Gerald P. YOUNG, Michael L. Haigh, and Suzanne M. Runyon, Individually and on Behalf of Others Similarly Situated, Appellees, v. HEALTHPORT TECHNOLOGIES, INC., Appellant.
No. 14-1918
Supreme Court of Iowa
March 18, 2016
McMillan v. Osterson, 191 Iowa 983, 985, 183 N.W. 487, 488 (1921). The appeal board‘s rules and claim form did not require McFadden to allege her representative capacity in presenting the tort claim in this case. Because McFadden had been appointed administrator before presenting her tort claim to the appeal board, she was entitled to present the claim and file suit in her own name as the estate‘s legal representative. We vacate the decision of the court of appeals, reverse the district court‘s dismissal order,4 and remand for further proceedings.
DECISION OF COURT OF APPEALS VACATED; DISTRICT COURT JUDGMENT AFFIRMED IN PART, REVERSED IN PART, AND REMANDED.
James J. Biscoglia, Ryan C. Nixon, George A. LaMarca, and Gary G. Mattson of LaMarca Law Group, P.C., Des Moines, for appellees.
Joel E. Fenton of Law Offices of Joel E. Fenton, PLC, Des Moines, and Elaine F. Gray of Fehseke & Gray Law Offices, Fort Madison, for amicus curiae Iowa Association for Justice.
WIGGINS, Justice.
Patients who requested medical records and billing statements from their healthcare providers filed a class action lawsuit claiming the company that fulfilled their records requests charged excessive fees in violation of
I. Prior Proceedings.
On April 23, 2014, Gerald P. Young, Michael L. Haigh, and Suzanne M. Runyon filed a class action alleging the fees HealthPort Technologies, Inc. charged for providing copies of their medical records and billing statements exceeded statutorily imposed limits set forth in
II. Issue.
The only issue we must decide in this appeal is whether the district court properly denied HealthPort‘s motion to dismiss.
III. Scope of Review.
We review district court rulings on motions to dismiss for failure to state a claim upon which any relief may be granted for correction of errors at law. Rees v. City of Shenandoah, 682 N.W.2d 77, 78 (Iowa 2004).
IV. Standards When Deciding a Motion to Dismiss.
A court should grant a motion to dismiss “only if the petition on its face shows no right of recovery under any state of facts.” Tate v. Derifield, 510 N.W.2d 885, 887 (Iowa 1994). Thus, a motion to dismiss may be properly granted “only when there exists no conceivable set of facts entitling the non-moving party to relief.” Rees, 682 N.W.2d at 79 (quoting Barkema v. Williams Pipeline Co., 666 N.W.2d 612, 614 (Iowa 2003)). When a moving party attacks a claim by filing a motion to dismiss, that party “admits well-pleaded facts and waives ambiguity or uncertainty in the petition.” Schaffer v. Frank Moyer Const., Inc., 563 N.W.2d 605, 607 (Iowa 1997). A court must decide the merits of a motion to dismiss based on the facts alleged in the petition, not the facts alleged by the moving party or facts that may be developed in an evidentiary hearing.1 Berger v. Gen. United Grp., Inc., 268 N.W.2d 630, 634 (Iowa 1978); Riediger v. Marrland Dev. Corp., 253 N.W.2d 915, 916-17 (Iowa 1977).
Under our notice-pleading standards, nearly every case will survive a motion to dismiss for failure to state a claim upon which any relief may be granted. Smith v. Smith, 513 N.W.2d 728, 730 (Iowa 1994). To survive a motion to dismiss, the petition need not allege the ultimate facts to support each element of a cause of action. Id. However, it must contain factual allegations sufficient to give the defendant fair notice of each claim asserted so the defendant can adequately respond. Schmidt v. Wilkinson, 340 N.W.2d 282, 283 (Iowa 1983). The allega-
V. Analysis.
At any time, upon a written request from a patient, a patient‘s legal representative or attorney, or an adverse party pursuant to subsection 3, any provider shall provide copies of the requested records or images to the requester within thirty days of receipt of the written request. The written request shall be accompanied by a legally sufficient patient‘s waiver unless the request is made by the patient or the patient‘s legal representative or attorney.
a. The fee charged for the cost of producing the requested records or images shall be based upon the actual cost of production. If the written request and accompanying patient‘s waiver, if required, authorizes the release of all of the patient‘s records for the requested time period, including records relating to the patient‘s mental health, substance abuse, and acquired immune deficiency syndrome-related conditions, the amount charged shall not exceed the rates established by the workers’ compensation commissioner for copies of records in workers’ compensation cases. If requested, the provider shall include an affidavit certifying that the records or images produced are true and accurate copies of the originals for an additional fee not to exceed ten dollars.
b. A patient or a patient‘s legal representative or a patient‘s attorney is entitled to one copy free of charge of the patient‘s complete billing statement, subject only to a charge for the actual costs of postage or delivery charges incurred in providing the statement. If requested, the provider or custodian of the record shall include an affidavit certifying the billing statements produced to be true and accurate copies of the originals for an additional fee not to exceed ten dollars. :
c. Fees charged pursuant to this subsection are exempt from the sales tax pursuant to section 423.3, subsection 96. A provider providing the records or images may require payment in advance if an itemized statement demanding such is provided to the requesting party within fifteen days of the request. Upon a timely request for payment in advance, the time for providing the records or images shall be extended until the greater of thirty days from the date of the original request or ten days from the receipt of payment.
d. If a provider does not provide to the requester all records or images encompassed by the request or does not allow a patient access to all of the patient‘s medical records encompassed by the patient‘s request to examine the patient‘s records, the provider shall give written notice to the requester or the patient that providing the requested records or images would be a violation of the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
e. As used in this subsection:
(1) “Records” and “images” include electronic media and data containing a
patient‘s health or billing information and “copies” includes patient records or images provided in electronic form, regardless of the form of the originals. If consented to by the requesting party, records and images produced pursuant to this subsection may be produced on electronic media. (2) “Provider” means any physician or surgeon, physician assistant, advanced registered nurse practitioner, mental health professional, hospital, nursing home, or other person, entity, facility, or organization that furnishes, bills, or is paid for health care in the normal course of business.
The petition alleged the following facts in support of the plaintiffs’ claims:
21. Plaintiffs are all residents of Polk, Marshall and Warren counties, State of Iowa. Plaintiffs, individually and/or through their legal representatives, requested medical records from various medical providers, including but not limited to Mercy Medical Des Moines.
22. Plaintiffs’ requests were fulfilled by HealthPort who has entered into contractual arrangements with the medical providers from whom the records were sought.
23. In addition to the fees permitted by the Patient Records/Billings Statute, HealthPort charged and Plaintiffs paid the excess per page medical records charges, Basic Fees and Electronic Delivery Fees. Plaintiffs paid the excess per page medical records charges, Basic Fees and Electronic Delivery Fees in order to obtain the requested records because HealthPort‘s policy is not to send the records until after the invoice is paid and Plaintiffs feared that refusing to pay the excess per page medical records charges, Basic Fees and Electronic Delivery Fees would delay the receipt of the needed records.
For purposes of our analysis, we treat these facts as true. Thus, in reviewing the district court‘s ruling on the motion to dismiss, we assume HealthPort acted as the agent of providers in fulfilling their obligations under the statute. We have found two reported cases addressing this issue.
The first is Cotton v. Med-Cor Health Information Solutions, Inc., 221 Ga. App. 609, 472 S.E.2d 92 (1996). Like HealthPort, the defendants in Cotton were companies that fulfilled records requests received by healthcare providers. The defendants moved to dismiss class-action complaints alleging they charged fees for producing patient records exceeding the statutory limits on such fees. Id. at 94. The defendants alleged the relevant statute governed only providers. Id. The court described the applicable Georgia Code sections as follows,
The Health Records Act governs the furnishing of the record of a patient by a “provider.” Under the Act, a “provider” is defined as meaning all hospitals and other specified entities providing health care services. Upon written request from the patient, the provider having custody and control of the patient‘s record is required to furnish a copy of that record to the patient or to any other person or provider designated by the patient. [The statute] states that the party requesting the patient‘s records shall be responsible to the provider for the “reasonable costs of copying and mailing the patient‘s record.”
Id. at 95 (citations omitted) (quoting Ga. Code Ann. § 31-33-3(a) (1995)). The court concluded the statute applied not only to healthcare providers, but also to entities fulfilling records requests received by providers. Id. In arriving at its conclusion, the court emphasized the intent of the statute “was to ensure that patients have access to medical records in the custody and control of health care providers without being charged more than the reasonable costs of copying and mailing them.” Id. The court also noted this intent would be completely defeated if it construed the statute to allow entities hired by providers to charge more for producing records the providers were required by law to produce than the providers were permitted to charge themselves. Id. Finally, the court concluded agents of the providers had no greater power to charge fees in excess of those permitted by the statute than the providers themselves had. Id. Therefore, the court rejected the argument that the statute did not limit the fees entities producing records on behalf of
The second case we identified dealing with this issue is Pratt v. Smart Corp., 968 S.W.2d 868 (Tenn. Ct. App. 1997). In Pratt, the plaintiff claimed Smart Corporation violated a Tennessee statute governing the production of medical records by hospitals. Id. at 870. The corporation moved for summary judgment, claiming the statute did not apply to an independent entity fulfilling records requests received by a hospital. Id. at 870, 873. The relevant statute required hospitals to furnish records to patients and patients’ authorized representatives and limited the fees that could be charged when those requests were fulfilled, but it did not explicitly state that those limits applied to requests fulfilled by other entities. Id. Adopting the rationale of Cotton, the court held that although the statute referenced only hospitals and not entities like Smart Corporation, when acting as a hospital‘s authorized agent the corporation “could not perform acts which the hospital was forbidden by law to perform itself.” Id. at 873. The court thus reversed the trial court‘s grant of summary judgment in favor of Smart Corporation. Id. at 873-74.
The statutes analyzed in Cotton and Pratt required healthcare providers to produce records and limited what fees could be charged when the providers produced the records: However, even though the Georgia and Tennessee statutes specifically referenced healthcare providers, the courts in Cotton and Pratt interpreted the statutes to limit the fees entities fulfilling records requests on behalf of healthcare providers could charge.
Subsections (6)(a) and (6)(b) limit what may be charged for fulfilling records re-
We agree with the analysis of the Georgia and Tennessee courts regarding the apparent intent of statutes like the ones considered in Cotton and Pratt and the relevancy of agency principles in the application of such statutes.3 We therefore conclude the intent of our state legislature in enacting
An entity that acts as a provider‘s agent in fulfilling records requests covered by
In deciding this interlocutory appeal, we are bound by the well-pleaded facts alleging HealthPort acts as the agent of providers in fulfilling records requests governed by
HealthPort argues that when a provider outsources medical-record production to a vendor like HealthPort, the fees the vendor charges for producing medical records are the provider‘s actual costs of production. However, we need not decide precisely how the cost limitations in
We recognize the temptation is strong for a defendant to strike a vulnerable petition at the earliest opportunity. Experience has however taught us that vast judicial resources could be saved with the exercise of more professional patience. Under the foregoing rules dismissals of many of the weakest cases must be reversed on appeal. Two appeals often result where one would have sufficed had the defense moved by way of summary judgment, or even by way of defense at trial. From a defendant‘s standpoint, moreover, it is far from unknown for the flimsiest of cases to gain strength when its dismissal is reversed on appeal.
Cutler v. Klass, Whicher & Mishne, 473 N.W.2d 178, 181 (Iowa 1991).
Therefore, we hold the district court was correct in denying HealthPort‘s motion to dismiss the plaintiffs’ petition.
VI. Disposition.
We affirm the order of the district court denying the motion to dismiss and remand the case to the district court for further proceedings.
AFFIRMED AND CASE REMANDED.
Notes
H.F. 2700, 82d G.A., 2d Sess., explanation (Iowa 2008). The enacted bill remained unchanged in relevant part following its introduction. Compare H.F. 2700, 82d G.A., 2d Sess. § 55 (Iowa 2008), with 2008 Iowa Acts ch. 1191, § 83. Therefore, this explanation is relevant to our analysis of the legislature‘s intent in enacting
Code section 622.10 is amended as it relates to communications made in professional confidence concerning health care and health care records including patient access to the patient‘s medical records, provisions relating to procedures for fees charged by certain medical providers for the production of certain health care records and consulting costs, and also to provisions relating to communications between certain medical providers and attorneys in a civil action in which the condition of the plaintiff is at issue.