Medical Care, Inc. v. Chiropody Ass'n of W. Va., CC827
| Decision Date | 29 May 1956 |
| Docket Number | No. CC827,CC827 |
| Citation | 141 W.Va. 741,93 S.E.2d 38 |
| Parties | MEDICAL CARE, Inc. v. CHIROPODY ASSOCIATION OF WEST VIRGINIA et al. |
| Court | West Virginia Supreme Court |
Syllabus by the Court.
1. A duly licensed chiropodist is not a duly licensed physician within the meaning of clauses (4) and (5) of Section 2, Article 13, Chapter 5, Acts of the Legislature, 1946, Extraordinary Session, as amended, and is not eligible to participate in the plan of a medical service corporation for medical and surgical care furnished by duly licensed physicians to its subscribers under the terms of their contracts with such corporation.
2. Under clauses (4) and (5), Section 2, Article 13, Chapter 5, Acts of the Legislature, 1946, Extraordinary Session, as amended, a medical service corporation is authorized to contract with the public and duly licensed physicians only for such medical and surgical care as may be furnished by duly licensed physicians and for the payment for such service as may be specified in the contracts made by its subscribers with such corporation; and the exclusion from such contracts of any charge made by a duly licensed chiropodist for treatment which he has furnished to any of the subscribers of such corporation is proper.
3. When a statute is clear and unambiguous and the legislative intent is plain, the statute should not be interpreted by the courts. In such case it is the duty of the courts not to construe but to apply the statute.
Scherr, Meek & Vinson, Huntington, for petitioner.
Palmer & Elkins, J. Campbell Palmer, III, Charleston, for respondents.
This is a declaratory judgment proceeding instituted in the Circuit Court of Cabell County, West Virginia, in December, 1954, pursuant to the provisions of Section 2, Article 13, Chapter 26, Acts of the Legislature, 1941, Regular Session, Michie's Code of West Virginia, 1955, Annotated, Section 2, Article 13, Chapter 55, in which the plaintiff, Medical Care, Inc., a corporation, seeks determination of the question whether the plaintiff is required to pay, under its contracts with certain defendants, charges incurred by them for treatments which they have received from certain practitioners of chiropody who are also defendants.
The plaintiff is a nonprofit corporation under the laws of this State with its principal office in the City of Huntington, West Virginia, and it does business pursuant to Article 13, Chapter 5, Acts of the Legislature, 1946, Extraordinary Session, as amended by Article 13, Chapter 40, Acts of the Legislature, 1947, Regular Session, and Article 13, Chapter 33, Acts of the Legislature, 1951, Regular Session, Michie's Code, 1955, Annotated, Article 13, Chapter 31. The defendant, Chiropody Association of West Virginia, is a voluntary unincorporated association of chiropodists, the defendants John J. Bates, Walter Adkins and Earl W. Gault are practitioners of chiropody who have treated as patients certain defendants who have contracted with the plaintiff for services covered by its plan of operations, and the defendants Mrs. Fred Way, Jr., Roy May, James Boys, Mrs. Grover Wild, Alice Andrews, and Oliver H. Ray are subscribers to the plan of the plaintiff who have received treatment by practicing chiropodists and have submitted bills for the payment of such treatment to the plaintiff which it has refused to pay.
To the petition of the plaintiff the defendants, on December 28, 1954, filed their joint and several answer and its exhibits; and to the answer the plaintiff filed its written demurrer which challenged the legal sufficiency of the answer on the grounds that a chiropodist is not a duly licensed physician within the meaning of the applicable statute and treatment by a chiropodist is not within the scope of the plan operated by the plaintiff or the contracts made by it with its subscribers.
By order entered October 19, 1955, the circuit court overruled the demurrer of the plaintiff to the answer of the defendants, and held that a duly licensed chiropodist was eligible to participate in the medical service plan operated by the plaintiff and that the plaintiff was obligated under its contracts with the defendants who are subscribers to its plan to pay bills incurred by them for services rendered by such chiropodists, provided such services consisted of medical, mechanical or surgical treatment of ailments of the human hand and foot with the use of local anaesthetics; and on the joint motion of the parties certified its ruling on the demurrer to this Court.
The questions presented by the certificate of the circuit court are:
(1) Whether a chiropodist is a duly licensed physician within the meaning of Section 3, Article 13, Chapter 5, Acts of the Legislature, 1946, Extraordinary Session, as amended, and is eligible to participate in the medical service plan operated by the plaintiff; and
(2) Whether the plan operated by the plaintiff embraces within its scope or contracts treatment by a chiropodist and entitles him to payment by the plaintiff for such treatment according to its contracts with its subscribers and the schedule of payments provided in such contracts.
Under the contracts between the plaintiff and its subscribers, in consideration of certain dues paid by them, the plaintiff agrees to pay for certain medical and surgical treatment furnished its subscribers in accordance with the contracts on the basis of a schedule of fees specified in the contracts for various medical and surgical services; a physician may become a participant in the plan by agreeing to comply with the specified schedule of fees; and if the medical services are furnished to subscribers by a physician who does not participate, the plaintiff agrees to pay seventy five percent of the fee specified in the schedule.
The contracts between the plaintiff and its subscribers and the specified fees are subject to supervision by the Insurance Commissioner of West Virginia and they have been approved by that official. The contracts do not expressly cover services furnished by chiropodists and services by them were not taken into consideration when the rate of the dues required to be paid by subscribers was fixed by the plaintiff and approved by the insurance commissioner. The plaintiff asserts that if its plan should be extended to cover treatment by chiropodists it will be necessary to revise the rate of the dues in order to preserve the financial solvency of the plan as presently operated by it.
The controlling issue presented for decision is whether a duly licensed practitioner of chiropody is a duly licensed physician within the meaning of the statute under which the plaintiff has formulated and is now operating its plan. To resolve that issue it is necessary to consider and apply the statutory provisions which relate to the plan and the members of the professions eligible or ineligible to participate in it.
Section 1, Article 13, Chapter 5, Acts of the Legislature, 1946, Extraordinary Session, as amended, relating to hospital and medical service corporations contains these provisions:
'In view of the desirability of making available to the people of the state increased hospital and medical services on a distributive cost basis, the declared policy of the Legislature in the enactment of this article is to encourage the organization, promotion and expansion of hospital service corporations and medical service corporations by exempting them from the payment of all taxes and from the operation of the general insurance laws of the state, but at the same time subjecting them to such regulation as may be necessary for the adequate protection of those members of the public who subscribe for the services offered by such corporations.'
Section 2 of the same statute provides in part:
'(4) 'Medical service corporation' shall mean a nonprofit, nonstock corporation, organized in accordance with the provisions of article one of this chapter for the sole purpose of contracting with the public and with duly licensed physicians for medical service to be furnished to subscribers under terms of their contract with the corporation, and controlled by a board of directors, the majority of whom are duly licensed physicians.
'(5) 'Medical service' shall mean only such medical and surgical care, to be provided by duly licensed physicians, or such payment therefor, as may be specified in the contract made by the subscriber with the corporation.'
Section 1, Article 2A, Chapter 97, Acts of the Legislature, 1949, Regular Session, Section 1, Article 2A, Chapter 30, Michie's Code, 1955, Annotated, contains these provisions:
'There is hereby created a medical licensing board to be known as 'The Medical Licensing Board of West Virginia.'
* * *
'Of the members to be appointed by the governor, six shall be physicians or surgeons holding the degree of doctor of medicine, two shall be chiropodists, and two shall be chiropractors. * * *
'The chiropodists who are members of the medical licensing board, shall participate in its proceedings and vote as members of the board only on matters pertaining to the licensure, examination, or suspension, revocation, or reinstatement of the licenses of chiropodists.
'The chiropractors who are members of the medical licensing board, shall participate in its proceedings and vote as members of the board only on matters pertaining to the licensure, examination, or suspension, revocation or reinstatement of the licenses of chiropractors. * * *.'
Section 2, Article 3, Chapter 30, Code, 1931, as amended, to the extent here pertinent, defining the practice...
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