Idaho Hospital Ass'n, Application of

• Decision Date: 24 November 1954
• Docket Number: No. 8049,8049
• Citation: 76 Idaho 34,277 P.2d 287
• Parties: In the Matter of the Application of IDAHO HOSPITAL ASSOCIATION, For Increase in Hospital Room Rates.
• Court: Idaho Supreme Court

Page 287

277 P.2d 287

76 Idaho 34

In the Matter of the Application of IDAHO HOSPITAL ASSOCIATION, For Increase in Hospital Room Rates.

No. 8049.

Supreme Court of Idaho.

Nov. 24, 1954.

Kibler & Beebe, Nampa, for appellant.

Robert E. Smylie, Atty. Gen., for Industrial Accident Board.

Glenn A. Coughlan, Boise, for State Insurance Fund.

Walter M. Oros, Boise, for St. Alphonsus Hospital.

Carver, McClenahan & Greenfield, Boise, for Idaho State Federation of Labor.

E. B. Smith, Boise, for Idaho Compensation Co.

McCarthy & Feeney, Lewiston, for North Idaho Medical Service Bureau.

Elder & Elder, Coeur d'Alene and Brown & Peacock, Kellogg, amici curiae.

GIVENS, Justice.

Pursuant to the remand in Application of Idaho Hospital Ass'n, 73 Idaho 320, 251 P.2d 538, the Industrial Accident Board January 12, 1953, called for a pre-trial conference January 23, 1953, notifying and giving all interested parties and their attorneys the right to comment upon the queries presented by the Board, summarized as to what order the then record before the Board would support and justify as to hospital rates; obligatory on the employer, and giving full opportunity for elaboration and suggestions relative to the entire matter by all parties.

The only result therefrom was appellant's indication that if the Order did not comply with its desires, it would appeal, which it had the right to do and has done; again somewhat questioning the overall and general authority or jurisdiction of the Board to fix hospital fees and charges, though this proceeding was initiated by appellant before the Board for that very purpose, specifically challenging the Statewide ceiling and the grouping of hospitals in communities, and the fees allowed the individual hospitals where such are less than the regular charges of such hospitals.

While we have again considered the holding as to the general jurisdiction of the Board announced in the above case, we continue to believe that such pronouncements were correct and do not need further consideration, justification or discussion.

After the pre-trial conference, the Board first seriatim extended the time within which any interested party could present supplemental pleadings or record to April 1, 1953 and thereafter, indefinitely.

Individual so-called petitions and statements by respective hospital members of appellant Association and others, joining in the original petition or acquiescent to those proceedings and describing the nature of the ownership and operation of the respective hospitals, services available and rendered, and the regular rates and fees therefor, and asking individual hearings, were filed, which added but little to the composite picture, except to bring their rates down to date. From these several statements, the Board prepared a chart of charges.

July 15, 1953 the Board made the following Order:

'To Hospitals and Sureties and all parties and attorneys in pending Hospital Rates Controversy:

'The enclosed Hospital Regulations and Rates, effective August 1, 1953, have this day been adopted by the undersigned.

'Industrial Accident Board

B. W. Oppenheim

Leo H. Houtz

C. R. Hunter

'Attest:

Joseph M. Smith

Secretary'

(Seal)

detailing the table of fees chargeable.

The pertinent and controlling statute is Section 72-307, I.C., ¹ authorizing the Board to regulate the medical and hospital charges for which the employer and the employer's insurance carrier are liable, Whittaker's Case, 319 Mass. 582, 66 N.E.2d 785, at page 788, construed in a cognate field to be a broad power, Western Hospital Ass'n v. Industrial Accident Board, 51 Idaho 334, 6 P.2d 845. The fees and charges for such services being 'limited to such charges as prevail in the same community for similar treatment of injured persons of a like standard of living when such treatment is paid for by the injured person. In determining what fees and charges are reasonable, the board shall consider the increased security of payment afforded by this act.'

The liability to furnish proper and adequate medical and hospital services to an injured employee is a positive liability resting upon the employer, guaranteed by the insurance carrier.

This Court's review of the fees and charges fixed by the Board, as on all appeals from an order of the Board, is by Const. Article V, Section 9, limited to a review of questions of law. In other words to determine whether or not the Board has regularly pursued its authority. McGarrigle v. Grangeville Elec. L. & P. Co., 60 Idaho 690, 97 P.2d 402; Totton v. Long Lake Lumber Co., 61 Idaho 74, 97 P.2d 596.

Appellant complains that the Order of the Board is arbitrary; that there was insufficient evidence to support the Statewide ceiling and charges and fees in individual hospitals when less than the regular charges of the respective hospitals; that the Order was made without consideration of the varying factors in the different communities and kinds of hospitals, and that the Board has improperly applied the comprehension of the word 'community.' The word 'community' has a flexible meaning, taking color and meaning from the context and the Board gave detailed consideration to the individual hospitals--certainly an application of the statute that is fair to the hospitals and not an expanded or unwarranted concept of 'community' as connoted in the statute.

The Order is flexible, was only for a year, specifically providing that:

'The rates herein approved or fixed are subject to modification as circumstances require. Under the law all persons interested, concerned or affected may at any time petition for a reconsideration of any and all of them. However, the board in practical administration has found that changes in medical service rates should ordinarily be considered not oftener than annually.'

While the Board has separated the hospitals into seven communities or sections or groups, within such seven groups the Board has differentiated as to the respective hospitals in each group; thus, has given particular attention to the individual hospitals.

This Order leaves operative Section 72-308, I.C.

The fact that the fees and charges approved are in some instances less than the regular charges of the particular hospital, does not of itself, prove the Board has not regularly pursued the authority granted by the statute, because under the statute there are three variables: first, the charges that prevail in the same community for similar treatment of the injured persons; second, like standard of living; and third, the increased security of payment. Communities, though geographically apart, may be similar as to factors affecting hospital charges.

It is to be remembered the Board had before it the extensive transcript of the hearing before the Honorable Charles F. Koelsch, former District Judge and referee in the matter, and his conclusion that reductions of 2.33% of the regular charges would be justified.

The hospital members of the Association, of course, are not component parts of one organization. They are individual hospitals, without monetary connection with each other, though all designed to serve the same purpose. The rates in one hospital, if less than its out-of-pocket cost of doing service, cannot be aided by rates in other hospitals which are more than their out-of-pocket cost of service. By way of general illustration of the percentage reduction made by the Board, the Bonner General Memorial Hospital for Bonner County in Sandpoint, shows regular charges of $10 for ward accommodation where three or more patients are housed; $11 for semi-private rooms, accommodating two patients, and $13 for a private room. The fees allowed by the Board are less on all three, being $9.50 for the ward; $10.50 for...