806 N.W.2d 17
Minn.2011Background
- Ronald Troyer, employed by Vertlu Management Co. and Kok & Lundberg Funeral Homes, suffered a lower back injury requiring spinal cord stimulator implantation at St. Joseph’s Hospital (HealthEast Care System).
- The implant hardware was supplied by Advanced Neuromodulation Systems, Inc. (ANS); HealthEast billed the implant hardware and Troyer’s care; State Auto Insurance Company paid part of the charges under the workers’ compensation regime.
- Vertlu and State Auto paid $24,440 toward the implant hardware; HealthEast claims an unpaid balance of $37,822 (85% of HealthEast’s usual and customary charge minus what was paid).
- HealthEast refused to disclose invoices for the ANS components, invoking confidentiality; Vertlu and State Auto sought to have HealthEast furnish the actual cost invoice or demonstrate stock on hand.
- A compensation judge ruled that HealthEast could charge for the implant hardware and that the judge could not set a price for the hardware below 85% of HealthEast’s usual and customary price; the WCCA affirmed.
- The Minnesota Supreme Court affirmed, adopting a narrow construction of “furnish” to determine which entity actually furnished the implant hardware and holding that HealthEast—not ANS—“actually furnished” the hardware to Troyer and thus may charge for it; the court also held the compensation judge lacked authority to determine a value below 85% of the lower of the usual and customary charge or the prevailing charge under Minn. Stat. § 176.136, subd. 1b(b).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Who actually furnished the implant hardware for charging purposes | Vertlu/State Auto: ANS furnished; HealthEast only stocked | HealthEast furnished the hardware to Troyer | HealthEast actually furnished; HealthEast may charge for the hardware |
| Can the compensation judge set a value below 85% of the usual or prevailing charge | Judge should determine a reasonable value, potentially below 85% | Statute fixes the floor at 85% of the lower of usual or prevailing charge | No; statute unambiguously limits value to the lower of 85% of either the usual or prevailing charge; judge cannot reduce further |
Key Cases Cited
- St. Otto’s Home v. Minn. Dep’t of Human Services, 437 N.W.2d 35 (Minn. 1989) (rule construction questions reviewed de novo; not directly about furnishing)
- Owens ex rel. Owens v. Water Gremlin Co., 605 N.W.2d 733 (Minn. 2000) (de novo review of legal determinations by WCCA)
- In re Welfare of the Children of N.F. and S.F., 749 N.W.2d 802 (Minn. 2008) (use of extrinsic sources to interpret statutes when ambiguous)
- Harris v. Cnty. of Hennepin, 679 N.W.2d 728 (Minn. 2004) (canons of construction and legislative intent considered for ambiguous language)
- State v. Lucas, 589 N.W.2d 91 (Minn. 1999) (use of canons and statutory interpretation framework)
- Swanson v. Brewster, 784 N.W.2d 264 (Minn. 2010) (language ambiguity determines interpretation approach)
- Wynkoop v. Carpenter, 574 N.W.2d 422 (Minn. 1998) (interpretation of statutory text and avoidance of superfluous language)
- Krueger v. Zeman Constr. Co., 781 N.W.2d 858 (Minn. 2010) (guidance on statutory-rule construction)