Herrera v. JFK Medical Center Ltd. Partnership
87 F. Supp. 3d 1299
M.D. Fla.2015Background
- Plaintiffs file a putative class action against HCA Holdings, JFK Medical Center, Memorial Hospital Jacksonville, and North Florida Regional Medical Center for allegedly charging unreasonable emergency radiology fees for PIP-covered patients.
- Patients signed admission Contracts that incorporate the hospital's Charge Master as the price term and note that estimates may vary based on treatment and other factors.
- Plaintiffs allege charges up to 65 times higher than similar services billed to other patients and claim premature exhaustion of PIP benefits.
- Plaintiffs bring FDUTPA, breach of contract, and breach of implied covenant of good faith and fair dealing claims; they seek class treatment for similarly situated PIP patients.
- The court grants judicial notice for certain corporate and licensing documents; determines parent liability may be pleaded; and resolves motions to dismiss and strike class allegations in part.
- The court allows a breach of contract claim incorporating the PIP reasonableness standard to proceed, dismisses the implied covenant claim, and rules on class certification issues.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether FDUTPA claims survive incorporation of the Charge Master | Herrera argues deceptive/unfair charges under FDUTPA due to incorporation of pricing. | HCA and hospitals contend no FDUTPA claim because no deceptive conduct and no trade or commerce by HCA. | Count I survives for now; FDUTPA viability pending summary judgment. |
| Whether PIP statute is incorporated to support breach of contract | Plaintiffs contend PIP reasonableness is part of contract due to incorporation of statute. | Hospitals argue PIP statute remedies insurers, not insureds; incorporation is improper or limited. | Plaintiffs may proceed with breach of contract claim incorporating the PIP reasonableness standard. |
| Whether parent HCA can be held directly liable | Plaintiffs allege parent policy and ratification of hospital billing practices by HCA. | HCA bears no direct liability absent alter ego or agency relationships pleaded. | Court denies dismissal on a parent-subsidiary liability theory; proceed with direct liability theory. |
| Whether the implied covenant claim stands independently | Plaintiffs rely on implied covenant as breach alongside contract. | Implied covenant cannot stand absent an express contract term breach. | Count III is dismissed; no independent implied covenant claim. |
| Whether class allegations should be struck | Plaintiffs contend common questions support class treatment. | Individual damages and PIP variances predominate; class treatment inappropriate. | Class allegations are stricken; case will proceed as individual actions. |
Key Cases Cited
- Bell Atl. Corp. v. Twombly, 550 U.S. 544 (U.S. 2007) (pleading standard requiring plausible claims)
- Vega v. T-Mobile USA Inc., 564 F.3d 1256 (11th Cir.2009) (predominance when individual issues predominate defeats class)
- Colomar v. Mercy Hosp., Inc., 461 F.Supp.2d 1265 (S.D. Fla. 2006) (unreasonable pricing supports breach of contract claim against hospital)
- Payne v. Humana Hospital, 661 So.2d 1239 (Fla. 1st DCA 1995) (pricing terms and reasonableness can be implied in contracts)
- Mercy Hosp. v. Carr, 297 So.2d 598 (Fla. 3d DCA 1974) (ability to question reasonableness of charges despite contract)