Hall v. Humana Hosp. Daytona Beach, 95-3283
| Decision Date | 06 December 1996 |
| Docket Number | No. 95-3283,95-3283 |
| Citation | 686 So.2d 653 |
| Court | Florida District Court of Appeals |
| Parties | 21 Fla. L. Weekly D2585 Jan HALL, Eugene C. Kiernan, et al., Appellants/Cross-Appellees v. HUMANA HOSPITAL DAYTONA BEACH, etc., et al., Appellees/Cross-Appellants. |
Stephen A. Scott, Law Offices of Stephen A. Scott, Gainesville, and Herbert T. Schwartz, Law Offices of Charles H. Puckett, III, Houston, Texas, for Appellants/Cross-Appellees.
Edward M. Waller, Jr., George A. Vaka, Charles Wachter, Elizabeth A. Boland, of Fowler, White, Gillen, Boggs, Villareal & Banker, P.A., Tampa, for Appellees/Cross-Appellants.
This is the appeal of a partial summary final judgment entered in favor of Humana Hospital Daytona Beach ["Humana"], now operating as Galen of Florida, Inc. The judgment concerns two counts of a class action suit brought by Humana's former patients seeking recovery of alleged overcharges for pharmaceuticals, medical supplies, and laboratory services. In essence, the suit is an attack on the practice whereby hospitals bill sums for items that are disproportionate to the market price of the items in a non-hospital setting. Examples are: a charge of $11.50 for a single Zantac tablet; a charge of $52 for a single tablet of Tylenol with codeine; and a charge of $20.50 for each Cipro tablet. We affirm.
All of the plaintiffs involved in the suit below are former patients of Humana. The class consists of "charge-based" "self payers", i.e., people who pay their hospital charges personally or through insurance. It does not include medicare or medicaid patients, indigent patients whose care is paid for by governmental entities or patients whose care has been paid for under the terms of a prospective payment arrangement which provides for the hospital to pay an amount other than the total of the itemized bill. Some of the members of the class have fully paid their bills, either directly or through insurance, some have partially paid their bills, and some have paid no portion of their bills. This appeal involves only those class plaintiffs, represented by Gayle Hoffman, who have fully paid their bills. 1
The complaint sets forth that, upon admission to Humana, plaintiffs and/or their representatives were presented a standard form agreement to guarantee payment and were required to execute the agreement as a prerequisite to treatment. The complaint also asserts that each of the plaintiffs, in order to obtain treatment, did in fact sign one of two standard form agreements presented by Humana. One of these forms obligated plaintiffs to pay the hospital's "prevailing rates," while the other required plaintiffs to pay the "rates set out in the Hospital's Master Charge List." 2 The Hospital's Master Charge List was a separate document which contained a statement of the hospital's then current charges.
The first of the two counts involved in this appeal is an action for money had and received. This count is based on a theory of imposition. It is alleged that Humana charged plaintiffs unreasonable amounts for pharmaceuticals, medical supplies, and laboratory services, despite an obligation to charge only a reasonable price for these items, and that Humana took "undue advantage of the class members' individual situations, virtual incarceration and lack of bargaining power" in imposing excessive charges. The count seeks a refund of such overpayments. The other count is an action for common law unjust enrichment, as well as unjust enrichment resulting from the hospital's alleged violation of section 395.015(6), Florida Statues (1991). 3 In this count, it is alleged that Humana is limited by law to fair and reasonable amounts for challenged items, and that Humana overcharged the plaintiffs for these items in violation of its common law and statutory obligations. 4
An action for money had and received, or the more modern action for unjust enrichment, see generally Moore Handley, Inc. v. Major Realty Corp., 340 So.2d 1238 (Fla. 4th DCA 1976), is an equitable remedy requiring proof that money had been paid due to fraud, misrepresentation, imposition, duress, undue influence, mistake, or as a result of some other grounds appropriate for intervention by a court of equity. Merritt v. Unkefer, 223 So.2d 723 (Fla.1969). The mere fact that an overpayment of some sort has been demanded and payment made will not support the action.
The basis alleged for equitable intervention in this case is "imposition." An action for imposition is an action for money had and received to recover "excess" payments coercively exacted from a plaintiff where only a reasonable compensation is allowable. See Cullen v. Seaboard Air Line Ry., 63 Fla. 122, 58 So. 182, 184 (1912); see also Southern States Power Co. v. Pittman, 122 Fla. 758, 165 So. 893 (Fla.1936).
Plaintiffs' action for imposition appears to be based on allegations that Humana unilaterally charged plaintiffs unreasonable amounts for pharmaceuticals, medical supplies, and laboratory services, in violation of an agreement to pay only a reasonable price for these items, not that Humana coercively exacted a promise to pay unreasonable prices. In this context, there appears to be no imposition in the act of sending a bill to a patient seeking payment of excessive charges once treatment has been completed, where there has been no agreement to pay such charges.
Even if this were viewed as an action based on allegations that Humana coerced plaintiffs into executing an agreement to pay unreasonable charges, imposition requires more than a mere agreement to pay overcharges. Any coercion that may have been practiced by Humana in obtaining an agreement to pay "prevailing rates" or "rates set out in the hospital's master charge list" had ceased by the time payment was made by plaintiffs. It is recognized that:
[a] prior compulsion will not render the payment compulsory unless its influence continues up until the time of payment. On this principle, if a person obtains relief from duress by a promise of future payment and makes the payment after the duress is removed and when he has had opportunity to escape it by legal methods, he cannot afterward recover it.
66 Am.Jur.2d Restitution and Implied Contracts § 113, at 1050 (1973). 5 By voluntarily making payment of these alleged overcharges once the alleged coercion practiced by Humana had ceased, plaintiffs ratified or affirmed their prior agreement to pay these charges.
That the compulsion must continue through the time payment is made is illustrated by Ferrari v. Board of Health, 24 Fla. 390, 5 So. 1 (1888). There, the appellant complained of overcharges which had allegedly been made in violation of a quarantine act, which the appellant had ultimately paid by virtue of a bank draft, which had later been dishonored. In a suit brought to recover the amounts due on the bank draft, the appellant defended on the basis of the illegal charges. However, the court held that by paying after the duress had passed, the contract had been validated by ratification. 6
In the present case, there is no coercion that continued through the time of payment. At best, the payments resulted from a mistake of law concerning the enforceability of the contract previously made with Humana. Relief based on this type of mistake was not pled and, in any event, does not furnish a basis for equitable relief once payment has been made. North Miami v. Seaway Corp., 151 Fla. 301, 9 So.2d 705 (Fla.1942); Jefferson County v. Hawkins, 23 Fla. 223, 2 So. 362 (Fla.1887); but see Sun Coast Int'l, Inc. v. Department of Business Regulation, 596 So.2d 1118 (Fla. 1st DCA 1992). The Seaway court stated:
Every man is supposed to know the law, and if he voluntarily makes a payment which the law would not compel him to make, he cannot afterwards assign his ignorance of the law as a reason why the state should furnish him with legal remedies to recover it.
Plaintiffs maintain that Humana is precluded from asserting voluntary payment of the hospital's charges by reason of section 725.04, Florida Statutes (1991), which provides:
When a suit is instituted by a party to a contract to recover a payment made pursuant to the contract and by the terms of the contract there was no enforceable obligation to make the payment or the making of the payment was excused, the defense of voluntary payment may not be interposed by the person receiving payment to defeat recovery of the payment.
We conclude, however, that this statute speaks only to...
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