Planned Parenthood Region v. Mo. Dep't of Soc. Servs., ED 109654

CourtCourt of Appeal of Missouri (US)
Writing for the CourtAngela T. Quigless, Judge
Citation639 S.W.3d 449
Parties PLANNED PARENTHOOD OF ST. LOUIS REGION, et al., Respondents, v. MISSOURI DEPARTMENT OF SOCIAL SERVICES, et al., Appellants.
Docket NumberNo. ED 109654,ED 109654
Decision Date14 December 2021

639 S.W.3d 449

PLANNED PARENTHOOD OF ST. LOUIS REGION, et al., Respondents,
v.
MISSOURI DEPARTMENT OF SOCIAL SERVICES, et al., Appellants.

No. ED 109654

Missouri Court of Appeals, Eastern District, DIVISION THREE.

Filed: December 14, 2021


Caleb M. Lewis, Ian D. Hauptli, Co-Counsel, P.O. Box 899, Jefferson City, Mo. 65102, for appellant.

Charles W. Hatfield, Alixandra Cossette, Co-Counsel, 20 W. McCarty Street, Jefferson City, Mo. 65101, for respondent.

Angela T. Quigless, Judge

The Missouri Department of Social Services, MO HealthNet Division, and Missouri Medicaid Audit and Compliance Unit (collectively "State") appeal the circuit court's award of attorney's fees to Planned Parenthood of St. Louis Region and Reproductive Health Services of Planned Parenthood of St. Louis Region (collectively "Planned Parenthood"). The award was part of the circuit court's judgment that reversed the decision of the Administrative Hearing Commission, and concluded that the State was required to pay Planned Parenthood for valid Medicaid claims submitted in fiscal year 2020. The circuit court remanded the cause to the Commission for

639 S.W.3d 452

a determination of the amount of the claims, interest, and attorney's fees and expenses due Planned Parenthood. We dismiss the appeal, for lack of a final judgment.

Factual and Procedural Background

This appeal stems from the State's denial of Planned Parenthood's Fiscal Year 2020 claims for physician and family-planning services provided to Medicaid-eligible individuals. A brief background of the operation and funding of Missouri's Medicaid program aids in understanding the background and posture of this case. Missouri's Medicaid program is known as MO HealthNet, and is administered by the Mo HealthNet Division of the Missouri Department of Social Services. Planned Parenthood of St. Louis Region v. Dept. of Social Servs., Div. of Med. Servs. , 602 S.W.3d 201, 204 (Mo. banc 2020). Under Missouri law, payments are made "on behalf of" the Medicaid-eligible person receiving the services, but are made to the authorized provider from which the eligible person received the services. Sections 208.152.1(6) and (12); Planned Parenthood of St. Louis Region , 602 S.W.3d at 205. Missouri law further provides that "any person entitled to MO HealthNet benefits may obtain it from any provider of services with which an agreement is in effect under this section and which undertakes to provide the services, as authorized by the MO HealthNet division." (Emphasis added). Section 208.153.1. MO HealthNet has authorized Planned Parenthood to provide physician and family-planning services to Medicaid-eligible individuals. In the past, this was sufficient to permit Planned Parenthood to provide those services and receive payment for them, from MO HealthNet, from money appropriated by the General Assembly. Planned Parenthood of St. Louis Region , 602 S.W.3d at 205.

House Bill No. 11 (2019) ("HB11") was the Department of Social Services’ appropriations bill for Fiscal Year 2020.1 The General Assembly appropriated funds for the fiscal year, for the purpose of funding "physician services and related services, including, but not limited to ... family planning services under the MO HealthNet fee-for-service program...." Section 11.645 HB11. But then the General Assembly attempted to prohibit funds from being paid to an abortion facility. Section 11.930 of HB11 provided that:

"[n]o funds shall be expended to any clinic, physician's office, or any other place or facility in which abortions are performed or induced other than a hospital, or any affiliate or associate of any such clinic, physician's office, or place or facility in which abortions are performed or induced other than a hospital."

Citing this section, the State notified Planned Parenthood that it would be denying Planned Parenthood's fiscal year 2020 provider claims due to lack of appropriation authority. The State reasoned that because Reproductive Health Services of Planned Parenthood of St. Louis Region is licensed by the Missouri Department of Health and Senior Services as an abortion facility, and because Planned Parenthood of St. Louis Region is an affiliate and/or associate of that provider, the two were thus ineligible for payments pursuant to

639 S.W.3d 453

Section 11.930 of HB11 and Article IV, Section 28 of the Missouri Constitution.2

Planned Parenthood appealed the denial of its claims to the Administrative Hearing Commission. The Commission concluded the State's denials were required by the language in Section 11.930 of HB11, and thus affirmed the denial of Planned Parenthood's claims.

Planned Parenthood petitioned for judicial review in the circuit court. While that review was pending, the Supreme Court of Missouri issued its decision in Planned Parenthood of St. Louis Region v. Department of Social Services, Division of Medical Services , 602 S.W.3d 201 (Mo. banc 2020). In that case, like here, the State refused to reimburse Planned Parenthood for family-planning and physician services provided to Medicaid-eligible individuals.3 Like here, the State based its denial on a provision in fiscal year's appropriation bill prohibiting funds from being expended to an abortion facility. That provision, Section 11.800 of House Bill No. 2011 (2018)("HB2011"), stated: "No funds shall be expended to any abortion facility as defined in Section 188.015, RSMo, or any affiliate or associate thereof."

Planned Parenthood challenged the constitutional validity of Section 11.800 of HB2011, contending it was impermissible to use an appropriation bill to amend substantive law – in particular, Sections 208.153.2 and 208.152.1(6), (12) – because such action violated the single-subject requirement of Article III, Section 23 of the Missouri Constitution. The Supreme Court of Missouri reached the same conclusion and declared Section 11.800 unconstitutional.

Article III, Section 23 of the Missouri Constitution prohibits bills with more than one subject.4 Planned Parenthood of St. Louis Region , 602 S.W.3d at 206-207. "Any bill that purports to combine appropriations with the enactment or amendment of general or substantive law necessarily contains more than one subject in violation of article III, section 23...."5 Id. at 207. Sections 208.153.2 and 208.152.1(6), (12) require MO HealthNet to pay its authorized providers, including Planned Parenthood, for covered physician and family-planning services provided to Medicaid-eligible individuals. Id. at 209. Section 11.800 of HB2011, however, purported to add a limitation on which health-care providers could receive payments. Id.

The Supreme Court of Missouri concluded that Section 11.800 of HB2011 was in direct conflict with Sections 208.153.2 and

639 S.W.3d 454

208.152.1(6), (12), and thus was an attempt to amend those general statutes. Id. at 208-209. Specifically, the Supreme Court of Missouri stated: "the language in section 11.800 seeking to disqualify certain authorized providers based on services they provide separately and apart from the MO HealthNet program – and for which no MO HealthNet payments can be made – is a naked attempt to use HB2011 both to appropriate funds for various purposes and to amend sections 208.153.1 and 208.152.1(6), (12)." Id. at 209. Accordingly, the Supreme Court of Missouri declared Section 11.800 unconstitutional, as a "clear and unmistakable violation of the proscription in article III, section 23 of the Missouri Constitution against bills with multiple subjects." Id. at 209-11.6

We return to the instant case. Planned Parenthood raised the same constitutional challenge to Section 11.930 of HB11, as it had to Section 11.800 of HB2011. The State conceded the validity of Section 11.930 was controlled by the Supreme Court of Missouri's Planned Parenthood decision, and therefore the section was invalid.

The circuit court, in following the Supreme Court's decision, reached the same conclusion, and reversed the Commission's decision. The circuit court declared Section 11.930 of HB11 unconstitutional, and ruled invalid the State's decision to deny payment to Planned Parenthood for physician and family-planning services based on that section. The circuit court thus found that the Missouri Department of Social Services was required to pay Planned Parenthood for valid MO HealthNet claims submitted in fiscal year 2020, including interest on money wrongfully withheld by the state pursuant to Section 621.055, and attorney's fees and expenses pursuant to Section 536.087. The circuit court, as argued for by the State, then remanded the cause to the Commission for a "determination of the amount of the claims, interest, and attorney's fees and expenses due [Planned Parenthood.]"

The State appeals, contesting the attorney's fees aspect of the circuit court's judgment. The State contends Planned Parenthood's purported application for attorney's fees and the circuit court's judgment both run afoul of the...

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