This class action presents the novel question of whether the Equal Credit Opportunity Act’s antidiscrimination provisions prohibit a medical clinic from refusing to accept new patients whose bills will be paid by Ohio’s Medicaid program. For the reasons discussed below, we hold that they do not. We do, however, believe that clear violations of Federal Rule of Civil Procedure 23 demand that we take the unusual step of addressing sua sponte the scope of the class certified below.
I. FACTS AND PROCEDURAL HISTORY
Plaintiffs-Appellants Teresa and Randy Barney and intervenor-appellant Bonita Wal-dron [hereinafter “plaintiffs”] are all residents of Vinton County, Ohio, who receive Aid to Families with Dependent Children and are therefore eligible for medical treatment under Medicaid. Defendant-Appellee Holzer Clinic is a “for-profit physician’s organization which generally provides non emergency medical services and treatment in various Ohio and West Virginia counties.” Appellee’s Br. at 3. The clinic presently has a policy under which it will accept new patients under the Medicaid program only if those patients live in counties in which Hol-zer has clinics. Holzer Clinic does not have any facilities in Vinton County and admits that “[p]laintiffs were not accepted as patients because they were non-emergency new Medicaid patients who live in Vinton County.” J.A. at 22-23 (Memorandum Contra Plaintiffs’ Motion for Class Certification).
Plaintiffs brought this action in federal district court claiming that Holzer, by refusing to treat them, had denied them incidental credit because they received public assistance, in violation of the Equal Credit Opportunity Act, Pub.L. No. 90-321, 82 Stat. 146 (1968) [hereinafter ECOA] and amendments, as interpreted by the Federal Reserve *1209 Board’s Regulation B (Equal Credit Opportunity), 12 C.F.R. § 202. The complaint requested injunctive and declaratory relief as well as compensatory and punitive damages on behalf of a broad plaintiff class under the ECOA and pendent state-law claims. The district court certified the class under Fed. R.Civ.P. 23(b)(2), J.A. at 50, and then, after both parties had briefed the merits of the case, granted Holzer’s motion to dismiss for failure to state a claim under the ECOA and dismissed the pendent state law claims without prejudice, id. at 106-07. Plaintiffs appeal.
II. JURISDICTION
The district court had jurisdiction under 15 U.S.C. § 1691e(f) (providing jurisdiction in ECOA cases) and 28 U.S.C. § 1367(a) (supplemental jurisdiction over pendent state law claims). We have jurisdiction over this timely appeal under 28 U.S.C. § 1291.
III. DISCUSSION
A. ECOA and Medicaid
The ECOA makes it “unlawful for any creditor to discriminate against any applicant, with respect to any aspect of a credit transaction ... because all or part of the applicant’s income derives from any public assistance program.” 15 U.S.C. § 1691(a)(2) (emphasis added). Plaintiffs argue that Hol-zer is a creditor 1 under the ECOA because it regularly extends “incidental credit” to patients by providing them with medical services and billing them later. 2 They further argue that because Holzer will treat privately insured residents of Vinton County, but will not accept new Medicaid patients from that county, it thereby discriminates against them because part of their income derives from public assistance. 3 We need not address either of these propositions, however, because plaintiffs are not “applicants” under the ECOA and therefore cannot invoke the Act’s protections.
The ECOA defines an “applicant” as “any person who applies to a creditor directly for an extension, renewal, or continuation of credit, or applies to a creditor indirectly by use of an existing credit plan for an amount exceeding a previously established credit limit.” 15 U.S.C. § 1691a(b). Regulation B provides a slightly different definition: “Applicant means any person who requests or who has received an extension of credit from a creditor, and includes any person who is or may become contractually liable regarding an extension of credit.” 12 C.F.R. § 202.2(e). Both definitions refer to “credit,” which itself has a statutory definition: “[T]he right granted by a creditor to a debtor to defer payment of debt or to incur debts and defer its [sic] payment or to purchase property or services and defer payment therefor.” 15 U.S.C. § 1691a(d). Again, Regulation B differs slightly: “Credit means the right granted by a creditor to an applicant to defer payment of a debt, incur debt and defer its payment, or purchase property or services and defer payment therefor.” 4 12 C.F.R. § 202.2(j) (emphasis added).
Plaintiffs do not argue that they were granted a right “to defer payment of a debt” or to “incur debt and defer its payment”; indeed, they seem to concede that if debt were a prerequisite for the ECOA’s protections they would fall outside the Act’s scope. See Appellants’ Br. at 22 (“[Plaintiffs were ‘applicants’ under the ECOA, irrespective of whether the requested arrangement would or would not have resulted in a traditional debt relationship with Holzer.”); id. at 26 (“Only the first two alternatives specify ‘debt’ as a *1210 necessary element. The third alternative does not; it requires only the deferral of ‘payment,’ not the existence of ‘debt.’”). They argue instead that the requisite credit transaction occurs when Holzer extends to patients a right to “purchase ... services and defer payment therefor.” Id. at 27 (“If the right to purchase property or services and defer payment therefor does not constitute ‘credit’ irrespective of whether debt will be created, then this criterion could be satisfied only where debt is created.”). Plaintiffs, however, have not asked Holzer to give them a right to purchase anything or to defer payment. Rather, as discussed below, they have asked the clinic to provide them with medical services under an agreement between Holzer and the State of Ohio, to which plaintiffs are third-party beneficiaries. This is not a request for credit under the ECOA, and that Act’s protections do not apply.
Congress created Medicaid
5
in 1965 to provide medical services to families and individuals who would otherwise not be able to afford necessary care.
See
42 U.S.C. § 1396;
Pennsylvania Med. Soc’y v. Snider,
Ohio has chosen to participate in the Medicaid program.
See
Ohio Rev.Code.Ann. § 5111.01 (Banks-Baldwin West 1996). Under federal law, medical service providers must accept the state-approved Medicaid payment as payment-in-full, and may not require that patients pay anything beyond that amount. 42 C.F.R. § 447.15 (“A State plan must provide that the Medicaid agency must limit participation in the Medicaid program to providers who accept, as payment in full, the amounts paid by the agency plus any deductible, coinsurance or copayment required by the plan to be paid by the individual.”);
Rehabilitation Ass’n of Virginia, Inc., v. Kozlowski,
Federal law allows states to pay either the provider or, in some circumstances, the patient.
See
42 U.S.C. § 1396d(a) (allowing Medicaid payment
“for
individuals, and ...
to
individuals” who meet certain eligibility requirements) (emphasis added); 42 C.F.R. § 447.25(a), (b) (implementing 42 U.S.C. § 1396d “by prescribing requirements applicable to States making direct payments to certain recipients for physicians’ or dentists’ services”); 42 C.F.R. § 447.10(d)(2). In Ohio, however, all Medicaid payments flow from the state directly to the medical provider; a provider is absolutely barred from requesting any payment from patients for treatment provided under the program.
See
Ohio Admin.Code § 5101:3-1-131(A) (“The department’s payment constitutes payment-in-full for any covered service. The provider may not bill the recipient for any difference between that payment and the provider’s charge. The provider may not charge the recipient any copayment, cost-sharing, or similar charge. The provider may not charge the recipient a down payment, refundable or otherwise.”);
Id.
§ 5101:3-1-60(A);
Sparks v. Sawaya,
Under Ohio law, then, Holzer Clinic could never grant patients requesting medical services under Medicaid the right to purchase those services and defer payment therefor. Patients who receive treatment under Medicaid are not granted a right to defer payment: where there is no duty to pay, there cannot be a right to defer payment. Similarly, although the ECOA does not define “purchase,” it is clear that any definition of the term must include some sort of exchange between the parties as an element. Holzer and the state have entered into a provider agreement, a “contract between the Ohio department of human services and a provider of medical assistance services,” under which Holzer provides services to Medicaid-eligible patients and then receives reimbursement from the state. Ohio Admin.Code § 5101:3-1-172.
See id.
§ 5101:3-1-60;
Linton by Arnold v. Commissioner of Health and Env’t,
We have resolved this issue on rather technical grounds because plaintiffs advanced technical arguments which merited a detailed discussion. We note, however, that even if plaintiffs were within the scope of the ECOA we would be reluctant to find that Holzer’s refusal to provide them Medicaid-reimbursed services violated federal law. If the ECOA prohibited Holzer from denying medical services under Medicaid to a particular class of recipients, it would seem similarly to prohibit any medical provider from ever refusing to provide services under Medicaid.
6
The extremely detailed federal Medicaid statute does not require a particular hospital to participate in the Medicaid program.
See Linton,
B. Sanctions
Holzer has moved for sanctions 7 for the filing of a frivolous appeal under Federal Rule of Appellate Procedure 38 8 and 28 U.S.C. §§ 1912 & 1927. We deny the motion.
Rule 38 allows a court of appeals to award appellees “just damages and single or double costs” in a frivolous appeal. We have recognized that an appeal may be frivolous if “it is obviously without merit
and
is prosecuted for delay, harassment, or other improper purposes.”
NRLB v. Cincinnati Bronze, Inc.,
We will usually impose Rule 38 and § 1927 sanctions only where there was some improper purpose, such as harassment or delay, behind the appeal.
Cincinnati Bronze,
Absent an improper purpose, this is also not the sort of appeal which merits sanctions under any of these provisions. The central issue was one of first impression.
See Overnite Transp. Co. v. Chicago Indus. Tire Co.,
C. Class Certification
Although neither party has raised the issue on appeal, we believe that the district court’s failure to modify the scope of the class when it became clear that the named plaintiffs were not appropriate representatives of such a broad class constitutes plain error
9
which may affect the rights of non-parties. We therefore find it necessary to explain more precisely the scope of our holding on the merits and to amend sua sponte the class certification to conform to the arguments that the parties have made in this court and below.
See Hines v. United States,
The district court in its original order certified a class “defined as all persons whose source of payment is public assistance and who are, have been, or will in the future be applicants for credit, as that term is defined by 12 C.F.R. § 202.2, from defendant Holzer Clinic, Inc.” J.A. at 50. However, the court then held, as do we today, that plaintiffs’ case must fail because they are not applicants for credit under the ECOA. This leaves persons whose positions are identical to the plaintiffs’ outside the scope of the class but includes potential plaintiffs who are applicants for credit and therefore able to invoke the ECOA’s protections, a result that could frustrate both Holzer Clinic’s interest in finality and also the broader interests in enforcement of the ECOA. 10
We could, of course, simply affirm the dismissal of plaintiffs’ claims and hope that future litigation will correct the certification error. However, in the past we have not been content to follow such a narrow path. In
Bowen v. General Motors Corp.,
the [district] court must be prepared under Rule 23(c)(1) to alter or amend [the class certification] if the course of trial on the merits reveals the impropriety of class action maintenance. And this of course necessarily implies that a reviewing court must be prepared to find error in a trial court’s failure to alter or amend — to “de-certify” the class action — if on the whole record, including the evidence adduced on trial, it appears to the reviewing court that this was the proper course.
Stastny v. Southern Bell Tel. and Tel. Co.,
As discussed above, the named plaintiffs are not in the end even members of the class that was certified. By holding that they are not applicants for credit we have held in effect that they are not members of the class that was defined in terms of “applicants for credit.” We therefore believe it is appropriate for us to amend the class certification so that the class includes the named plaintiffs and those similarly situated.
See Johnson v. Uncle Ben’s, Inc.,
IV. CONCLUSION
For the reasons discussed above, we AFFIRM the judgment of the district court as to the merits. The class certification is MODIFIED as stated above to conform to the arguments presented, and Holzer’s motion for sanctions is DENIED. AFFIRMED as MODIFIED.
Notes
. "The term 'creditor' means [inter alia] any person who regularly extends, renews, or continues credit...." 15 U.S.C. § 1691a(e). Accord 12 C.F.R. § 202.2(1).
. "If a service provider (such as a hospital [or] doctor ... ) allows the client or customer to defer the payment of a bill, this deferral of debt is credit for purposes of the regulation....” 12 C.F.R. § 202 Official Staff Interpretation § 202.3(c).
. "[P]hysicians, hospitals, and others to whom the benefits are payable need [to] consider Medicare and Medicaid as public assistance.” 12 C.F.R. § 202 Official Staff Interpretation § 202.2(z)(3).
. The Board’s definition serves to make clear that applicants who have yet to be granted any credit, and who thus may not be debtors, are nonetheless covered by the Act.
. Title XIX of the Social Security Act. See Social Security Amendments of 1965, Pub.L. No. 89-97, § 121, 79 Stat. 286, 370-80 (1965).
. Plaintiffs argue that a decision in their favor could apply to medical providers who have chosen to participate in the Medicaid program without requiring that all providers take part in the program. Appellants' Br. at 34-35. Their argument is, first, that such providers who do not participate in Medicaid may not receive payments under the program, are therefore not “physicians, hospitals, and others to whom [Medicaid] benefits are payable,” and thus need not "consider ... Medicaid as public assistance,” 12 C.F.R. § 202.2 Official Staff Interpretation § 202.2(z)(3). Such a narrow interpretation would allow doctors who do not participate in Medicaid or Medicare to refuse to extend incidental credit to patients covered by those programs, and we would therefore reject it as incompatible with ECOA’s broad remedial goals. Plaintiffs argue in addition that the ECOA does not require that medical providers offer incidental credit, only that if they do so they must not discriminate. Therefore, they argue, a medical provider that refused to extend any credit under Medicaid would not violate the ECOA. This argument, too, is unconvincing. If, as plaintiffs argue, a Medicaid transaction implies the extension of incidental credit, then a doctor who billed any patients, rather than demanding payment at the time of treatment, could not categorically exclude Medicaid recipients from such incidental credit, and would thus have to accept all such patients.
. The request was properly made in a separately filed motion. See Fed.R.App.P. 38.
. Although Holzer’s motion cites Rule 38 of the Federal Rules of Civil Procedure — which addresses the right to a jury trial — we assume counsel intended to refer to the appellate rule.
. We usually review a district court's class certification for abuse of discretion.
Schachner v. Blue Cross and Blue Shield of Ohio,
. The usual principles of both res judicata (claim preclusion) and collateral estoppel (issue preclusion) apply in class actions.
Cooper v. Federal Reserve Bank of Richmond,
. We recognize that we do not here determine the res judicata effect of this judgment; that task is for the court in a subsequent action in which previous adjudication is raised as a defense. Fed.R.Civ.P. 23(c)(3) Advisory Committee Notes (1966 Amendment); Charles Alan Wright, Arthur R. Miller, and Mary Kay Kane, 7B Federal Practice and Procedure § 1789 p. 245 (1986). However, neither this principle nor the fact that the absent class members may later collaterally attack a faulty judgment by challenging the adequacy of class representation,
see Shults
v.
Champion Int’l Corp.,
. Strict adherence to what courts and commentators have taken to be hortatory, rather than descriptive, language in Rule 23(c)(3) that the judgment in such class actions "shall include and describe those whom the court finds to be members of the class” would perhaps eliminate this type of problem in the future by forcing courts to reexamine the class certification when entering judgment.
Compare Vaughter v. Eastern Air Lines, Inc.,
