Parrish v. Lamm
| Decision Date | 11 July 1988 |
| Docket Number | No. 86SA452,86SA452 |
| Citation | 758 P.2d 1356 |
| Parties | , 8 A.L.R.5th 1048 Michael W. PARRISH, D.C. and William W. Ranney, Plaintiffs-Appellants, v. Richard LAMM, Governor, State of Colorado; State Board of Chiropractic Examiners, William Dold, D.C., Glen Hultgren, D.C., Richard Ratliff, D.C., William Newcomer and J. Eric Griffiths, D.C.; Colorado State Board of Dental Examiners; Colorado State Board of Nursing; Colorado State Board of Optometric Examiners; Colorado State Board of Physical Therapy; Colorado State Board of Psychologist Examiners; Colorado Department of Health; David J. Thomas, District Attorney, 1st Judicial District; Norman S. Early, Jr., District Attorney, 2nd Judicial District; Barney Iuppa, District Attorney, 4th Judicial District; Kurt Schulke, District Attorney, 5th Judicial District; Vic Reichman, District Attorney, 6th Judicial District; Reid Pixler, District Attorney, 7th Judicial District; Stuart Van Meveren, District Attorney, 8th Judicial District; Milton K. Blakey, District Attorney, 9th Judicial District; Gus Sandstrom, District Attorney, 10th Judicial District; Robert Larsen, District Attorney, 11th Judicial District; Douglas Primavera, District Attorney, 12th Judicial District; Gregory F. Long, District Attorney, 14th Judicial District; Garth Neischburg, District Attorney, 15th Judicial District; Gary R. Stork, District Attorney, 16th Judicial District; James F. Smith, District Attorney, 17th Judicial District; Robert Gallagher, Jr., District Attorney, 18th Judicial District; Stanley C. Peek, District Attorney, 19th Judicial District; Alexander M. Hunter, District Attorney, 20th Judicial District; William H. Kain, III, District Attorney, 21st Judicial District; Dean Johnson, District Attorney, 22nd Judicial District, Defendants-Appellees. |
| Court | Colorado Supreme Court |
Roger W. Calton and Associates, Roger W. Calton, Laguna Niguel, Cal., Robert L. Russel, Colorado Springs, for plaintiffs-appellants.
Duane Woodard, Atty. Gen., Charles B. Howe, Chief Deputy Atty. Gen., Richard H. Forman, Sol. Gen., Linda Baker, First Asst. Atty. Gen., Denver, for defendants-appellees.
In 1985 the General Assembly established the crime of abuse of health insurance by enacting House Bill No. 1333 as section 18-13-119, 8B C.R.S. (1986). Michael W. Parrish and William W. Ranney (appellants) are doctors of chiropractic practicing in Colorado who regularly used the telephone directory and other media to advertise their willingness to waive insurance payments of deductible and copayment fees in providing health care service to their patients. They brought a declaratory judgment action 1 against a number of parties (appellees) in Denver District Court challenging the constitutionality of section 18-13-119. They argued that the statute violated various provisions of the United States and Colorado Constitutions. The district court upheld the statute under the federal constitution but did not address its status under the state constitution. The appellants appeal directly to this court pursuant to section 13-4-110(1)(a), 6A C.R.S. (1987). We conclude that the statutory scheme created by House Bill No. 1333 violates neither the United States Constitution nor the Colorado Constitution, and therefore affirm the judgment of the district court.
This dispute centers about the health care industry and the insurance industry. Traditionally, insurors have not undertaken the obligation to pay the entire cost of a compensable injury. The insuror's obligation to pay does not usually arise until the cost of health care service exceeds a given amount known as the deductible. In addition, coverage does not usually extend to a fixed percentage of the cost of health care service in excess of the deductible amount, known as the copayment. The obligation to pay the deductible and the copayment to the health care provider in those cases falls on the insured patient.
Certain health care providers, however, decided as a regular business practice not to enforce their right to demand payment of the deductible and the copayment; instead, they agreed to accept the amount of insurance coverage as payment in full for their services. Many of these health care providers as a regular business practice advertised their willingness to waive these patient fees in telephone directories, newspapers and other broadcast media. Members of the health insurance industry claimed that such practices by health care providers discouraged patients from using health care services responsibly by removing the economic burden of receiving care, which indirectly raised the cost of health insurance to all subscribers. They sought relief through the legislature in the form of House Bill No. 1333.
In its progression through the legislature, House Bill No. 1333 underwent a number of revisions. When introduced, the bill was entitled: "An act concerning misleading advertising by health care providers relating to third party payments as grounds for disciplinary action." It defined as "misleading" the regular business practice of advertising a willingness to waive patient payment of deductibles and copayments, and subjected health care providers to professional discipline. Before the first house committee hearing, the bill was amended. The bill no longer defined the practice of advertising a waiver of patient fees as "misleading," although the practice remained as grounds for professional discipline.
The bill passed the house in this form but was amended prior to the senate committee hearing by striking everything but the enacting clause and by inserting language creating the crime of abuse of health insurance as a class one petty offense. Under the proposed senate amendment, a health care provider committed the crime of abuse of health insurance by knowingly accepting from the patient's insuror the amount of its insurance coverage without demanding that the patient pay the deductible and the copayment, or by knowingly submitting a fee to the patient's insuror which was greater than the fee the health care provider agreed to accept from the patient with the understanding of waiving the deductible or the copayment. 2 The regular business practice of waiving the deductible and copayment obligations also became grounds for professional discipline of health care providers. 3
The title of the bill was further amended to reflect these changes. The title became: "An act concerning advertising by health care providers relating to third-party payments as grounds for disciplinary actions, and, in connection therewith, providing that certain business practices are illegal." With few changes, House Bill No. 1333 passed the senate in this form. The house concurred in the senate amendments and repassed the bill. It was signed by the governor and became effective July 1, 1985. 4
The appellants argue that passage of House Bill No. 1333 violates sections 17 and 21 of article V of the Colorado Constitution. We do not agree.
Section 17 of article V of the Colorado Constitution provides that "no bill shall be so altered or amended on its passage through either house as to change its original purpose." The appellants argue that House Bill No. 1333 violates section 17 for two reasons: first, because the senate amended the original bill not through line-by-line reconsideration but by completely rewriting the bill; and second, because the original purpose of the bill was changed from prohibiting certain forms of advertising to prohibiting the regular business practice of waiving patient obligations to pay deductibles and copayments. The appellees argue that the original purpose of House Bill No. 1333 was not changed when the General Assembly amended the bill; rather, they claim, the General Assembly merely changed the means of accomplishing the original purpose of the bill.
The controlling reason behind section 17 is to prevent bills relating to one subject when introduced from afterwards being so amended as to relate to an entirely different subject. People v. Brown, 174 Colo. 513, 524, 485 P.2d 500, 506 (1971), appeal dismissed, 404 U.S. 1007, 92 S.Ct. 671, 30 L.Ed.2d 656 (1972). Subsequent amendments which merely extend the original purpose, however, are permissible by either body of the legislature, irrespective of the question as to the particular body in which the bill originated. In re Amendments of Legislative Bills, 19 Colo. 356, 360, 35 P. 917, 918 (1894). Section 17 also does not prohibit the legislature from amending a bill by changing the means of accomplishing the bill's original purpose. Brown, 174 Colo. at 524, 485 P.2d at 506.
In Brown, we upheld the constitutionality of Colorado's implied consent law. The defendant had challenged the statute on section 17 and other grounds. He argued that the bill as introduced related to the proposed misdemeanor of driving while ability impaired, while the bill as adopted related to implied consent of drivers to alcohol testing by the police. 5 We held that section 17 was not violated by subsequent amendment because the General Assembly had not changed the original purpose of the bill but merely the means of accomplishing its original purpose. Brown, 174 Colo. at 524, 485 P.2d at 506.
The purpose that the General Assembly sought to further in House Bill No. 1333 was not to regulate advertising but to prohibit regular business practice of waiving certain patient fees. Advertising was perceived by the legislature merely as the means of promoting the undesirable practice of waiving patient fees. That the General Assembly in the final version of House Bill No. 1333 decided to criminalize the practice of waiving these patient fees in addition to making the practice grounds for professional discipline does not so alter or amend its original purpose as to violate section 17. We therefore...
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