Leet v. Hosp. Serv. Dist. No. 1 of E. Baton Rouge Par.

• Decision Date: 25 February 2021
• Docket Number: NO. 2020 CA 0745,2020 CA 0745
• Parties: VICTORIA LEET, INDIVIDUALLY AND ON BEHALF OF ALL OTHERS SIMILARLY SITUATED v. HOSPITAL SERVICE DISTRICT NO. 1 OF EAST BATON ROUGE PARISH, LOUISIANA D/B/A LANE REGIONAL MEDICAL CENTER; ALEGIS REVENUE SOLUTIONS, LLC; AND LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY D/B/A BLUE CROSS AND BLUE SHIELD OF LOUISIANA
• Court: Court of Appeal of Louisiana (US)

VICTORIA LEET, INDIVIDUALLY AND
ON BEHALF OF ALL OTHERS SIMILARLY SITUATED
v.
HOSPITAL SERVICE DISTRICT NO. 1 OF EAST BATON ROUGE PARISH,
LOUISIANA D/B/A LANE REGIONAL MEDICAL CENTER;
ALEGIS REVENUE SOLUTIONS, LLC; AND LOUISIANA HEALTH SERVICE
& INDEMNITY COMPANY D/B/A BLUE CROSS AND BLUE SHIELD OF LOUISIANA

NO. 2020 CA 0745

STATE OF LOUISIANA COURT OF APPEAL FIRST CIRCUIT

February 25, 2021

On Appeal from the 19^th Judicial District Court In and for the Parish of East Baton Rouge State of Louisiana
Trial Court No. 639818

Honorable Donald R. Johnson, Judge Presiding

J. Lee Hoffoss, Jr.
Donald W. McKnight
Lake Charles, LA

Derrick G. Earles
Lafayette, LA

Scott R. Bickford
Lawrence J. Centola, III
New Orleans, LA

Andrew J. D'Aquilla
St. Francisville, LA

Attorneys for Plaintiff-Appellant
Victoria Leet, Individually and on
behalf of all others similarly situated

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Thomas R. Temple, Jr.
David R. Kelly
Joseph J. Cefalu
Baton Rouge, LA

Attorneys for Defendant-Appellee,
Hospital Service District No. 1 of East
Baton Rouge Parish, Louisiana d/b/a
Lane Regional Medical Center

BEFORE: THERIOT, WOLFE, AND HESTER, JJ.

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HESTER, J.

Plaintiff, Victoria Leet, appeals a judgment granting a motion for reconsideration and a motion for summary judgment filed by defendant, Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center, thereby dismissing all of plaintiff's claims, with prejudice. For the reasons that follow, we affirm.

FACTUAL AND PROCEDURAL HISTORY

This matter initially came before this court on appeal filed by plaintiff. Leet v. Hospital Service District No. 1 of East Baton Rouge Parish, 2018-1148 (La. App. 1st Cir. 2/28/19), 274 So.3d 583 ("Leet I"). The applicable prior factual and procedural history, as set forth in Leet I, is as follows:

On May 29, 2014, Victoria Leet was injured in an automobile accident and received treatment at Hospital Service District No. 1 of East Baton Rouge Parish, Louisiana d/b/a Lane Regional Medical Center (referred to herein as "Lane Regional"). At the time of the accident, Leet was insured under the comprehensive medical benefit plan of her husband's employer, Louisiana Machinery Company, LLC. Through a contract between Louisiana Machinery and Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana ("Blue Cross"), Louisiana Machinery's self-funded plan was administered by Blue Cross, and Louisiana Machinery purchased access to the Blue Cross contracted healthcare provider network, which allows its insureds to seek treatment from network providers at the contracted reimbursement rate. Thus, as a covered beneficiary of a plan participant, Leet was able to obtain treatment from specific providers within the Blue Cross preferred provider network for a reduced rate, with her only responsibility being the applicable copay, deductible, or coinsurance. Lane Regional is a contracted health care provider with Blue Cross. Pursuant to its provider agreement with Blue Cross, Lane Regional contractually agreed to accept these reduced rates as payment in full for services provided to Blue Cross insureds.

At the time of treatment, Leet presented her Blue Cross insurance card to Lane Regional. However, on June 24, 2014, prior to submitting a claim for its services to Blue Cross, Lane Regional, through its accounts receivable contractor, asserted a lien, by sending medical lien letters to Leet and her attorney, for the full, undiscounted amount of $8,789.35 against any tort recovery Leet may receive from a third party as a result of the automobile accident. By check dated August 21, 2014, USAgencies Casualty Insurance Company ("USAgencies"), the third-party automobile liability insurer, issued a payment to Lane Regional for $8,789.35, the full amount of the lien.

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Meanwhile, on July 15, 2014, several weeks after asserting the lien, Lane Regional filed an insurance claim with Blue Cross, seeking reimbursement for the services provided to Leet. Thereafter, on September 16, 2014, after initially "pend/denying" the claim while awaiting additional information, Blue Cross paid Lane Regional for the claim at the reduced, contracted reimbursement rate of $1,477.74. Despite efforts by Leet's attorney to have Lane Regional reimburse Leet the full amount of any payment over the reduced, contracted rate for the services provided, Lane Regional retained the full, undiscounted payment from USAgencies. With regard to the payment of the reduced, contracted rate from Blue Cross, Lane Regional, after first attempting to return the $1,477.74 payment to Blue Cross, issued a refund to Leet on December 1, 2014, in the amount of $1,477.74, as reimbursement of the overpayment on her account.

Thereafter, on December 10, 2014, Leet filed a petition styled "Class Action Petition for Payment of a Thing Not Due, for Damages, for Declaratory Relief, and for Injunctive Relief" in the Twentieth Judicial District Court. Through original and amending petitions, Leet named as defendants Lane Regional; Alegis Revenue Group, LLC,¹ Lane Regional's accounts receivable contractor; and Blue Cross.

¹Alegis Revenue Group, LLC was at times improperly referred to as "Alegis Revenue Solutions, LLC" and "Alegis Corporation" in the petitions.

Regarding the claims against Lane Regional, Leet, individually and on behalf of the class, alleged that Lane Regional, in filing a lien and collecting the full, undiscounted rate for services provided to Leet, violated LSA-R.S. 22:1874 of the Balance Billing Act and that, as a result of these allegedly illegal billing practices by Lane Regional, she and those similarly situated were entitled to repayment of all overpayments, damages for mental anguish and emotional distress, loss of profits or use, out-of-pocket expenses, and all other damages allowed by law, as well as attorney's fees, costs, and expenses. Leet, individually and on behalf of all others similarly situated, also sought declaratory judgment, declaring that the practices of Lane Regional were in violation of law and in breach of contract and that all actions at law asserted by Lane Regional be deemed unenforceable and cancelled, and preliminary and permanent injunctive relief, enjoining Lane Regional from refusing to accept a patient's health insurance when a patient has been involved in a liability accident and from maintaining actions at law in violation of LSA-R.S. 22:1874.

Subsequently, on December 15, 2014, five days after Leet filed suit, but before service was perfected on Lane

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