Docket No. 107719.



### IN THE SUPREME COURT OF THE STA TE OF IL LINOIS

WALTER

SOLON et al. , on Behalf of Themselves and a Class of Other s Sim ilarly Situated, Appellee, v. MI DWEST MEDICAL RECORDS ASSOCIATION, I NC., Appellant.

Opinion filed March 18, 2010.

JUSTICE KARMEIER delivered the judgment of the co urt, with opinion. Chief Justice Fitzgerald and

Justices Freeman, Thomas, Kilbride, Garman, and Burke concurr ed in the judgment and opinion.

OPINION

The certified question

at issue addresses the proper interpretation of sections 8–2001 and 8–2003 of the Code of Civil Procedure (735 IL CS 5/8–2001, 8–2003 (We st 2004)) , whic h limit any handling charge imposed for

processing requests for copiesof medic al records. Inits motion to dismiss the lawsuit filed by the plaintiff class, the defenda nt, Midwest Medical Records Association, Inc. (MMRA), argued that charging a $20 handlin g charge for pr ocessing medical record requests was per se re asonable under sections 8–2001 and 8–2003. Th e c ir cu it co ur t o f C oo k C ou nt y denied t he motion to dismiss but agreed

to certify a

question on the issue for interlocutory appeal under

Supreme Court Rule 308 (155 Ill. 2d R. 308). With one-2- justice diss entin g, the appellate court held t hat a $ 20 han dlin g charge

was not per

se reasonable under the statutory language. 386 Ill. App. 3d 78. MMRA sought review of the statutory construction qu e stion in this court. For the f

ollowing reasons , we reverse the judgment of the appella te court an

d remand the caus e to the c ir cuit court for further proceedings consistent with this opinion.

I. BACKGROUND In2004, named

plaintiffs Walter Solon and Cynthia Za

letel filed

a four-count class action

lawsuit in

the circ uit court o f Cook Coun

ty agains tde fe nd an t M MR A, a m an ag em en t c om pa ny t hat c ontract s with hospitals and health -care practitioners to handle reque sts for patient medical records. The trial court certifie d t he cla ss, and amended compl aints were filed. The third-amend ed complaint allege d that MMRA overcharged for fulfilling pa tient requests for medical record s, resulting in a brea ch of contract, as well as violations of

se ction s 8–2001 and 8–2003 of the Code (735 ILCS 5/8–2001, 8–2003 (West 2004)), section 2 of the Consum er Fr aud and Deceptive Business Practices Act (815 IL CS 505/2 (West 2004)), and section2 of the Uniform Deceptive Trade P ractice s Act (815 IL CS 510/2 (West 2004 )). This a ppeal re lates o nly to count II of the third-amended

complain t, alleg ing that

MMRA violated restrictions insections 8–2001 and 8–2003 of the Code by char

ging more than the permissib le amount for providing requested copies of medica l record s. As alleged

in the complaint, MMRA entered into exclusive contracts with heal

th-car e provide rs to fulf ill reque sts for me dical record s. MMRA emplo ye es worke d with in tho se offices, receiving copy reques ts, l ocati ng and c opying r ec ords, sending copies, and performing

related administrative work. MMRA did not ch arge the health-care providers for the se serv ices, choosing in stead to b ill directly th e r eq ue st in g p ar ty. MMRA charged a flat h andli ng charge plus a varia ble pe r-page charge for the copies. The handling charg es of $20 in 2002 and $20.48 in2003 wer e within th e statutor

y “ not to exceed” amount (effective January 20, 2003, the C omptroller adjuste d the handling charge for i

nflation from $20 to $20.48 in accordance-3- with the Consumer Price Index pursuant to section 8– 2006 of the Code (735 I

LCS 5 /8 –2006 (West 2004))). The third-amended complaint alleged that MMRA’s charge s violated the p rici ng restrictions in sections 8–2001 and 8–2003 of the Code. The complaint sought

damages “in the amount of the difference between the actual sums charged for these copies and the least of the

reasona ble expense of produ ctio n, Illinois’ statutory price limit for copies applicable to the type of copies MMRA furnishe d, or a fai r price for the copie s,” plus expenses an d attorne y f ees. The complaint als o sough t an injunction barr ing MMRA “ from cha

rging prices in

excess of the least of the reasona ble expens e of produc

tion, I llinois’ statu tory p rice limit for copies applicable to the ty pe of copies MMRA furnished, or a fair price for the copie s.” MMRA filed a motion to dismiss count II of the third-am en ded complaint under section

2–615 of the Cod

e (735 I LCS 5/2 –615 (West 2004)), arguing that the handling cha rges were per se

reas onab le as within the “not to exceed” charges permitte d by

the statut es. MMRA noted that other than the “not to exceed” amount, the statutes do not provide an y cri teria (or expert commission or board) to determine what is a “reasonable”handling charg e. Among

other cases, MMRA cited a recent Texas opinion, In re Metro ROI, Inc. , 203 S.W.3d 400, 406 (Tex. App. 2006), which construed the maximumfee set out in its similarly worded statute as presumptively reasonable. The trial court denied the motion to dismiss. MMRA fil ed a motion for

certifi cation of

an immedia

te interlocutory a ppeal und

er Supre me Court Ru

le 308 (15 5 Ill. 2d R. 308), and th e tr ial court certified the following question for revie w: “Is it reason

able per se

for a provider of medical record c opies under 735 IL CS §§5/8–2001, 2003 to charge the full amoun t of the $20 process fee, or is the provider limited to a lesser charge if the

ev ide nc e s how s th at

the le sse r c ha rg e i s a ll t ha t isre as ona

ble ?” The appellate court initially denie d MMRA’s request for interlocutory

appeal under Rule 308, and MMRA filed a petition for leave to appeal in this court. We entered a supervisory order instructing the appe llate cou rt to vac ate its order and

to consider the certified question on the merits. A divided appellate court then found that the statutory lang

uage was unambiguous and that a f lat $20 handling charg e was not per se reasonable. 386 Ill. App. 3d at 81-84.-4- The court rejected

MMRA’s argument that

extrinsic evidence, such

as legis l ative history, should be considere d in interpreting the statutory provision s and inste ad examine d only the plain language of the st atu to ry pr ovi si ons . 38 6 Il l. App. 3d at 82-83. I n his disse

nt, Justice Greiman relied

upon both le gislativ e history and the r ationale of In re Metro ROI, Inc. , 203 S.W.3d 400, to conclu de that a flat $20 handling charg e was per se reasonab le and that the majority’s conclusioncreate d absurd, unjust, an d inconve nient con sequenc es. 386 Ill. App. 3d at 84-88 (Greiman, J., dissenting). This court allowed MMRA’s petition for leave to appeal. 210 Ill. 2d R. 315. We a

ls o grant ed the Illinois Trial L awyers Association (ITL A) leave to file an amicus curiae brief. 210 Ill. 2d R. 345.

II. AN ALYS IS The trial court’s certified question raises the sole issue for revie w inthis interlocutory appea l. To qualify for a

n interl ocutory appe al under Supreme C ourt Ru le 308 (155 Ill. 2d R. 308), a certified ques tion must present an issue of law that is reviewable de novo

. Townsend v. Sears, Roebuck &

Co. , 227 Ill. 2d

147, 153 (2007). The cert ified question h ere is one of statu tory construc

tion, well established

to constitute aquestion of lawsubject to de novo review. People e x rel. Bir kett v. D ockery , 235 Ill. 2d 73, 79 (2009). The certifi ed questi on we ar e asked t o answer is: “I s it reasonable per se for a provider o f me dical re cord cop ies under 735 I LCS §§5/ 8–2001, 2003 to ch arge t he full a mount of th e $20 pro cess fee , or is the pro vider limi

ted to a le sser cha

rge if the evidence shows that the le sse r c ha rg e i s a ll t ha t isre as ona

ble ?” In answering the s ame question, the appellate majority determ ine d that a $20 han

dling charge was not per

se reasona

ble. MMRA

argues that this inter pretation causes

absurd, u njust, and incon

venient r esults by endlessly forc ing each record provider to face litigation over the

reasona blenessof the handling charge a ssessed for ea ch individual

r e cord request without an

y ju dicial g uideline s. In

addition, MMRA

a rgues that the appellate court majority failed to cons ider th e legislative purpose, the evils to be remedied, the consequences of the alternative constructions set out in the certifi ed questi on, and th e realworld co ntext and a

ctivities

.-5- As we have consistently held, our prima

ry objectiv e in interpretinga

statute is to ascertain and give effec t to the intentof the legislature. Blum v. Koster , 235 I ll. 2d 21, 29(2009). T he mo s t reliable indicator of suc h int ent is the la nguage of the statute, which is to be given its plain and ordinary mea

ning. Blum , 235 I ll. 2d at 29. Indetermining the plain meaning of the statute, we consider the statute it its entir

ety , the subje ct it addr

esses, and the apparent

intent of the legislature in enacting it. Blum , 235 Ill. 2 d at 29. Whe n the statutory language is clear a

nd unambiguous, it must be app lied a s written, withou t reso rt to extrinsic aids of statutory construction. Blum , 235 Ill. 2d at 29. However, if a st atute is cap able o f bein g u nderstoo d by

reasona bly well-informed

persons i n two or mor

e diffe rent way s, the statute will be deeme d ambigu

ous. Landis v. Marc Realty, L.L.C. , 235 Ill. 2d 1, 11 (2009). If the statute is ambig uous, the court

may con sider extrinsic aids of construction

in order to discer n the legislative i

ntent. Landis , 235 Ill. 2d

at 11. We construe the statute to avoid rendering any part of it meaningless or

superfluous. Blum , 235 I ll. 2d at 29. We do not de part fro m the plain statutory langua ge by reading into it exception s, limitations, or conditions that conflict with the expressed intent. Blum , 235 Ill. 2d at 29. We ma y also consider the consequences that would result from construing the statute one way or the other. Landis , 235 Ill. 2d at 12. Indoing so, we pres ume that t he legislature did not intend absurd, inconvenient, or unjust consequences. Landis , 235 Ill. 2d at 12. Withtheseprinciples in mind, we turn to the applicable statutory provision s, sect io ns 8–2001 a nd 8–2003 o f the Code

(735 I LCS 5/8–2001, 8–2003 (West

2004)). Section 8–2001 governs the records of a “health care facility

,” and section 8–2003 applies to the records of “health care practitioners.” A “hea lth care facility” is “a

public or private hospital, ambulatory surgical treatment center, nursing home, independent

practice association, or physician hospital org anization,

or any other e

ntity where hea

lth care services are provide d to any person.” 735 IL CS 5/8–2001 (West 2004) . A “practitioner” is “any health care pr actitio ner, including

a phy sician, d

entist, po diatrist, advanced practice nurse, phy sician assistant, clinical psycholog ist, or clinical social worker,” including “a m edical o ffice, health care clinic, health department, group practice, and any ot her organizational-6- structure for a

license d profes sional to provide he alth care services,” bu t n ot “a health care facility as defined in Section 8–2001.” 735 IL CS 5/8–2003 (

West 2004) . Here, we refe r to “hea lth care f acilitie s” and “practitioners” collectively as “health-care providers.” Exceptfor the type of

health-care provider affe cted, the relevant portions of sections 8–2001 and 8–2003 of the Code are identical and provide, in pertine

nt part, a s follows: “The [health-care provider] shall be reimbursed by the person requestin g [p ati ent medical] records at the time of such copying for all reasonable expenses, including the costs of independent

copy servic e companies, incurred bythe [healthcare provider] in connection with such copying not to exceed

a $20 handling charge for pr ocessing the request for copi es , and 75 cents pe r p age for the first through 25th pag es, 50 cents per page for the 26th throu gh 50th p ages, and 25 ce

nts per pag e for al l pages in excess of 50 (except that the charge shallnot exceed $1.25 per page for any copies made from microfiche or microf

ilm), and a

ctual ship ping co sts. These rates sh al l b e a ut om at ic al ly a djusted as set forth in Section 8–2006. The [health-care provider] may, howeve r, charge for the reasonable cost of all duplication of reco rd material or informat ion that c annot rou

tinely be copied or duplicated on

a st andard comm ercial p

hotocopy machine such as x-r

ay films or pictures.” 735 ILCS 5/8–2001, 8–2003 (West 2004). MMRA argues that

the st atuto ry language is ambiguous, that the legislative hi st or y demonstrates that the $20 cap on the handling charge was a compromise among various parties intere sted in the legislation, and that t

he legislature intended to make any handling charge of $20 or less per se

reasonable. MMRA claims the legislature defined the only “

unreasonable” handling charg e as one over $20. Ont he oth er hand, the plaintiff class argues that the sta tutory langua ge is unambiguous and that the plain language of the statutory provisions demonstrates the legislature’s intent to limit the handling charge to the re imburseme nt of a sum

r eas onably repr

esenting the expenses incurred in processing a copy request as long as that amount is not over $20. One reasonable interpretation of the statutory language is that the-7- health-care provider

is to be rei

mbursed f

or all reasonable expenses incurred in processingthe copy

request , as long as th ose reaso nable

ex penses do not exceed

“a $20 handl ing cha rge for p rocess ing t h e request for copi es, and 7 5 cents per p age for the fir st throug h 25th pages , 50 cents pe

r page for the 2 6th throug

h 50th pages , and 25 c ents per page for all pages in excess of 50.” 735 I LCS 5/8–2001, 8–2003 (West 2004). Under tha

t i nterpretation, the health-care provider would be reimbursed for the lesser of: (1) actual expenses incurred; (2 ) reasona

ble expens es incur

red; or ( 3) the amount of the caps. Under that interpretation, if actual expenses incurred were more than what was reasonable, the provider would be reimbursed for only what

was reasonable. Moreover, even if actual expenses incurred were reasonable, if

th ey wer

e more than the amount of the caps, the provider would be reimbursed for only the amount of the caps. However, another equally reasonable interpretation of t he statutory langua ge is tha t the hea lth-car e provide r is to be reimbursed for all reas onable

expense s incurr

ed in proc essing t

he copy request and that “reasonable expenses” are specifically defined as “not t o exceed a $20 handling charge f

or processing the reque st for c opies, and 75 cents per page for the first thr oug h 25th pages, 50 cents per page for the 26th thr ou gh 50th p ages, and 25 ce nts per pa ge for all pages in excess of 50.” 735 IL CS 5/8–2001, 8–2003 (West 2004). Under this interpretation, although the health-care provider (or copy

co mp an y) would always be free to charge less than the $20 handling charge, as long as the h andling charg e did not exceed $20 , it would be presumptively re asonable. We agree with MMRA that the statut ory langua ge is ambiguous inthat it is capable of being understood by reasonably

well-informed persons in two or more different ways. See Landis , 235 Ill. 2d at 11. Giventhis appa

rent amb iguity

in the stat

utory langua ge, it is appropriate for us to consider extrinsic evidence, such as leg islative history, to ascertain the legislative intent. See People v. Bailey , 232 Ill. 2d 285, 292(2009). I n this case , there is an abundance of legislative history, which c learly demonstrates the legisla

tive inten t. The prior version of

the applicable statute provided, in pertinent part, as follows: “The [health-care provider] shall be reimbursed by the person requesting such records at the time of such examination or copying , for all reasonable expenses incurred by the [health-care-8- provider] in connection with such examination or c opying.” 735 I LCS 5/8–2003 (West 2000). At that time, there wa s nothing in the stat

ute about cop y c ompanies , handling

fees, pe r-pag e charg es, or

shipping charg es; inst ead, pr oviders w ere to be reimburs ed simply

for “al l

reasona ble expenses incurred *** i n connection with such examination or copying.” 735 IL CS 5/8–2003 (West 2000). Inintroduc ing Sena

te Bill 72 1, Se nator John Cullerton, the sponsor of the bill, stated:

“This bill *** reflects a compromise, the issue being how much money patients *** can be charg ed to get their own

reco rds back. *** [A]s a result of our negotiations ***, we

were able to get the Trial L awyers, the Medical Society, the Hospi tal Association and the representatives of the c ompanie s that *** copy rec ords to agreeto this proc edur e *** . *** [ I]t basi cally set s up a slidin

g scale of copy ing cha rges and an initial fee that you have to pay, a handl ing charge of [$20]

. And as I said, every

body has ag reed to i t.” (Emphasis added.) 92d Ill . Gen. Assem., Senate Proceedings, April 5, 2001, at 226-27 (statements of Senator Cullerton). Representative John Turner, the House sponsor of the bill, stated that the bill “ ‘[p]rovides that the charges[ ] imposed by a hospital or

a physician for c opying re cords may not excee d a $20 handling charge plus [75] cents per pag e for th e first 25 pages, and then on a sliding scale.’ ” 92d Ill. Gen. A ssem., House Proceedings, May 8, 2001, at 42 (statements of Representative Turner). When asked if there was any opposition to the bill, Representative Turner stated:

“Not to my knowledge. I be lieve that we have changed the provisions in the Bill so many times asto accommodate all of the opposition *** there has been in the past. So, I be lieve , the honest an

d corre ct answe

r to y our quest ion is ‘ n o’, there is no opposition.

***

*** I als o believe

that if the

re was o pposition I

would know about it. Because the Bill has been around f or approxima

tely two and a half[ ] or three ye ars.” 92d Ill. Gen. Assem., House Proceedings, May 8, 2001, at 42-43-9- (statements of Representative Turner). When asked ab out how th ey arr ived at the fees, Representative Turner stated:

“[T]he amo

unt that is going to be the maximum that can be charged originates f

rom compromise betwe en t he Trial Law ye rs, the I llinois Stat

e Bar A ssociation, the Hos p ita l Association, the Me di ca l S oc ie ty, and other s, includi ng those who represen

t t he copy

ing comp anies. The amount t hat is allowed to be c harge d h as changed many times. *** [T]he latest compromise provides for a slid ing s cale . *** [ I]t

allows for [75] cents per page for *** pages 1 through 25, and then [for] pages 26 through 50, I believe, it’s [50] cents per page , and [2 5] ce nt s t he re af

te r. I th in k I’ m s ta ti ng th at co rr ec tl y. *** [T]here is n

o magic though * ** in

how *** we [came] up with [75] cents, or [50] cents, or the $20 h and li ng c har ge. It sim ply was a mat

ter of ne gotiations after

a very length y process.” 92d I ll. Gen. A ssem., Ho use Pr oce edings, May

8, 2001, at 43 (statements of Representative Turner). Representat ive Turne r confi rmed t hat th e $20 h andli ng charge could be deemed an “order fee ” or a “deposit fee” at the time the records were req

u ested. 92 d Ill. Gen. Asse m., House

Proceed ings, May 8, 2001, at 46. In closing, Represe

ntative Turner stated: “The gene sis of this Bill actually was not fr om the Trial Lawy ers Association nor was it from the ISBA. I t came from what I saw going

on inmy law prac

tice where I would, from time to time on behalf of

clients, r equest me dical re cords. On several occasi ons I wou ld get o ne page for $30, or two pages for $35, or perha

ps three or four p ages f

or $50. I t became *** abundan tly clear that we needed

to try to addre ss this situation throu gh legislation that would put some cap on wh at the charges would be for medic al records. *** [T]he purpose of this is not to ass ist la

wye rs, it’s not to assist doctors. It’s simply to assist pa

tients *** s o that they can g et copies of their ownrecords at a reasonable cost. This is a B ill that has been com pro mi sed . I t hin k that it does address, in part, the concerns that caused me to raise the issue in the first plac e.”-10- 92d Ill. Gen. Asse

m., House

Proceedings, May

8, 2001, at 47- 48 (statements of Representative Turner). After a careful review of the

applicable statutory pr

ovisions along with the legislative history, we conclude that, by specifica lly allowing for reimb ursem ent of

a hand ling ch arge “not to exceed *** $20,” the legislature intended to define what was a “reasonable” handling charge. Although health-care providers and c opy companies ca n charge less t han th e $20 h andli ng c harge if t hey so choose, the

y cannot charge more. The legislatur e t hought it necessa ry to specific ally def

ine what was reasonable in order to avoid ar bitrary and

unrea s onable

charges to patients, which appare ntly was happening under the prior version of the statute. We find f urther support for our conclusion in out-of-state cases interpretingsimilar statutes. For example, in In re Metro ROI, Inc. , 203 S.W.3d 400 ( Tex. App. 2 006), a T exas cour t in terpre te d the maximum fee set out in its statute as presumpt ively reasonable. In re Metro ROI, Inc. , 203 S.W.3d at 406. The Texas statute provided that “the hospital may charg e a reasonable fee” for copy ing health-care information; however, the “ ‘fee may not exceed the sum of *** a basic retrieval or processing fee , which must include the fee f o r providing the first 10 pages of the copies and which may not exceed $30’ ”; variable per

page charge s thereafter; and “ ‘the actual cost of mail ing, shipping, or

otherwise delivering

the provided copies.’ ” In

re Metro ROI, Inc. , 203 S.W.3d at 404, quoting Tex. Health & Safety Code Ann. §2 41.154(b) (Vernon 2001). The Texas court reasone d that, “[b]y specify

ing the maximum fees which can be cha rged, th e Legislature

has clea rly indicate d what constitutes a n unreas onable fee.” In re Metro ROI, Inc. , 203 S.W.3d at 406. Moreover, in In re Casillo , 151 Misc. 2d 420, 580 N.Y.S.2d 992 (N.Y. Sup. 1992), a New York court analy zed the legislative intent

of

anamended statute that

stated that “the reasonable charg e for paper copies shall

not e xcee d [7 5] cents per pag e” and c oncluded that “it

was enacted to create a unify ing definition

for the ‘reasonable charg e’ standard and to stemthe burgeoning costs being imposed on patien ts seekin g to obtain their own medical records for whateve r purpose.” Casillo , 151 Misc. 2d at 425, 429, 580 N.Y.S.2d at 996, 99 8 . See N.Y. Pub. Health Law §17 (McKinn ey 2001) . As the comments by Senator Cullerton and Representa tive Turner demonstrate, the-11- applica ble statutory provisions in the present ca s e we re enac ted to achieve the same result; therefore, we believe a similar construction should be applied. A cc or di ng ly, we conclude that the $20 handling fee is per s e reasonable. The alternative interpret atio n would force everyhealthcare provider

to undergo an assessment of theappropriate charge f or each individual copy request, inevitably resulting ina lack of uniform charges and natural inequities. Such a result is ab surd , unjust, and inconvenient

and not in l i ne with the intent of the legislature, especia lly where, as here, the language was expressly agreed upon

by competin g inter ested pa rties af ter leng thy negotia tions.

III. CONCL

USION For the foregoing reasons, we answer the certified question as follows: It is reasonable per se for a provider of medical record copies under sections 8–2001 and 8–2 003 of the Code to ch arge t

he full amount of th e $ 20 pr oc es s f

ee . A cc or di ng ly, we reve

rse the judgment of the app ellate c ourt and remand the cause to the circuit court for further proceedings consistent with this opinion.

Certified question answered; appellate court judgment reversed;

cause remanded

.