FACTUAL AND PROCEDURAL HISTORYThis 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.
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 Regional, Lane Regional issued a second payment to Leet in the amount of $7,211.61, representing the remaining sums it had retained over the contractually reduced reimbursement rate less Leet's $100.00 copayment.
After transfer of the suit from the Twentieth Judicial District Court to the Nineteenth Judicial District Court, removal of the suit to federal court, and a remand back to the state district court, Lane Regional filed a motion for summary judgment on February 23, 2018, contending that it was entitled to judgment in its favor as a matter of law, dismissing plaintiff's claims against it. Specifically, Lane Regional contended that: (1) as a public entity, it was entitled to immunity pursuant to LSA-R.S. 9:2798.1 ; (2) it did not violate the Balance Billing Act, nor was plaintiff entitled to general damages for its alleged violation of the Act; (3) plaintiff's claims were moot because she received full redress from Lane Regional; and (4) Lane Regional did not breach any "contract" or "quasi-contract" for which plaintiff would have a claim against it, nor did plaintiff sustain any compensable damages for any alleged breach.
Following a hearing on the motion, the trial court found that Leet's claims were moot because Lane Regional had reimbursed her "all amounts that could conceivably be due to her" and, thus, pretermitted ruling on Lane Regional's remaining arguments in support of its motion. Because Leet was the only identified class representative, the trial court, by judgment dated April 18, 2018, granted Lane Regional's motion for summary judgment and dismissed Leet's claims against it with prejudice.
Leet I , 274 So.3d at 584-86. Plaintiff appealed the judgment dismissing all claims against Hospital Service District No. 1 of East Baton Rouge d/b/a Lane Regional Medical Center ("Lane Regional"), and this court reversed, finding that material issues of fact existed and that defendant had not addressed all of plaintiff's claims for relief. Id. at 591.
On remand, Lane Regional, as the sole remaining defendant,1 filed a second motion for summary judgment and sought to have plaintiff's claims against it dismissed on the basis that: (1) Lane Regional, as a public entity, is entitled to immunity from liability under La. R.S. 9:2798.1 and (2) Lane Regional did not violate the Balance Billing Act,2 La. R.S. 22:1871, et seq. , as the Act is inapplicable. These two issues were raised in the original summary judgment; however, neither the trial court nor this court reached the merits of the applicability of the Balance Billing Act or immunity.3 A hearing was held by the trial court at which time the motion was denied.
Thereafter, Lane Regional filed a motion for reconsideration of the denial of the second motion for summary judgment, urging that the Balance Billing Act was not applicable under the particular facts of this case. By this time, plaintiff had filed the motion for class certification, and the two motions were set for hearing on the same date. After the hearing, the trial court took both motions under advisement. The trial court later granted the motion for reconsideration, thereby granting Lane Regional's second motion for summary judgment, and denied plaintiff's motion for class certification. On November 12, 2019, the trial court signed a judgment in favor of Lane Regional, denying the motion for class certification, granting the motion for reconsideration as well as the second motion for summary judgment, and dismissing all claims of plaintiff, with prejudice.
It is from the November 12, 2019 judgment that plaintiff...
