151 So. 3d 984
La. Ct. App.2014Background
- Plaintiff Gloria Vallare received treatment at Acadian Medical Center (a branch of Ville Platte Medical Center, LLC — VPMC) after a car accident; the hospital sent a lien to the tortfeasor’s insurer rather than billing Vallare’s health insurer (Blue Cross).
- Vallare sued VPMC (and Blue Cross) under La. R.S. 22:187 alleging the hospital sought amounts in excess of contracted reimbursement rates and improperly pursued third‑party liability proceeds.
- Plaintiffs moved for class certification; the trial court certified a broad class covering persons with health insurance who were billed by VPMC (or its branch) and from whom VPMC attempted to recover, or received, amounts above contracted rates (2004–2013), with two subclasses ("Attempt to Recover" and "Payor").
- VPMC appealed certification, arguing the named plaintiff was an inadequate representative, did not fit both subclasses, could not represent patients of other facilities or with different insurers, and that numerosity, typicality, identifiability, and predominance were not satisfied; it urged the court to follow Baker v. PHC‑Minden.
- The court found class prerequisites satisfied (numerosity, commonality, typicality, identifiability, predominance), concluded there is a single common question (whether VPMC’s billing practice violated La. R.S. 22:1874), declined to follow Baker, affirmed certification but amended it by deleting the subclasses.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Adequacy / representative fit | Vallare can represent all class members whose claims arise from same billing practice | VPMC: Vallare only fits one subclass and cannot represent patients of different facilities or insurers | Court: Representative adequate for overall class; subclasses deleted and class maintained (modification allowed later) |
| Numerosity / Identifiability | Class is numerous, members are identifiable from billing records | VPMC: Joinder practicable; numerosity not shown | Court: Numerosity satisfied; class easily definable and members identifiable |
| Typicality / Commonality | Claims arise from same practice and legal theory (La. R.S. 22:1874) | VPMC: Individual differences (facility, insurer) prevent typicality/common issues | Court: Typicality and commonality met; single controlling legal question predominates |
| Predominance / Novelty of claim | A common question will resolve all claims in one stroke (billing violated statute) | VPMC: Issue is novel/untested (citing Baker) so class certification inappropriate | Court: Issue not novel in this circuit (Desselle); predominance satisfied; declined to follow Baker; certified class as amended |
Key Cases Cited
- Desselle v. Acadian Ambulance Serv., Inc., 83 So.3d 1243 (La. App. 3 Cir. 2012) (similar class certified for hospital billing practice)
- Dupree v. Lafayette Ins. Co., 51 So.3d 673 (La. 2010) (class certification errors should favor maintenance because modification/decertification remains available)
- Price v. Martin, 79 So.3d 960 (La. 2011) (requirement that common questions must be shown with significant proof and rigorous analysis)
- Wal‑Mart Stores, Inc. v. Dukes, 131 S.Ct. 2541 (U.S. 2011) (discusses predominance and common questions for class actions)
- Baker v. PHC‑Minden, LP, 146 So.3d 921 (La. App. 2 Cir. 2014) (held class certification improper in similar context; court declined to follow)
- Brooks v. Union Pac. R. Co., 13 So.3d 546 (La. 2009) (discusses analysis for predominance in class actions)
- Hagan v. Hagan, 70 So.3d 1081 (La. App. 3 Cir. 2011) (circuit precedent authority rules)