Title: Liberty Nat. v. Univ. of Ala. Health Servs.
Citation: 881 So. 2d 1013
Docket Number: 1012346
State: Alabama
Issuer: Alabama Supreme Court
Date: September 19, 2003

881 So. 2d 1013 (2003)
LIBERTY NATIONAL LIFE INSURANCE COMPANY
v.
UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, P.C., et al.
1012346.

Supreme Court of Alabama.
September 19, 2003.
Rehearing Denied November 21, 2003.
*1016 William J. Baxley and Charles A. Dauphin of Baxley, Dillard, Dauphin &amp; McKnight, Birmingham, for appellant.
W. Stancil Starnes, Laura Howard Peck, and Bryan O. Balogh of Starne &amp; Atchison, LLP, Birmingham, for appellees.
W. Boyd Reeves and M. Kathleen Miller of Armbrecht Jackson, LLP, Mobile, for amicus curiae Alabama Hospital Association.
Robert A. Huffaker and R. Austin Huffaker, Jr., of Rushton, Stakely, Johnston &amp; Garrett, P.A., Montgomery, for amicus curiae Hal Phillips, in support of the appellant.
HARWOOD, Justice.
On May 24, 2002, Liberty National Life Insurance Company ("Liberty National") sued the University of Alabama Health Services Foundation, P.C., University of Alabama at Birmingham Hospital, and UAB Health System (hereinafter collectively referred to as "UAB"). Liberty National's complaint presented claims alleging "prima facie tort";[1] violation of Ala.Code 1975, § 22-21-7;[2] intentional interference with Liberty National's "contractual and/or business relationships" with its insureds; and a claim seeking a declaratory judgment under the Alabama Declaratory Judgment Act ("the Act"). Liberty National alleged that UAB's billing statements to its patients who are also Liberty National policyholders often contain charges for various services that exceed the amounts UAB has accepted or will accept as full payment for those services; thus, Liberty National claims that UAB causes it to pay its policyholders amounts in reimbursements for services performed by UAB that exceed what UAB accepts as full satisfaction of those services. Liberty National sought an injunction to prevent UAB from continuing its allegedly improper billing practice, an award of compensatory and punitive damages, and a judgment declaring that UAB's billing practices violated Ala.Code 1975, § 22-21-7.
UAB filed a motion to dismiss the action pursuant to Rule 12(b)(1), (6), (7), and Rule 19, Ala.R.Civ.P. In its motion UAB asserted that the "Board of Trustees of the University of Alabama for its Division, University Hospital" was the correct designation for the defendant designated in Liberty National's complaint as "University of Alabama at Birmingham Hospital." This defendant is referred to hereinafter as "UAB Hospital." UAB asserted lack of subject-matter jurisdiction arising from Liberty National's lack of standing to bring any of the claims except the claim alleging intentional interference with contractual and/or business relationships; failure to state a claim upon which relief could be granted as to the prima facie tort claim and the claim asserting a violation of § 22-21-7; failure to join policyholders as necessary parties; and UAB Hospital's immunity from Liberty National's claims against it by virtue of Ala. Const.1901, Art. I, § 14. Liberty National responded and UAB then filed a reply brief in response to Liberty National's opposition. In that brief, UAB expanded its ground of failure to state a claim upon which relief could be granted to include the declaratory-judgment claim. On September 9, 2002, the trial court granted UAB's motion to dismiss the case, *1017 on the ground that the court lacked jurisdiction over the action because Liberty National lacked standing to bring it. Liberty National appealed.
On appeal, Liberty National argues that the trial court's ruling that it lacks standing was improper and that this Court cannot affirm the trial court's judgment on the basis of any of the other grounds contained in UAB's motion to dismiss.
Lyons v. River Road Constr., Inc., 858 So. 2d 257, 260 (Ala.2003).
The complaint states that since 1969, Liberty National has issued cancer insurance policies that pay policyholders amounts equal to their medical expenses for the treatment of cancer. These cancer policies are supplemental, as opposed to primary, insurance policies; Liberty National makes payments directly to the policyholders or their family members, and only "rarely, if ever," makes payments directly to health-care service providers. The cancer policies are intended to assist in paying medical bills or other expenses incurred by policyholders afflicted with cancer and to pay the expenses of cancer treatment, regardless of the presence of, and payments by, other insurance or other primary payment sources, such as Medicare. As Liberty National states in its brief to this Court:
These cancer policies are renewable for the life of the policyholder; Liberty National cannot modify or eliminate any of the terms or conditions of the policies. However, Liberty National may, subject to regulatory limitations, increase the annual premiums. As Liberty National stated in its complaint, "[U]nder the terms of the Cancer Policies, Liberty National is obligated to pay Liberty National Insureds benefits on some policies of `expenses incurred' or, in other policies, the `actual charges by a hospital, physician or other provider' for a Covered Treatment of the Liberty National Insured.... [Liberty National] is not obligated to pay benefits `in excess of the usual and customary charges' for such treatment." Many of the cancer policies issued by Liberty National have no dollar limit on the amounts Liberty National may be required to pay for radiation treatment, chemotherapy, prescription chemotherapy drugs, and other out-of-hospital prescription drugs. Liberty National designates those policies as the "no dollar limit policies." The complaint states that at the end of the year 2001, *1018 Liberty National had approximately 78,000 no dollar limit policies in force.[3]
As a part of its billing practice, UAB used a price list it refers to as "Charge Master." UAB states that this price list "exhaustively compiles" its actual charges. It explained in its reply brief in the trial court that "[t]he Charge Master inventories the actual charges and ensures their universal application to every patient, irrespective of whether a third party payor may ultimately satisfy part or all of the charges." The "actual charges" thus derived are the amounts billed by UAB. However, as is common practice in the health-care industry, and as required by law in certain instances, UAB often accepts as payment in full an amount less than the actual total charge reflected on the billing statement generated using Charge Master. For example, pursuant to 42 C.F.R. § 412.42(a): "A hospital may not charge a beneficiary for any services for which payment is made by Medicare, even if the hospital's costs of furnishing services to that beneficiary are greater than the amount the hospital is paid under the prospective payment systems." The Medicare Provider Reimbursement Manual, Part I, Chapter 22, § 2203, states: "While the Medicare program cannot dictate to a provider what it charges or charge structure may be used, the program may determine whether or not the charges are allowable for use in apportioning costs under the program." (UAB's brief, p. 7.) Also, hospitals often enter into agreements with insurance companies pursuant to which the hospital agrees to accept a "reimbursed amount" that is less than the actual charge incurred by the policyholder.[4] As stated in UAB's reply brief in the trial court, unless UAB is statutorily or contractually limited to the amount it may accept as full payment for the health-care services it provides, it expects reimbursement for the "full amount of the actual charges."
Liberty National's complaint states that when UAB provides cancer treatment to a Liberty National policyholder, UAB issues a billing statement that some policyholders then present to Liberty National. That statement does not reflect the actual amount UAB can charge and collect for treatments if the policyholder also receives benefits from Medicare or from some other insurance company that has a special arrangement with UAB for reimbursing its charges. Rather, as noted, the statement reflects the charges an otherwise uninsured patient must pay, compiled using Charge Master, without regard to any limiting special program or contract. Thus, the Liberty National policyholder, just like all other patients, receives a statement showing amounts extracted using Charge Master, amounts that are not necessarily the amounts UAB has accepted or will accept as full payment of its services. The terms of Liberty National's cancer policies require that Liberty National pay the policyholder the full amount listed on the statement. As Liberty National states in its brief to this Court: "It is the practice of [Liberty National] to pay the insureds the amount billed by [UAB] even though the amounts are greatly inflated." Liberty National avers in its complaint that during the years 2000 and 2001, UAB's billing practice caused it to pay its cancer policyholders treated by UAB who also received Medicare benefits more than $276,094 in excess of what UAB accepted from Medicare as full payment for their cancer treatments.
*1019 On May 4, 2002, Liberty National sent a letter notifying UAB of the alleged injury UAB's billing practice was causing and demanding that UAB "cease and desist from engaging in their billing practice." UAB has not changed its billing practice. The trial court's order granting UAB's motion to dismiss states, in part:
Liberty National contends that the trial court erred in holding that it lacked standing to bring this action.
Doremus v. Business Council of Alabama Workers' Compensation Self-Insurers Fund, 686 So. 2d 252, 253 (Ala.1996).
State v. 2018 Rainbow Drive, 740 So. 2d 1025, 1027-28 (Ala.1999) (emphasis omitted). With respect to the issue of standing *1020 and the standard of review discussed in Lyons, supra, we must consider whether, viewing the allegations of the complaint most strongly in Liberty National's favor, Liberty National could prove any set of circumstances that would show that UAB has injured Liberty National's legally protected rights. Given our subsequent disposition of Liberty National's claim premised on an alleged violation of § 22-21-7, Ala.Code 1975, we affirm the trial judge's judgment insofar as it found that Liberty National lacked standing to bring that claim.
However, given the broad standard used to determine standing, we cannot conclude that there is no possible situation in which Liberty National might show the requisite injury as to its other claims. See by way of analogy and example, the elements required for proof of the tort of intentional interference with business relations in Folmar &amp; Associates LLP v. Holberg, 776 So. 2d 112, 115 (Ala.2000) ("`(1) The existence of a contract or business relation; (2) Defendant's knowledge of the contract or business relation; (3) Intentional interference by the defendant with the contract or business relation; (4) Absence of justification for the defendant's interference; and (5) Damage to the plaintiff as a result of defendant's interference.'" (quoting Gross v. Lowder Realty Better Homes &amp; Gardens, 494 So. 2d 590 (Ala.1986))). As noted, UAB does not raise a standing issue as to Liberty National's claim alleging intentional interference with contractual or business relationships. Accordingly, we will not affirm the trial court's dismissal of the entire complaint upon a rationale that Liberty National lacked standing to bring any aspect of it.
Nonetheless, this Court will affirm the trial court on any valid legal ground presented by the record, regardless of whether that ground was considered, or even if it was rejected, by the trial court. Ex parte Ryals, 773 So. 2d 1011 (Ala.2000), citing Ex parte Wiginton, 743 So. 2d 1071 (Ala.1999), and Smith v. Equifax Servs., Inc., 537 So. 2d 463 (Ala.1988). This rule fails in application only where due-process constraints require some notice at the trial level, which was omitted, of the basis that would otherwise support an affirmance, such as when a totally omitted affirmative defense might, if available for consideration, suffice to affirm a judgment, Ameriquest Mortgage Co. v. Bentley, 851 So. 2d 458 (Ala.2002), or where a summary-judgment movant has not asserted before the trial court a failure of the nonmovant's evidence on an element of a claim or defense and therefore has not shifted the burden of producing substantial evidence in support of that element, Rector v. Better Houses, Inc., 820 So. 2d 75, 80 (Ala.2001) (quoting Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S. Ct. 2548, 91 L. Ed. 2d 265 (1986), and Kennedy v. Western Sizzlin Corp., 857 So. 2d 71 (Ala.2003)).
Liberty National contends that this Court cannot affirm the trial court's judgment based upon any of the other grounds of UAB's motion to dismiss. Those other grounds, as argued by UAB in its brief to this Court, are that Liberty National policyholders are "necessary parties" who must be joined in the action pursuant to Rule 19, Ala.R.Civ.P.; that Liberty National has failed to state a claim upon which relief can be granted as to its respective claims of prima facie tort and intentional interference with contractual and/or business relationships; that there has been no violation of Ala.Code § 22-21-7; and that UAB is protected by the doctrine of sovereign immunity.
Accordingly, we consider those arguments, starting with whether the trial court's judgment is sustainable by application *1021 of the joinder requirements of Rule 19, Ala.R.Civ.P.
Rule 19 states, in part:
We have discussed the application of Rule 19 as follows:
Dawkins v. Walker, 794 So. 2d 333, 336 (Ala.2001) (quoting Byrd Cos. v. Smith, 591 So. 2d 844, 846 (Ala.1991)).
Holland v. City of Alabaster, 566 So. 2d 224, 226-27 (Ala.1990) (emphasis omitted). "The absence of a necessary and indispensable party necessitates the dismissal of the cause without prejudice or a reversal with directions to allow the cause to stand over for amendment." J.C. Jacobs Banking Co. v. Campbell, 406 So. 2d 834, 850-51 (Ala.1981). See also Stamps v. Jefferson County Bd. of Educ., 642 So. 2d 941, 945 (Ala.1994) (Almon, J., concurring in part and dissenting in part).
Britnell v. Alabama State Bd. of Educ., 374 So. 2d 282, 285 (Ala.1979), (quoting 7 C. Wright &amp; A. Miller &amp; M. Kane, Federal Practice and Procedure: Civil § 1609, Rule 19). Thus, a critical question is whether the Liberty National policyholders who have primary insurance coverage through Medicare or some other source entitled by law or contract to fully satisfy UAB's actual charges by payment of an amount less than those actual charges are necessary parties to Liberty National's action.
Liberty National entered into contracts with its policyholders pursuant to which it agreed that it would pay them, depending on the particular policy, either the "expenses incurred" or the "actual charges" that arose from covered cancer treatments. UAB contends that the relief Liberty National is seeking will have the direct effect of reducing the amounts Liberty National is contractually obligated to pay its policyholders. Liberty National argues that the "actual charges" UAB generates using Charge Master are not the "expenses incurred" or the "actual charges" of the health-care services UAB provides to patients who have Medicare or some other primary insurance coverage. Clearly, Liberty National seeks to reduce the amount it has to pay its policyholders who are covered by those forms of primary insurance for health-care services provided by UAB, to the amount UAB accepts as full payment for those services. If Liberty National is successful in that regard, policyholders will experience a reduction in the amount of benefits now payable to them for cancer treatments, to whatever amount UAB accepts as full payment.
Liberty National contends that the interests of those policyholders are "merely financial" rather than legally protected, and, therefore, that those policyholders are not necessary parties to this action. In Ross v. Luton, 456 So. 2d 249, 256 (Ala.1984), this Court quoted the following statement:
In Ross, a landowner, Ross, entered into a contract to provide water from a well on his land to Smiths Water Authority. The withdrawal of water from Ross's well depleted the surrounding water table to an extent that neighboring landowners could not obtain water from their wells, and various landowners sued Ross. After suffering an adverse judgment, Ross appealed, arguing, among other things, that the trial court had erred in not granting his motion seeking to join Smiths Water Authority and the City of Phenix City as indispensable parties under Rule 19, Ala.R.Civ.P. This Court analyzed that issue as follows:
456 So. 2d  at 256-57.
Liberty National policyholders do have not merely a secondary financial interest in the manner in which UAB bills patients for cancer treatments and the manner in which Liberty National pays those bills, but a financial interest that arises from their contracts with Liberty National. Under those contracts the policyholders agree to pay premiums to Liberty National and, in the event a policyholder is diagnosed with cancer, Liberty National agrees to pay the policyholder either the "expenses incurred" by the policyholder for the cancer treatment or the "actual charges" charged by the health-care provider.
As it did in Ross, this Court has recognized in several other cases that an interest created by a contract is a legally protected interest. See BellSouth Mobility, Inc. v. Cellulink, Inc., 814 So. 2d 203 (Ala.2001), citing Electronics Store, Inc. v. Cellco P'ship, 127 Md.App. 385, 732 A.2d 980, 981 (1999). See also Strojnik v. General Ins. Co. of America, 201 Ariz. 430, 434, 36 P.3d 1200, 1204 (Ct.App.2001) (an interest created by a contract is a legally protected interest). We therefore conclude that the subject policyholders have a legally protected interest that will be affected by the outcome of Liberty National's asserted claims. Additionally, if those policyholders are not joined in this action and are not bound by its outcome, the issue whether Liberty National may reduce the amount of cancer benefits it provides those policyholders under its cancer policies, in the event of an outcome favorable to Liberty National, could be subject to relitigation by a policyholder, potentially resulting in an outcome inconsistent with the outcome of this case. Boles v. Autery, 554 So. 2d 959 (Ala.1989) (county deemed indispensable party to an action brought by landowners against purchasers of nearby property seeking a determination of whether a road being used by the purchasers was *1024 private and not public, because results of later litigation on the issue might be inconsistent with results of that initial litigation). Accordingly, we conclude that the group of Liberty National policyholders composed of persons who have primary health insurance coverage of the sort discussed are necessary parties within the meaning of Rule 19(a), Ala.R.Civ.P.[5]
We must further consider, however, whether the joinder of this group of policyholders is feasible. In order to make a determination as to the feasibility of joinder under Rule 19, Ala.R.Civ.P., a court must consider whether the absentee party is subject to service of process, whether the absentee party's joinder will deprive the trial court of subject-matter jurisdiction, or whether the absentee party makes a valid objection to the court's venue after joinder. See 3 Charles Alan Wright, Arthur R. Miller &amp; Mary Kay Kane, Federal Practice and Procedure: Civil § 1604 (2001). See also Tick v. Cohen, 787 F.2d 1490, 1493-94 (11th Cir.1986) ("Limitations on service of process, subject matter jurisdiction, and venue ... may bar joinder in some cases."); Potts v. Gordon, 34 Colo.App. 128, 134, 525 P.2d 500, 503-04 (1974), citing C. Wright &amp; A. Miller, Federal Practice and Procedure § 1604 ("Joinder is `feasible' under [Rule 19, Colo.R.Civ.P., substantially similar to Rule 19, Ala.R.Civ.P] as long as the absentee is subject to service of process; his joinder will not deprive the court of jurisdiction; and he has no valid objection to venue of the court."). In this case, the record is devoid of information sufficient to inform us as to the feasibility of joinder of the affected Liberty National policyholders. Accordingly, the trial court would have to conduct further proceedings to develop that information and make a finding as to the feasibility of joinder, before the issue would be ripe for appellate review.
Liberty National also contends that this Court cannot affirm the trial court's judgment based upon UAB's argument that Alabama law does not recognize a cause of action for prima facie tort. Liberty National describes its theory of prima facie tort as a tort theory designed to "ensure that no legitimately aggrieved party is denied justice because, by happenstance, its claim does not fall neatly within a traditionally recognized category of tort liability." (Liberty National's brief, p. 44.) Liberty National quotes the following formulation of the prima facie tort from the Restatement (Second) of Torts:"One who intentionally causes injury to another is subject to liability to the other for that injury, if his conduct is generally culpable and not justifiable under the circumstances. This liability may be imposed although the actor's conduct does not come within a traditional category of tort liability." Restatement (Second) of Torts § 870 (1977). Liberty National asserts that UAB's billing practice satisfies all of the characteristics of a prima facie tort of the sort recognized by a number of courts in other jurisdictions, as well as by the Restatement (Second) of Torts. Liberty National also argues, relying on our decision in Polytec, Inc. v. Utah Foam Products, *1025 439 So. 2d 683 (Ala.1983), that this Court, like the trial court, "need not and should not" address UAB's argument opposing its prima facie tort claim and "need not and should not" determine whether a cause of action for prima facie tort should be recognized under Alabama law.
In Polytec, the defendant appealed from the dismissal of two of the three counts in its counterclaim, and the plaintiff appealed from the refusal of the trial court to dismiss the third count. This Court declined to address the prima facie tort theory argued by the defendant/counterclaimant as one of several bases for overturning the dismissal of one count of the counterclaim because that count stated the cognizable tort of "wrongful interference with business." Any right to recover under a prima facie tort theory was deemed to "coincide[] more or less" with the business-interference theory. 439 So. 2d  at 689. This Court concluded that a discussion of whether a cause of action existed for prima facie tort would be "premature and unnecessary" because such a cause of action was not supported by precedent in this State and the business-interference claim was supported by "ample precedent." 439 So. 2d  at 690.
Liberty National likewise asserts a claim alleging interference with business, which UAB never moved to dismiss. In light of our holding in Polytec, the presence in the case of the alternative claim alleging business interference, and the early stage of this case, we do not determine whether a claim for prima facie tort should be a recognized cause of action in this State under the claims and factual underpinnings involved here.
Liberty National argues that the trial court's order of dismissal cannot be affirmed on the basis of UAB's contention relating to Ala.Code 1975, § 22-21-7. In its motion to dismiss, UAB asserted that § 22-21-7 neither created nor implied a private cause of action. "`One claiming a private right of action within a statutory scheme must show clear and convincing evidence of legislative intent to impose civil liability for a violation of the statute.' American Auto. Ins. Co. v. McDonald, 812 So. 2d 309, 311 (Ala.2001). C.B. v. Bobo, 659 So. 2d 98 (Ala.1995)." Blockbuster, Inc. v. White, 819 So. 2d 43, 44 (Ala.2001). Section 22-21-7 states, in pertinent part:
The statute contains no language suggesting that the Legislature intended to create a private cause of action for any violation of those provisions. The Legislature expressly reserved to the attorney general a cause of action for such violations, and Liberty National has presented no evidence to support the idea that § 22-21-7 creates or implies a private cause of action. American Auto Ins. Co., supra.[7] Accordingly, we conclude that Liberty National is not a party entitled to bring a private action for an alleged breach of § 22-21-7.
Liberty National further asserts that UAB's argument that UAB Hospital is protected by the doctrine of sovereign immunity does not provide a sufficient basis on which to affirm the trial court.
Larkins v. Department of Mental Health &amp; Mental Retardation, 806 So. 2d 358, 363-64 (Ala.2001).
Liberty National's complaint describes "University of Alabama at Birmingham" as "an affiliate of the University of Alabama" and UAB Hospital as "a division (and/or component) of the University of Alabama at Birmingham." As noted earlier, UAB represents that UAB Hospital is properly designated only as the "Board of Trustees of the University of Alabama for its Division, University Hospital." The University of Alabama is a State *1028 university. "This Court has held that the operation of a hospital by a state university falls within the realm of sovereign immunity. Hutchinson v. Board of Trustees of University of Alabama, 288 Ala. 20, 24, 256 So. 2d 281, 284 (1971)." Sarradett v. University of South Alabama Med. Ctr., 484 So. 2d 426, 426 (Ala.1986). Therefore, UAB Hospital is protected by the doctrine of sovereign immunity from Liberty National's claims against it.[8]
Although UAB asserts a sovereign-immunity barrier only on behalf of UAB Hospital, because subject-matter jurisdiction is implicated by that doctrine, Ex parte Alabama Dep't of Mental Health &amp; Retardation, 837 So. 2d 808, 811 (Ala.2002) (sovereign immunity is a jurisdictional bar that precludes a court from exercising subject-matter jurisdiction), we must consider whether the UAB Health Services Foundation and UAB Health System enjoy that immunity. "`The question of jurisdiction is always fundamental, and if there is an absence of jurisdiction over the person, or the subject matter, a court has no power to act....'" Mobile &amp; Gulf R.R. v. Crocker, 455 So. 2d 829, 831 (Ala.1984) (quoting Norton v. Liddell, 280 Ala. 353, 356, 194 So. 2d 514, 517 (1967), in turn citing Rinehart v. Reliance Life Ins. Co. of Georgia, 272 Ala. 93, 128 So. 2d 503 (1961)). See also Koppers C. v. Gulf Welding &amp; Constr. Inc., 285 Ala. 331, 231 So. 2d 896 (1970), and B.F. Goodrich Co. v. Parker, 282 Ala. 151, 209 So. 2d 647 (1967). "`[I]t is the duty of an appellate court to consider the lack of subject matter jurisdiction ex mero motu.'" Thompson v. Board of Pardons &amp; Paroles, 806 So. 2d 374, 375 (Ala.2001), quoting Ex parte Smith, 438 So. 2d 766, 768 (Ala.1983). The Health Services Foundation is a nonprofit, independent professional corporation that, in part, attends to the billing for UAB Hospital. See University of Alabama Health Servs. Found., P.C. v. Bush, 638 So. 2d 794, 798 (Ala.1994), and Wendy's Int'l, Inc. v. City of Birmingham, 868 F.2d 433, 434 (11th Cir.1989). The complaint, the parties submissions to the trial court, and the briefs submitted to this Court do not state what type of entity UAB Health System is or the purpose it serves. Accordingly, we conclude that because the Health Services Foundation and the UAB Health System are entities separate and distinct from UAB Hospital and have not been shown to qualify for sovereign immunity, they are not protected by that doctrine.
In summation, we conclude that under the facts and arguments presented there could not exist a possible situation in which Liberty National might show an injury to a legally protected right sufficient to provide the necessary standing to bring its claims, other than its claims dependent on a private cause of action for a violation of § 22-21-7, Ala.Code 1975. We also conclude, however, that § 22-21-7 neither creates nor implies a private cause of action. We conclude that resolution of the issue *1029 whether this Court should recognize a cause of action for prima facie tort would be premature and unnecessary. We determine that Liberty National policyholders within the stated group are "necessary parties" to this action and it is for the trial court to determine whether their joinder will be feasible pursuant to Rule 19 Ala.R.Civ.P. We conclude that UAB Hospital is protected by the doctrine of sovereign immunity from Liberty National's claims against it but that the Health Services Foundation and the UAB Health System are not so protected.
For the forgoing reasons, the judgment of the trial court is affirmed in part and reversed in part and the case remanded for further proceedings consistent with this opinion.
AFFIRMED IN PART; REVERSED IN PART; AND REMANDED.
HOUSTON, LYONS, BROWN, JOHNSTONE, WOODALL, and STUART, JJ., concur.
[1]  A "prima facie tort" is "[a]n unjustified, intentional infliction of harm on another person, resulting in damages, by one or more acts that would otherwise be lawful." Black's Law Dictionary 1497 (7th ed.1999).
[2]  Section 22-21-7 lists a variety of general billing requirements applicable to hospitals and other health-care facilities.
[3]  The record does not reveal the number of cancer policies Liberty National had outstanding that were not no dollar limit policies.
[4]  Liberty National and UAB have not entered into such an agreement.
[5]  Although we base our determination upon the conclusion that Liberty National's policyholders who are directly financially affected by its claims are necessary parties under Rule 19, we note that Liberty National suggests that all of its policyholders might be necessary parties. That is, Liberty National states in its complaint that as a result of UAB's billing practice, Liberty National is forced to increase the premiums paid for existing cancer policies by all policyholders, which often leads to some policyholders allowing their policies to lapse, thereby causing them to forgo any potential benefit from the premiums they have previously paid.
[6]  UAB asserted in its motion to dismiss that neither the UAB Health Services Foundation nor the UAB Health System could be designated a hospital or a nursing home.
[7]  Liberty National also presents a negligence-per-se argument on the basis that the class § 22-21-7 was enacted to protect includes health insurers. However, because we have concluded that that statute does not create or imply a private cause of action, we need not address that assertion.
[8]  As to UAB's sovereign-immunity argument, Liberty National asserts that such immunity does not protect the State from the following, all of which Liberty National contends it is seeking as relief from this Court: (1) "[a]ctions brought to compel State officials to perform their legal duties"; (2) "[a]ctions to compel state officials to perform ministerial acts"; or (3) "[a]ctions brought under the Declaratory Judgments Act, ... seeking construction of a statute and how it should be applied in a given situation." Patterson v. Gladwin Corp., 835 So. 2d 137, 142 (Ala.2002). Liberty National states that it seeks to compel UAB to perform ministerial acts, which "constitute `legal duties'" to be truthful in compliance with § 22-21-7. Additionally, the declaratory relief Liberty National seeks is solely a construction of § 22-21-7 and a determination of how it should be applied in this case. Because we have concluded that § 22-21-7 neither creates nor implies a private cause of action, the exceptions to the doctrine of sovereign immunity do not come into play.