THOMAS FOTUSKY v. PROHEALTH CARE, INC.
Case No.: 2021AP1395
COURT OF APPEALS OF WISCONSIN
March 15, 2023
2023 WI App 19
Gundrum, P.J., Neubauer and Grogan,
PUBLISHED OPINION. †Pеtition for Review filed. Cir. Ct. No. 2018CV1829.
Opinion Filed: March 15, 2023
Submitted on Briefs: May 31, 2022
Oral Argument:
JUDGES: Gundrum, P.J., Neubauer and Grogan, JJ.
Concurred: Neubauer, J.
Dissented:
Appellant ATTORNEYS: On behalf of the defendant-appellant, the cause was submitted on the briefs of Terry E. Johnson and Kevin M. Fetherston of von Briesen & Roper, s.c., Milwaukee.
Respondent ATTORNEYS: On behalf of the plaintiff-respondent, the cause was submitted on the brief of Robert C. Welcenbach of Welcenbach Law Offices, S.C., Milwaukee, Scott Borison of Legg Law Firm LLC, Baltimore, Maryland, and John Craig Jones of Jones & Hill Trial Lawyers, South Oakdale, Louisiana.
COURT OF APPEALS DECISION DATED AND FILED March 15, 2023
Sheila T. Reiff Clerk of Court of Appeals
NOTICE
This opinion is subject to further editing. If published, the official version will appear in the bound volume of the Official Reports.
A party may file with the Supreme Court a petition to review an adverse decision by the Court of Appeals. See
STATE OF WISCONSIN IN COURT OF APPEALS
THOMAS FOTUSKY, PLAINTIFF-RESPONDENT, v. PROHEALTH CARE, INC., DEFENDANT-APPELLANT.
APPEAL from an order of the circuit court for Waukesha County: LLOYD CARTER, Judge. Reversed and cause remanded for further proceedings.
Before Gundrum, P.J., Neubauer and Grogan, JJ.
¶1 GROGAN, J. ProHealth Care, Inc. (ProHealth) appeals from a circuit court order certifying a class action lawsuit related to ProHealth‘s alleged violations of
I. BACKGROUND
¶2 Fotusky hired Welcenbach Law Offices, S.C. to represent him in regard to a personal injury he sustained in January 2017. During the course of that representation, Fotusky signed a HIPAA3 form authorizing his attorneys to request copies of his medical records. Fotusky‘s attоrneys thereafter provided ProHealth with the HIPAA authorization and requested Fotusky‘s medical records on or about February 23, 2017, and again on or about May 11, 2017. ProHealth charged the attorneys $33.86 and $33.28 for each request, respectively, both of which included certain certification and retrieval fees. Fotusky‘s attorneys paid the charges, and Fotusky thereafter reimbursed his attorneys for those costs.
¶4 Prior to filing its Answer, ProHealth successfully sought to transfer venue to the Waukesha County Circuit Court and filed a Motion to Dismiss,5 which the circuit court ultimately treated as a motion for summary judgment. The circuit court denied the Motion, ProHealth filed its Answer, and in January 2021, Fotusky filed a motion seeking class certification. In support of his Motion, Fotusky asserted that class certification was appropriate for numerous reasons, including that: (1) numerous Wisconsin cоurts had previously certified classes based on the same claims Fotusky raised; (2) the matter satisfied
¶5 ProHealth raised numerous arguments opposing class certification. It focused largely on its position that the proposed class was overly broad for multiple reasons as well as its position that the proposed class failed to protect both the class members’ and ProHealth‘s rights in regard to
¶6 As to its argument that the proposed class was overly broad, ProHealth first argued it “include[d] not only patients who requested records through their attorneys, but [also] patients who requested their own records[,]” which it asserted could lead a jury to “find different culpability” regarding each group (direct patient requests versus patient-authorized attorney requests). ProHealth also argued a jury could reach differing conclusions as to ProHealth‘s culpability based on when it charged the proposed class members because Moya v. Aurora Healthcare, Inc., 2016 WI App 5, 366 Wis. 2d 541, 874 N.W.2d 336 (2015), rev‘d, 2017 WI 45, 375 Wis. 2d 38, 894 N.W.2d 405 (Moya I), and Moya v. Aurora Healthcare, Inc., 2017 WI 45, 375 Wis. 2d 38, 894 N.W.2d 405 (Moya II), which reached opposing conclusions in interpreting
¶7 In addition to arguing that these purported deficiencies rendered the proposed class overly broad, ProHealth also asserted that these deficiencies prevented Fotusky from satisfying
¶8 The circuit court held a hearing on Fotusky‘s Class Certification Motion in May 2021, and it issued an oral ruling granting the certification in July 2021. In granting the class certification, the circuit court noted and discussed each of the prerequisites set forth in
- “The potential class size is in the hundreds making joinder impractical (numerosity)“;
- “[T]here is a common question of fact and law as to the legality of the Defendant‘s charges for certain fees for copies of health care records (commonality)“;
- Fotusky‘s claim “is typical of the claims asserted because it is based on the same facts and law (typicality); and”
- Fotusky‘s interests were not “antagonistic to the class,” and “his counsel are adequate based on their experience and knowledge in class proceedings and the specific claims asserted in this action ... (adequacy).”
The court further reiterated that:
- “[T]he common legal and factual issue identified is also the predominant issue for this action under
WIS. STAT. § 893.08(2)(c) [,]” and the claims “are dependent on prevailing on the common legal and factual issue” (predominance); and - “[A] class is superior under
WIS. STAT. § 803.08(2)(c) ” when “[r]epetitive individual actions based on the small amount of fees collected ... make[] a class proceeding the most efficient method to address the claims[,]” there is no indication any other purported class member had filed litigation asserting these claims, class members can opt out, the court is “a proper forum for these claims,” and “[t]he class is manageable[.]”
The written order defined the certified class as follows:
Any patient or person authorized in writing who Prohealth directly, or indirectly through an agent other than Ebix, Inc., charged a basic, retrieval оr certification fee to obtain their healthcare records when the records were requested by the patient or by a person authorized by the patient in the six-year period preceding the filing of the Plaintiff‘s complaint.
The Class specifically excludes the following persons or entities: (i) Defendant, any predecessor, subsidiary, sister and/or merged companies, and all of the present or past directors, officers, employees, principals, shareholders and/or agents of the Defendant; (ii) any and all Federal, State, County and/or Local Governments, including, but not limited to their departments, agencies, divisions, bureaus, boards, sections, groups, councils and/or any other subdivision, and any claim that such governmental entities may have, directly or indirectly; (iii) any currently-sitting Wisconsin state court Judge or Justice, or any federal court Judge currently or previously sitting in Wisсonsin, and the current spouse and all other persons within the third degree of consanguinity to such judge/justice or (iv) any law firm of record in these proceedings, including any attorney of record in these proceedings; and (vi) anyone who has recovered the fee at issue as member of any class in Moya v. HealthPort Technologies, LLC,
13CV2642 (Milwaukee Co. Cir. Ct.) (the “Moya Action“) or Rave v. Ciox Health LLC, 2:18-CV-00305-LA (E.D. WI.).
¶10 ProHealth subsequently filed this interlocutory appeal pursuant to
II. DISCUSSION
¶11 In December 2017, our supreme court repealed and recreated
(a) The class is so numerous that joinder of all members is impracticable.
(b) There are questions of law or fact common to the class.
(c) The claims or defenses of the representative parties are typical of the claims or defenses of the class.
(d) The representative parties will fairly and adequately protect the interests of the class.
The first three prerequisites—generally referred to as numerosity, commonality, and typicality, respectively—require that the plaintiff establish specific “facts about the proposed class and the representative[.]” Harwood, 388 Wis. 2d 546, ¶23. The fourth prerequisite—adequacy—addresses “the plaintiff‘s ability to represent the class.” Id. “The party seeking class certification bears the burden of showing, by a preponderance of the evidence, that a proposed class meets the requirements of [the class certification statute].” Steimel v. Wernert, 823 F.3d 902, 917 (7th Cir. 2016).11
¶12 If a circuit court concludes a plaintiff has established all four prerequisites, the court must then look to
1. The class members’ interests in individually controlling the prosecution or defense of separate actions.
2. The extent and nature of any litigation concerning the controversy already begun by or against class members.
3. The desirability or undesirability of concentrating the litigation of the claims in the particular forum.
4. The likely difficulties in managing a class action.
¶13 Circuit courts determining whether to grant or deny a motion seeking class certification are afforded broad discretion. Harwood, 388 Wis. 2d 546, ¶41. A circuit court “exercises its discretion when it considers the facts of record and reasons its way to a rational, legally sound conclusion.” Id. We will affirm the circuit court‘s decision if the court “applied the corrеct law to the facts of record and reached a reasonable decision.” Id. Only where the circuit court erroneously exercised its discretion will we reverse the circuit court‘s certification decision. Hammetter v. Verisma Sys., Inc., 2021 WI App 53, ¶9, 399 Wis. 2d 211, 963 N.W.2d 874.
A. WISCONSIN STAT. § 146.83(3f)(b) and Prior Class Action Lawsuits
¶14 Prior to determining whether the circuit court erred in certifying the class in question here, we begin by first reviewing a series of recent court of appeals and supreme court opinions that have interpreted
(b) Except as provided in sub. (1f), a health care provider may charge no more than the total of all of the following that apply for providing the copies requested under par. (a):
1. For paper copies: $1 per page for the first 25 pages; 75 cents per page for pages 26 to 50; 50 cents per page for pages 51 to 100; and 30 cents per page for pages 101 and above.
2. For microfiche or microfilm copies, $1.50 per page.
3. For a print of an X-ray, $10 per image.
4. If the requester is not the patient or a person authorized by the patient, for certification of copies, a single $8 charge.
5. If the requester is not the patient or a person authorized by the patient, a single retrieval fee of $20 for all copies requested.
6. Actual shipping costs and any applicable taxes.
(Emphases added.)
¶15 The meaning of
¶16 The circuit court agreed with Moya; however, wе reversed in a split decision. Id., ¶¶1, 3. We said that a “‘person authorized by the patient‘” means “a person who has been authorized to consent to the release of a patient‘s health care records in place of the patient[,]” as opposed to an individual like Moya‘s attorney who “only ha[d] a HIPAA release from [his] client” authorizing the attorney to obtain copies of her medical records. Id., ¶13. We therefore instructed the circuit court to grant HealthPort‘s motion for summary judgment on remand. Id., ¶16.
¶17 The Wisconsin Supreme Court disagreed with our interpretation, determining that “a person authorized by the patient,” as used in
¶18 Numerous opinions addressing class action lawsuits involving
¶20 Two years later, we again affirmed a circuit court‘s exercise of discretion in granting class certification in Hammetter, 399 Wis. 2d 211, ¶¶1-2, which likewise involved allegations that a hеalth care system had violated
¶21 After the supreme court reversed our Moya I decision, Hammetter and Vinkavich filed a class action lawsuit alleging Verisma and Froedert (collectively, “Verisma“) had violated
¶22 On appeal, Verisma argued the circuit court had erroneously exercised its discretion. Id., ¶1. More specifically, Verisma argued that its “mental state may have differed depending on whether” it had charged the fees before Moya I, after Moya I but before Moya II, or after Moya II, as well as whether the requestor had sought his own medical records or if someone sought records on the patient‘s behalf. Hammetter, 399 Wis. 2d 211 ¶12. Verisma, however, failed to provide any evidence suggesting its mental state may have varied depending “on when the records were requested or the nature of the person who made the request[,]” and we therefore rejected Verisma‘s argument, stating that “[s]peculation related to issuеs to be addressed later in the ‘merits’ phase of a class-action lawsuit” was insufficient to defeat class certification. Id., ¶13.
¶23 Verisma also asserted that the proposed class was overbroad because the requirement that class members had “incurred and ultimately paid the certification
¶24 We similarly rejected Verisma‘s argument that the plaintiffs’ claims did not satisfy the typicality requirement because their claims “would only relate to Verisma‘s pre-Moya I state of mind and thus would not be typical of claims of class members who were charged in either of the other two time periods.” Hammetter, 399 Wis. 2d 211, ¶19. We explained, however, that “[t]he question on typicality ... is not whether the [plaintiffs‘] claims ... are identical in every way with every potential class member but whether their claims are typical” and noted that Verisma had failed to point to evidence suggesting it had different mental states based on when the records had beеn requested and by whom. Id., ¶20. We also noted that
¶25 Just a few months later, we determined in an unpublished opinion, Schuler v. Schubbe Family Chiropractic, Ltd., No. 2020AP1753, unpublished slip op. (WI App Dec. 22, 2021), that there could be no “negligent, willful, or knowing violation” of
¶26 In Schuler, Schubbe, the chiropractic office, charged Schuler‘s attorneys retrieval fees on March 21, 2017, when the attorneys, who had obtained a written HIPAA authorization form from Schuler, requested Schuler‘s health care records pursuant to
¶27 The specific question we addressed in Schuler was “whether Schuler ha[d] alleged facts that, if true, show a violation of
¶28 In concluding that Schuler could not recover as a matter of law, we also responded to his argument that Moya I had no retroactive prеcedential value after our supreme court decided Moya II. In doing so, we noted that regardless of whether there had been a violation of
B. The Circuit Court Erred in Certifying this Specifically Defined Class.
¶29 With the relevant law governing class certifications and recent opinions addressing similar claims involving
¶30 Having reviewed the applicable law and the Record, we conclude that the circuit court erroneously exercised its discretion when it certified the class as defined because the certified class does not comply with the prerequisites set forth in
¶31 As noted above, in Schuler, we determined that Schuler ultimately could not prevail on his
¶32 Schuler‘s logic likewise applies here to those individuals included in the certified class who were charged certification and retrieval fees after seeking a patient‘s medical records with written authorization while Moya I was the law in effect. Consequently, because attorneys did not fall within
¶33 That does not mean that class certification is ultimately inappropriate in this matter. What it does mean, however, is that it is necessary to remand this matter to the circuit court to reanalyze, with thе Moya I individuals identified herein excluded from the circuit court‘s analysis, whether Fotusky has established class certification is appropriate under
¶34 First, it does not appear from the Record that ProHealth charged Fotusky—or anyone with authorization on his behalf—the certification and retrieval fees at issue during the pre-Moya I time period. Thus, the circuit court should consider whether subclasses or separate classes are appropriate. Second, should the circuit court conclude on remand that class certification is appropriate, it should also ensure that the class does not include class members who have already recovered damages in prior litigation addressing the same claims as those addressed here. Finаlly, because it does not appear that the circuit court considered Fotusky‘s unjust enrichment claim in its initial class certification analysis, it is instructed to do so on remand.
III. CONCLUSION
¶35 In summary, for the reasons set forth herein, we reverse the circuit court‘s grant of class certification and remand to the circuit court for further consideration of Fotusky‘s Class Certification Motion consistent with this opinion. Additionally, on remand, the circuit court is further instructed to exclude Fotusky‘s claims related to charges issued during the time period Moya I was in effect as he cannot establish he is entitled to damages pursuant to
By the Court.—Order reversed and cause remanded for further proceedings.
¶36 NEUBAUER, J. (concurring). As the Majority notes, ProHealth does not oppose certification of a class in this case, but rather only the specific class certified by the сircuit court. Majority, ¶1. I agree with the Majority that the identified authorized individuals who were charged the fees while this court‘s decision in Moya v. Aurora Healthcare, Inc., 2016 WI App 5, 366 Wis. 2d 541, 874 N.W.2d 336 (2015), rev‘d, 2017 WI 45, 375 Wis. 2d 38, 894 N.W.2d 405,1 was binding law cannot, as a matter of law, show that ProHealth negligently or knowingly and willfully violated
¶37 I part with the Majority, however, as to the legal significance of the error, and what it requires of the circuit court on remand. The Majority, without explanation, concludes that, because the class definition should have excluded the Moya I individuals, the court must redo the entire class certification analysis under
¶39 But the erroneous inclusion of the Moya I individuals does not render the circuit court‘s decision an erroneous exercise of discretion as it pertains to the remaining proposed class members. Under that standard of review, we are to uphold the court‘s decision if it considered the facts of record, applied the correct law, and reached a reasоnable decision. Harwood v. Wheaton Franciscan Servs., Inc., 2019 WI App 53, ¶41, 388 Wis. 2d 546, 933 N.W.2d 654.
¶40 At most, the circuit court‘s inclusion of the Moya I individuals could arguably affect only one of the prerequisites for class certification—numerosity. See
¶41 Because the circuit court‘s error does not require a complete reassessment of whether Fotusky “has established class certification is appropriate under
¶42 First, ProHealth contends that Fotusky did not establish numerosity because he did not identify how many persons fit within an exclusion in the certification order for individuals who obtained a recovery
¶43 ProHealth also argues that Fotusky did not establish the prerequisites of commonality, typicality, and adequacy, see
¶44 ProHealth‘s arguments do not distinguish the present case from Hammetter. As to the issue of commonality, ProHealth seizes on our conclusion in Hammetter that the defendants had not presented evidence of “a different mental state dependent on when the records were requested[.]” Id., ¶13. ProHealth argues that, unlike the defendants in Hammetter, it did present evidence to the circuit court that its “state of mind changed during the class period,” as to the pre-Moya I and post-Moya II requests. Even if discovery bears this out, however, it does not undermine the circuit court‘s finding that the claims of the class members raise a common question—whether ProHealth lawfully charged retrieval and certification fees. And, as we also notеd in
¶45 As to the issues of typicality and adequacy, we noted in Hammetter, 399 Wis. 2d 211, ¶¶18-20, that the named plaintiffs’ claims were typical of those in the class because they arose from the same “practice or course of conduct,” are grounded in the same legal theories, and have the same “essential characteristics.” The same is true with Fotusky‘s claims here.
¶46 As to the issue of predominance, we explained in Hammetter that “[t]he guiding principle behind predominance is whether the proposed class‘s claims arise from a common nucleus of operative facts and issues.” Id., ¶23 (quoting Beaton v. SpeedyPC Software, 907 F.3d 1018, 1029 (7th Cir. 2018)). Here, the circuit court found that Fotusky‘s and the proposed class member‘s claims shared a “common legal and factual issue, that is whether [they] werе charged illegal fees and the level of Pro[H]ealth‘s culpability in collecting illegal charges for medical records.” That different evidence might ultimately prove relevant to the level of culpability does not mean that the common issues identified by the court are not predominant.
¶47 ProHealth also challenges the class definition because it does not limit the class to individuals who actually paid the fees. This is not a sufficient reason to disturb the circuit court‘s decision. As we explained in Hammetter, 399 Wis. 2d 211, ¶15, if an individual or his or her authorized representative is ultimately found not to have paid any improper charge, that individual would not have a valid claim. But that does not compel a conclusion that the class is overbroad. “How many (if any) of the class members have a valid claim is the issue to be determined after the class is certified.” Parko v. Shell Oil Co., 739 F.3d 1083, 1085 (7th Cir. 2014). The salient difference is between individuals “who are ultimately shown tо have suffered no harm,” and those, like the Moya I individuals, who “could not have been harmed by the defendant‘s allegedly unlawful conduct.” Messner, 669 F.3d at 824. Only if the class definition includes persons in the latter category is it “defined too broadly to permit certification.” Id.
¶48 Lastly, ProHealth argues that the circuit court failed to address the unjust enrichment claim in the certification order and that the claim is not amenable to class treatment. As to the first point, I disagree with ProHealth‘s reading of the order, which states that “[t]he claims and issues to be addressed are the claims set forth in the Plaintiff‘s complaint as it pertains to ProHealth.” Fotusky‘s complaint asserts claims for violation of
¶49 As to the second point, ProHealth again relies on evidence it contends shows a different state of mind in charging individuals pre-Moya I and post-Moya II. But as we said in Hammetter, 399 Wis. 2d 211, ¶34, in rejecting precisely this same argument as it pertains to the unjust enrichment claim, this argument “puts the cart before the horse.” If that difference persists during discovery, the
