admission within 72 hours only for the patient's initial hospital admission, not for subsequent admissions for follow-up treatment. Id. at 504. The Texas court reasoned:

"The overriding purpose of article 5506a, as amended, is to induce hospitals to receive a patient, injured by the negligence of others, by giving the hospital a lien on the claims, suit or settlement of the patient. The inducement is for `immediate' (within seventy-two hours) reception of the patient. The inducement is co-extensive with the `treatment, care and maintenance as may have been

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