Donald E. O‘BRIEN and Carol O‘Brien v. Dr. Akbar RIZVI, Dr. Arthur Carl Plautz, Jr., St. Paul Fire & Marine Insurance Company and CHG Companies, Inc. (Formerly CompHealth, Inc.) d/b/a CompHealth.
Nos. 2004-C-2252, 2004-C-2257.
Supreme Court of Louisiana.
April 12, 2005.
898 So.2d 360 (2005)
KNOLL, Justice.
Percy, Smith & Foote, LLP, Elizabeth Erny Foote, Alexandria, Susan Claire Segura, Roedel, Parsons, Koch, Blache, Balhoff & McCollister, Larry Michael Roedel, David Alva Woolridge, Jr., Baton Rouge, Counsel for Respondent (No. 2004-C-2252).
Roedel, Parsons, Koch, Blache, Balhoff & McCollister, Larry Michael Roedel, David Alva Woolridge, Jr., Baton Rouge, Counsel for Applicant (No. 2004-C-2257).
Beard & Sutherland, Frederick Haydel Sutherland, Shreveport, Edward P. Sutherland, Baton Rouge, Percy, Smith & Foote, LLP, Elizabeth Erny Foote, Alexandria, Susan Claire Segura, Counsel for Respondent (No. 2004-C-2257).
KNOLL, Justice.
In this medical malpractice case we granted certiorari to consider two issues. The first issue is whether the court of appeal erred in denying the Louisiana Patient‘s Compensation Fund Oversight Board‘s (hereinafter “Board“) petition of intervention on plaintiffs’ request for rehearing. The second issue is whether the court of appeal erred in ruling the defendants were qualified health care providers (QHCP) under Louisiana‘s Medical Malpractice Act,
FACTS AND PROCEDURAL HISTORY
CompHealth is a staffing company that places locum tenens physicians in hospital and clinic positions for short-term assignments. CompHealth placed Dr. Arthur Plautz, Jr. at the Veterans Administration Hospital (VA Hospital) in Pineville, Louisiana. CompHealth sought qualification with the Louisiana Patient‘s Compensation Fund (hereinafter PCF) by purchasing a policy of professional liability insurance through St. Paul Fire and Marine Insurance Company (St. Paul) on a claims-made basis.1 The policy covered
In February 2001, when CompHealth obtained the claims-made policy, CompHealth also submitted a check dated February 23, 2001 in the amount of $7,529 for a surcharge to the PCF. On March 8, 2001, the PCF issued CompHealth a certificate of enrollment with effective dates of February 23, 2001 to February 1, 2002.
In February 2002, CompHealth submitted a revised certificate of insurance to the PCF for the period of February 1, 2001 to February 1, 2002, reflecting the actual days worked by CompHealth‘s physicians in Louisiana. The revised surcharge amount due to the PCF was $16,104. CompHealth submitted the additional surcharge due of $8,575. At the same time CompHealth purchased an unlimited Extended Reporting Endorsement, or “tail” coverage, with St. Paul, which provided coverage for any alleged acts of malpractice that occurred between February 1, 2001 and February 1, 2002, even if the claim was made after February 1, 2002. CompHealth submitted to the PCF an additional surcharge on the tail coverage in the amount of $28,756.
In March, 2002, the PCF informed CompHealth that its physicians who were assigned to governmental agencies or who were not licensed in Louisiana could not participate in the PCF. This information came about by CompHealth‘s inquiry to the PCF, wherein CompHealth informed the PCF that assignments to VA Hospitals and “Indian Health” do not require the physicians to have a Louisiana license. CompHealth then asked the PCF if a doctor does not have a Louisiana license, can the doctor participate in the PCF? The PCF replied a health care provider must have a Louisiana license to participate in the PCF. CompHealth did not protest this response. CompHealth informed the PCF that it had reviewed the physician days worked in Louisiana, subtracting from those days the “government days where [the physicians] are not required to have a L[ouisiana] license“, and requested a refund of the surcharge paid to the PCF in the amount of $19,850 for physicians who did not qualify. CompHealth received part of the refund on May 9, 2002 and the remainder on September 30, 2002.
On December 11, 2002, Donald O‘Brien filed a claim with the Commissioner of Administration and the Board against Dr. Plautz and Dr. Akbar Rizvi for alleged acts of malpractice committed by Dr. Plautz, a CompHealth locum tenens physician and Dr. Rizvi, an employee of the VA Hospital. In a letter dated January 9, 2003, the PCF informed the plaintiff that none of the defendants have coverage in the PCF. On December 18, 2002, plaintiff filed suit in state court against Dr. Rizvi and Dr. Plautz, alleging malpractice arising out of medical treatment received at the VA Hospital from April 18, 2001 through January 16, 2002. The plaintiff amended the suit to add as defendants CompHealth, as Dr. Plautz‘s employer, and St. Paul, as the liability insurer of CompHealth and/or Dr. Plautz.2
The court of appeal reversed. The court found that Dr. Plautz and CompHealth satisfied both prongs of
The plaintiffs filed an application for re-hearing, and the Board filed a petition to intervene. The court of appeal denied both. We granted writs to review the appellate court‘s decision. O‘Brien v. Rizvi, 04-2252, 04-2257 (La.12/10/04), 888 So.2d 820.
DISCUSSION
We begin by noting that at oral argument, the parties informed us that the day before, the plaintiffs had settled their claims with Dr. Plautz, St. Paul and CompHealth. The plaintiffs specifically reserved their right to proceed against the PCF. Because the PCF‘s liability depends on whether the physician is a QHCP, and the plaintiffs have not released the PCF, this remains a justiciable controversy.4 Therefore we will review the correctness, vel non, of the appellate court‘s decision rejecting the Board‘s petition to intervene and its decision that Dr. Plautz and CompHealth were qualified health care providers afforded the benefits of the Act.
Board‘s Standing to Intervene
In Bennett v. Krupkin, 01-0209 (La.10/16/01), 798 So.2d 940, we addressed the issue of whether the Board has standing to appeal a trial court judgment granting a doctor‘s exception of prematurity, where the Board claims the doctor is not a QHCP under the Act. We noted that under the Act, the Board is responsible, and has full authority for the management and defense of the PCF. Krupkin, at p. 6, 798 So.2d at 943-944.
The functions of collecting, administering, and protecting the fund, including all matters relating to establishing reserves, the evaluating and settlement of
claims, and relating to defense of the fund, shall be carried out by the board. La.Rev.Stat. 40:1299.44 D(2)(a) provides: The board shall be responsible, and have full authority under law, for the management, administration, operation and defense of the fund in accordance with the provisions of this Part.
La.Rev.Stat. 40:1299.44 D(2)(b)(x) expressly grants the Board authority to:
Defend the fund from all claims due wholly or in part to the negligence or liability of anyone other than a qualified health care provider regardless of whether a qualified health care provider has settled and paid its statutory maximum or has been adjudged liable or negligent. (Emphasis added).
In Krupkin we found
In the present case, the Board argues that if it is not allowed to intervene and seek review of the appellate court‘s granting of the exception of prematurity, that decision could become a final judgment not appealable by the Board. Therefore, it is only reasonable that the Board has authority under the Act and Code of Civil Procedure articles 1091,5 20836 and 20867 to seek review in this Court of the appellate court‘s judgment. We agree. Louisiana jurisprudence declaring that the Board has no standing to involve itself in a medical malpractice action relating to issues of liability unless there is a judgment or settlement pursuant to the provisions of
Our decision in Krupkin recognized that the Board had standing to determine the threshold issue of whether the health care
Qualified Health Care Provider
A. To be qualified under the provisions of this Part [Part XXIII. Medical Malpractice Act], a health care provider shall:
(1) Cause to be filed with the board proof of financial responsibility as provided by Subsection E of this Section.
(2) Pay the surcharge assessed by this Part on all health care providers according to R.S. 40:1299.44.
(3) For self-insureds, qualification shall be effective upon acceptance of proof of financial responsibility by and payment of the surcharge to the board. Qualification shall be effective for all others at the time the malpractice insurer accepts payment of the surcharge.
Subsection E provides, in pertinent part:
E. (1) Financial responsibility of a health care provider under this Section may be established only by filing with the board proof that the health care provider is insured by a policy of malpractice liability insurance in the amount of at least one hundred thousand dollars per claim with qualification under this Section taking effect and following the same form as the policy of malpractice liability insurance of the health care provider[.]
Thus there are two prongs to the test of whether a health care provider is qualified under the Act, namely, (1) proof of financial responsibility filed with the Board,
But the qualification inquiry does not end here. The two prongs inquiry satisfies only the financial aspects of qualifying under the Act. There are licensing requirements that must be satisfied in order for a physician to qualify under the Act.
Of significant relevance are the definitions of “health care provider” and “physician” as used in the Act. The Act defines those terms, in pertinent part, as follows:
“Health care provider” means a person, partnership, limited liability partnership, limited liability company, corporation, facility, or institution licensed or certified by this state to provide health care or professional services as a physician, hospital, ... or any professional
corporation a health care provider is authorized to form under the provisions of Title 12 of the Louisiana Revised Statutes of 1950, or any partnership, limited liability partnership, limited liability company, management company, or corporation whose business is conducted principally by health care providers, or an officer, employee, partner, member, shareholder, or agent thereof acting in the course and scope of his employment.
La.Rev.Stat. Ann. 40:1299.41 A(1) , (Emphasis added).
“Physician” means a person with an unlimited license to practice medicine in this state.
La.Rev.Stat. Ann. 40:1299.41 A(2) , (Emphasis added).
In its opinion reviewing the trial court‘s denial of the exception of prematurity, the court of appeal reviewed only the two financial prongs necessary for a health care provider to qualify under the Act. The appellate court first reviewed the proof of financial responsibility filed by CompHealth. The court noted that the “claims-made” policy was effective from February 1, 2001 to February 1, 2002, but that CompHealth purchased tail coverage on February 27, 2002 to provide coverage for claims arising during that policy period but not reported until after the expiration of the claims-made policy. The court of appeal concluded, correctly, that CompHealth and Dr. Plautz satisfied the first prong by purchasing tail coverage which covered the claim filed on December 18, 2002.
The court then reviewed the surcharge prong and determined that CompHealth and Dr. Plautz had also met this requirement. The court relied upon Bennett, supra and Bennett‘s interpretation of
Well accepted principles of statutory interpretation dictate that when a law is clear and unambiguous and its application does not lead to absurd consequences, the law shall be applied as written and no further interpretation may be made in search of the intent of the legislature.
The pivotal undisputed fact in this case is that Dr. Plautz was not licensed by the State of Louisiana to practice medicine. The dispositive issue before us is whether a physician not licensed by the State of Louisiana is eligible for qualification under the Act. The statutory language is clear that only those individuals and entities that meet the definition of health care provider in
Nor do we agree with CompHealth‘s argument that it is a QHCP and therefore, Dr. Plautz, as an agent of CompHealth, is also a QHCP.
“Health care provider” means a person, partnership, limited liability partnership, limited liability company, corporation, facility or institution licensed or certified by this state to provide health care or professional services ... or any professional corporation a health care provider is authorized to form under the provisions of Title 12 of the Louisiana Revised Statutes of 1950, or any partnership, limited liability partnership, limited liability company, management company, or corporation whose business is conducted principally by health care providers, or an officer, employee, partner, member, shareholder, or agent thereof acting in the course and scope of his employment.
(Emphasis added).
CompHealth contends that as a QHCP, Dr. Plautz, as its agent, was also a QHCP.
When, and during the period that each shareholder, partner, member, agent, officer or employee of a corporation, partnership, limited liability partnership, or limited liability company, who is eligible for qualification as a health care provider under this Part, and who is providing health care on behalf of such corporation, ... is qualified as a health care provider under the provisions of R.S. 40:1299.42 A, such corporation, ... shall, without the payment of an additional surcharge, be deemed concurrently qualified and enrolled as a health care provider under this Part.
(Emphasis added).
Contrary to CompHealth‘s argument, the corporation‘s qualification is concurrent with the qualification of the agent or employee who is providing health care on behalf of such corporation.10
The Board argues that under
Simply stated, a plain reading of the statute suggests that the corporation‘s qualification is dependent upon each shareholder, agent, officer or employee that is providing health care being qualified under
Defendants cite Miller v. Columbia/HCA Healthcare Corp.,11 and Caruso v. Columbia/HCA Healthcare Corp.,12 to support their argument that CompHealth is entitled to qualification. However, those cases are inapplicable because in both matters, the hospital and/or doctor was a QHCP. In Caruso, the plaintiffs filed suit against University Healthcare System d/b/a Tulane Univ. Hospital and Clinic and its corporate owner, Columbia/HCA. Both defendants filed exceptions of prematurity, which the trial court granted. In affirming, the court of appeal agreed with Columbia that
These two statutory provisions,
CONCLUSION
In conclusion, the court of appeal erred in denying the Board‘s petition of intervention. We reiterate our holding that in the narrow circumstances concerning the issue of whether a health care provider is qualified under the Medical Malpractice Act, the Board has standing to intervene. The court of appeal further erred in reversing the trial court‘s denial of the defendants’ exception of prematurity. We hold the Board was correct in determining a physician unlicensed by Louisiana is not eligible for the PCF, pursuant to the statutory language of the Medical Malpractice Act.
DECREE
For the above and foregoing reasons, the judgment of the court of appeal is reversed and set aside. The Board‘s petition for intervention is hereby granted and the judgment of the trial court denying the defendants’ exception of prematurity is reinstated. This matter is remanded to the trial court for further proceedings consistent with the views expressed herein.
REVERSED and REMANDED.
Notes
A third person having an interest therein may intervene in a pending action to enforce a right to or connected with the object of the pending action against one or more of the parties thereto by:
(1) Joining with plaintiff in demanding the same or similar relief against the defendant;
(2) Uniting with defendant in resisting the plaintiff‘s demand; or
(3) Opposing both plaintiff and defendant.
A. An appeal may be taken from a final judgment rendered in causes in which appeals are given by law whether rendered after hearing or by default, from an interlocutory judgment which may cause irreparable injury, and from a judgment reformed in accordance with a remittitur or additur under Article 1814.
B. In reviewing a judgment reformed in accordance with a remittitur or addittur, the court shall consider the reasonableness of the underlying jury verdict.
A person who could have intervened in the trial court may appeal, whether or not any other appeal has been taken.
The board [Louisiana State Board of Medical Examiners] may issue a license as provided for in R.S. 37:1274, without examination in this state, to any applicant possessing a valid, unrestricted license to practice medicine, whether allopathic or osteopathic, or osteopathy in any other state of the United States provided the board is satisfied that the license from the other state is based upon an examination and other requirements substantially equivalent to the requirements of this Part.
