1986-2 Trade Cases 67,192
HURON VALLEY HOSPITAL, INC., a Michigan nonprofit
corporation, Plaintiff-Appellee,
v.
CITY OF PONTIAC, et al., Defendants,
Bailus Walker, Jr.; Maurice S. Reizen, M.D.; Herman A.
Ziel, M.D.; Richard Reihmer, Defendants-Appellants.
No. 85-1693.
United States Court of Appeals,
Sixth Circuit.
Argued April 8, 1986.
Decided May 30, 1986.
Frаnk J. Kelley, Louis J. Caruso, Marvin L. Bromley, Edwin M. Bladen (argued), William E. Molner, Lansing, Mich., for defendants-appellants.
Ann C. Yahner, Kohn, Milstein, Cohen & Hausfeld, Jerry S. Cohen, Washington, D.C., John P. Morris (argued), Tempe, Ari., for plaintiff-appellee.
Before KEITH and MARTIN, Circuit Judges, and WEICK, Senior Circuit Judge.
BOYCE F. MARTIN, Jr., Circuit Judge.
Bailus Walker, Jr., Maurice Reizen, Herman Ziel, Jr. and Richard Reihmer, former employees of the Michigan Department of Public Health, attempt to appeal the district court's denial of their motions for summary judgment.
Huron Valley Hospital is a Michigan nonprofit corporation that was organized in late 1975 for the purposes of constructing, оwning and operating a hospital in Oakland County, Michigan. In 1976, Huron Valley filed an application for a state certificate of need under Michigan Compiled Laws sections 331.451 et seq.1 Huron Valley also filed, as it was required to do, for federal capital expenditure approval under section 1122 of the Social Security Amendments of 1972, 42 U.S.C. Sec. 1320a-1, with the Michigan Department of Public Health and the federally designated regional health systems agency. The Department of Public Health had been designated by the Governor of Michigan to administer the federal section 1122 program under an agreement between Michigan and the Secretary of the United States Department of Health and Human Services.2 Both applications sought permission to proceed with the construction of a 153 bed acute care hospital in Oakland County which would cost 14.789 million dollars. The applications were complete in February of 1977.
The Michigan Deрartment of Public Health denied Huron Valley's certificate of need application. Huron Valley then requested and received a hearing before the Michigan State Health Facilities Commission seeking a reversal of this decision. The Commission affirmed the denial in January, 1980. In the meantime, on June 27, 1977, Pontiac General Hospital, an existing facility, filed a notice of intent to request a certificate of need to build a new hospital. Pontiac General's completed application was approved on August 25, 1978.
Having exhausted all of the Michigan administrative avenues, Huron Valley filed suit in the Oakland County Circuit Court which reversed the Commission on March 27, 1981, and ordered the Department of Public Health to issue a certificate of need to Huron Valley. Huron Valley Hospital, Inc. v. Michigan State Health Facilities Comm'n, Civ. Action No. 80-200439-AA (Oakland County Div.Ct. Mar. 27, 1981). The Michigan Court of Appeals affirmed the trial court's findings, holding that the Department of Public Health had bаsed its decision upon unpublished criteria that favored the application of Pontiac General. Huron Valley Hospital, Inc. v. Michigan State Health Facilities Comm'n,
Following the Michigan Supreme Court's denial of the Commission's application for leave to appeal,
During the same period, Huron Valley was also discussing the fеderal section 1122 approval with the Michigan Department of Public Health. On February 23, 1983, the Regional Health Administrator issued a section 1122 approval after the Michigan Department of Public Health, after discussions and intervention by the Michigan Attorney General, recommended approval. Shortly thereafter, an Assistant United States Surgeon General vacated the section 1122 approval. More litigation followed in the United States District Court which ordered that the section 1122 approval be reinstated. Huron Valley Hospital, Inc. v. City of Pontiac,
In addition to the litigation discussed earlier, Huron Valley began the present action in 1978, claiming that numerous defendants conspired to violate the antitrust laws by preventing Huron Valley from entering the Oakland County health care market. In 1979, Huron Valley sought to amend its original complaint to add 42 U.S.C. Sec. 1983 violations and to add the state defendants who are now bеfore us. The district court did not allow the tendered amendment and granted summary judgment in favor of the various defendants. Huron Valley Hospital, INc. v. City of Pontiac,
With the present case thus reactivated, Huron Valley filed an amended complaint in 1983, adding the four defendants who now pursue this appeal. Huron Valley claims that beginning in 1976, the various defendants engaged in a general conspiracy to restrain trade in violation of section one of the Sherman Act and that certain of the defendants, including those before us on appeal, conspired to deprive Huron Valley of its fourteenth amendment due process rights in violation of 42 U.S.C. Sec. 1983.
The defendants moved the district court to dismiss this action and alternatively moved for summary judgment. The court denied the motions on various grounds, finding, among other things, that these defendants could not claim qualified immunity or the state action antitrust exemption.
Denials of summary judgment usually may not be appealed immediately because they are not "final decisions of the district courts." 28 U.S.C. Sec. 1291. The requirement of finality means that all claims must be raised in a single appeal after a judgment on the merits. Richardson-Merrell, Inc. v. Koller, --- U.S. ----,
For every rule, however, we generally have found a "narrow exception," Firestone,
The Supreme Court, in Mitchell v. Forsyth, --- U.S. ----,
Having resolved that we have jurisdiction to review the qualified immunity issue, we turn now to the attempted appeal of the denial of the state action antitrust exception. The state action antitrust exemption originated with the notion that the Sherman Act did not prohibit a state from restraining competition and did not otherwise hinder a state's ability to regulate commerce within its borders. Parker v. Brown,
We believe that a denial by the district court of this defense does not satisfy the three requirements necessary for an appeal under the collateral order doctrine. First, the exemption is not an "entitlement" of the same magnitude as qualified immunity or absolute immunity, but rather is more akin to a defense to the original claim. Further, it is doubtful that the exemption is lost if immediate appeal is denied. Review of the denial on direct appeal after further development of the record certainly affords the necessary protection if the defense is valid. Moreover, the state action antitrust exemption does not satisfy the requirement of the collateral order doctrine that the claim be completely separate from the merits of the original claim. In the case before us, the claim is that the defendants conspired and acted to prevent Huron Valley from entering the appropriate health care market in violation of the Sherman Act. The analysis necessary to determine whеther clearly articulated or affirmatively expressed state policy is involved and whether the state actively supervises the anticompetitive conduct overlaps the analysis necessary to determine whether the defendants have violated the rights of Huron Valley. This is not a simple conclusion that the law is clearly established as is necessary with qualified immunity. It is a determination that affirmatively expressed state policy is involved and that the state actively suрervises the anticompetitive conduct. These conclusions are intimately intertwined with the ultimate determination that anticompetitive conduct has occurred in violation of the protected rights of Huron Valley.
Immediate appeals of collateral orders have been allowed in very few situations. See, e.g., Mitchell v. Forsyth, --- U.S. ----,
We have always read the Cohen collateral order doctrine narrowly, in part because of the strong policies supporting the Sec. 1291 final judgment rule. The rule respects thе responsibilities of the trial court by enabling it to perform its function without a court of appeals peering over its shoulder every step of the way.
This Court is not required to review the state action issue simply because we review the qualified immunity issue. In Abney v. United States,
Thus, the only issue before us is the defendant's claim to qualified immunity. In reviewing the denial we begin with this statement from Mitchell:
An appellate court reviewing the denial of the defendant's claim of immunity need not consider the correctness of the plaintiff's version of the facts, nor even determine whether the plaintiff's allegations actually state a claim. All it needs to determine is a question of law: whether the legal norms allegedly violated by the defendant were clearly established at the time of the challenged actions or, in cases where the district court has denied summary judgment for the defendant on the grоund that even under the defendant's version of the facts the defendant's conduct violated clearly established law, whether the law clearly proscribed the actions the defendant claims he took.
There can be no doubt here that the defendants' "conduct violated clearly established law." Mitchell,
Even if the requirements of the Administrative Procedure Act were unclear at the outset, by 1976, the Michigan Court of Appeals had clarified that the Administrative Procedure Act required promulgation, processing and publication of all rules and regulations of a state agency. See Mallchok v. Liquor Control Comm'n,
The Michigan state courts found in the proceedings involving the Huron Valley application that the Department of Public Health and its Director were guided in their analysis of the certificate of need applications by the following three specific criteria:
(1) no new beds will be constructed in a service area which is classified as overbedded by the State Plan;(2) the highest priority will be granted to existing facilities seeking a certificate of need to modernize or correct licensing deficiencies; and
(3) the statute would be utilized to remove existing beds from line only in the most extreme circumstances.
While Mitchell requires a simple finding that the law was clearly established at the time the act was committed, we note that the Harlow v. Fitzgerald,
The district court correctly denied these dеfendants the protections of the defense of qualified immunity, and we affirm on that issue only. On the state action antitrust exception issue, we dismiss the appeal.
Costs are awarded to Huron Valley.
Notes
Michigan Compiled Laws Sections 331.451 et seq. were repealed and replaced by sections 333.22101 et seq., effective September 30, 1978
The certificate of need program and the section 1122 program were created to eliminate unnecessary medical costs. The certificate of need рrogram was designed to insure that new hospitals were not built and existing hospitals did not expand in areas where such facilities were not needed
Those eleven criteria were
(1) The patterns and level of utilization, availability, and adequacy of existing facilities, institutions, programs, and services, in the immediate community and region concerned.
(2) The degree to which the residents and physicians of the immediate community and region concerned, are provided access to the services and prоgrams of the health facility applying for the certificate of need.
(3) The availability, and adequacy and promotion of services such as preadmission, ambulatory, or home care services which may serve as alternatives or substitutes for inpatient or resident care.
(4) The possible economies and improvement in services to be derived from consolidation of highly specialized health facility services and from the operation of coоperative or shared central services including but not limited to laboratory, radiology, pharmacy, and laundry service.
(5) The possible economies and improvement in patient or resident care to be anticipated from affiliation or other contractual arrangements between facilities, institutions and service agencies and organization.
(6) The availability of manpower.
(7) That the health facility does not discriminate because of race, religion, color, national origin, аge, or sex in any area of its operations including but not limited to employment, patient admission and care, room assignment, and professional and nonprofessional selection and training programs....
(8) In the case of a nonprofit hospital, that health facility is in fact governed by a body which is composed of a majority consumer membership.
(9) The applicant's ability to finance the project for which the certificate of need is requested and ability to finance the operation of the health facility following completion of the project.
(10) Local and regional rules, regulations and standards adopted by the appropriate local and regional area wide comprehensive health planning agencies which reflect the conditions, problems, and resources of the various areas represented by such agencies and which are not inconsistent with the foregoing criteria.
(11) Other factors and criteria which contribute toward the orderly development of quality health care for all citizens.
Mich.Comp.Laws Sec. 331.455a.
