Keith Wright and Belinda Melancon Southern v. Johnna C. Hooker, Mary Sanford, Brandy Mireles and Ryan Brewer
12-17-00095-CV
| Tex. App. | Dec 13, 2017Background
- Four appellees (Hooker, Sanford, Mireles, Brewer) were treated by City of Lufkin EMS after separate vehicle accidents; EMS later filed Chapter 55 medical-services liens against their third‑party claims.
- Southern (Lufkin director of finance) testified about EMS billing: EMS contracts with Medicare/Medicaid but not private insurers; EMS sometimes submits bills to motor‑vehicle insurers first, and will bill private health insurance or pursue liens/collection if appropriate.
- Appellees sued for declaratory and injunctive relief, arguing EMS’s liens were invalid under Tex. Prop. Code § 55.004(g)(3) (and that one lien exceeded the $1,000 EMS cap), because EMS could have billed their private health insurance or had assignments of benefits.
- The trial court granted summary judgment for appellees, enjoining EMS from filing liens against patients who have private medical indemnity plans from which EMS can recover under an assignment or similar right.
- On appeal, appellants (Wright and Southern) challenged the summary judgment, arguing (inter alia) that appellees failed to prove EMS had recoverable rights against their private policies, that Hooker gave no assignment, and that Sanford’s lien was released (moot).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether EMS liens are excluded by §55.004(g)(3) when patient has private medical indemnity coverage from which EMS can recover | Appellees: §55.004(g)(3) bars liens if EMS is entitled to payment from private insurance; lien invalid here | Appellants: exclusion requires EMS to have contractual recourse/contract with insurer or proof that EMS could actually recover | Court: Appellees failed to conclusively prove EMS s charges were covered by a private plan and that EMS was entitled to recover; trial court erred in granting plaintiffs' traditional summary judgment (reversed and remanded) |
| Whether evidence established existence of an assignment of benefits (Hooker) | Appellees: attorney letter and patient care report show authorization/assignment or similar right | Appellants: letter is not an assignment; no clear AOB | Court: Evidence (attorney letter/patient care report) raised fact question — more than scintilla — so no-evidence motion denied on Hooker (assignment issue unresolved for trial) |
| Whether EMS lien to Hooker was invalid for exceeding $1,000 cap under §55.004(f) | Appellees: bill shows $1,202 charged; lien cap is $1,000 so lien invalid | Appellants: filed notice of lien did not state amount >$1,000; notice complied with statute | Court: Notice of lien complied with §55.005 and did not assert >$1,000; lien not invalid on that basis as filed |
| Whether Sanford's claims were moot because EMS released her lien pre-suit | Appellants: Southern affidavit shows EMS released Sanford's lien prior to filing | Appellees: no contrary evidence | Court: Sanford's claim was moot; trial court erred by denying appellants' no‑evidence motion as to Sanford — rendered take‑nothing judgment for appellants on Sanford's claims |
Key Cases Cited
- Drake Interiors, L.L.C. v. Thomas, 433 S.W.3d 841 (Tex. App.—Houston [14th Dist.] 2014) (summary judgment standard for declaratory actions)
- Valence Operating Co. v. Dorsett, 164 S.W.3d 656 (Tex. 2005) (de novo review of summary judgment)
- City of Keller v. Wilson, 168 S.W.3d 802 (Tex. 2005) (evidence and reasonable inferences in summary-judgment review)
- Sci. Spectrum, Inc. v. Martinez, 941 S.W.2d 910 (Tex. 1997) (defendant summary judgment standard)
- McAllen Hosps., L.P. v. State Farm Cty. Mut. Ins. Co. of Tex., 433 S.W.3d 535 (Tex. 2014) (purpose of hospital lien statute)
- Bashara v. Baptist Mem'l Hosp. Sys., 685 S.W.2d 307 (Tex. 1985) (background on hospital lien policy)
- Rhone-Poulenc, Inc. v. Steel, 997 S.W.2d 217 (Tex. 1999) (plaintiff must conclusively prove entitlement to traditional summary judgment)
- King Ranch, Inc. v. Chapman, 118 S.W.3d 742 (Tex. 2003) (no-evidence summary judgment / scintilla standard)
