306 P.3d 360
Nev.2013Background
- Penny Bielar, uninsured, received inpatient treatment at Washoe Medical Center in 2003 and 2005 and signed Conditions of Admission (COA) and Inpatient Payment Arrangement (IPA) forms granting Washoe statutory liens under NRS 108.590 and acknowledging possible eligibility for a 30% discount under NRS 439B.260(1).
- Bielar sued the tortfeasor; Great West (tortfeasor’s insurer) paid a $1.3 million settlement in 2005; Bielar agreed to indemnify Great West against healthcare liens and received funds, some identified as medical damages.
- Washoe recorded liens against the settlement and refused to apply the 30% statutory inpatient discount, arguing the settlement constituted an "other contractual provision for the payment of the charge by a third party" under NRS 439B.260(1)(a).
- District court held Bielar ineligible for the discount and later granted defendant judgment as a matter of law on Bielar’s accounting claim; this court reversed part of the denial earlier and ultimately reviewed eligibility and the NRCP 50(a) ruling.
- Nevada Supreme Court held that eligibility for the 30% discount is determined at the time services are rendered; a later settlement with a third-party tortfeasor is not a contractual provision for payment under NRS 439B.260(1)(a), so Bielar was eligible for the discount; but the court affirmed the NRCP 50(a) ruling except Bielar recovered a conceded overbilling of $3,801.23.
Issues
| Issue | Bielar’s Argument | Washoe’s Argument | Held |
|---|---|---|---|
| Whether a later settlement with a third-party tortfeasor bars the 30% NRS 439B.260(1) inpatient discount | Settlement proceeds (even if earmarked for medicals) do not constitute an "other contractual provision for payment by a third party" and thus do not disqualify her because she was uninsured when services were rendered | The settlement (and insurer payment) is a contractual provision for payment by a third party that disqualifies Bielar from the discount | Held for Bielar: eligibility is assessed when services are rendered; later settlement with tortfeasor/insurer is not covered by subsection (a) pre-2011 and does not disqualify her |
| Whether Bielar assigned away her right to recover from Washoe by indemnifying Great West and accepting settlement funds | Bielar’s COA/IPA and lien rights preserve her statutory discount right and allow challenge to lien reasonableness despite indemnifying Great West | Washoe argued Bielar intended to and did pay the full lien from settlement proceeds, precluding recovery against Washoe | Held for Bielar: COA/IPA/NRS 108.590 govern Bielar’s obligation to Washoe; indemnity to Great West does not negate her right to the statutory discount |
| Whether district court violated law of the case on remand | Bielar asserted prior reversal required different treatment on remand | Washoe asserted district court’s remand rulings were proper | Held for Washoe on procedure: remand rulings were consistent with prior order; no law-of-the-case violation found |
| Whether the district court properly granted NRCP 50(a) judgment as a matter of law on accounting claim | Bielar argued she presented sufficient evidence that Washoe’s billed amounts were unreasonable | Washoe argued plaintiff failed to prove unreasonableness of specific charges; trial evidence insufficient | Held for Washoe: plaintiff failed to prove that specific billed amounts were unreasonable, so NRCP 50(a) was properly granted, except for conceded $3,801.23 overbilling recoverable by Bielar |
Key Cases Cited
- May v. Anderson, 119 P.3d 1254 (Nev. 2005) (contract interpretation reviewed de novo; every contract term given effect)
- Musser v. Bank of Am., 964 P.2d 51 (Nev. 1998) (contract construction principles)
- United States v. Wilson, 503 U.S. 329 (1992) (statutory verb tense is significant in construction)
- Beazer Homes Nev., Inc. v. Eighth Judicial Dist. Court, 97 P.3d 1132 (Nev. 2004) (plain statutory language controls)
- Pub. Emps.' Benefits Program v. Las Vegas Metro. Police Dep't, 179 P.3d 542 (Nev. 2008) (use of subsequent legislation as evidence of legislative intent)
- Foster v. Dingwall, 227 P.3d 1042 (Nev. 2010) (plaintiff must demonstrate damages to prevail on an accounting claim)
- Caperton v. A.T. Massey Coal Co., 556 U.S. 868 (2009) (due process standard for judicial impartiality)