Opinion ID: 2798730
Heading Depth: 2
Heading Rank: 1

Heading: One or more members of a class may sue or be sued as

Text: representative parties on behalf of all, only if: (1) The class is so numerous that joinder of all members is impracticable. (2) There are questions of law or fact common to the class. (3) The claims or defenses of the representative parties are typical of the claims or defenses of the class. (4) The representative parties will fairly and adequately protect the interests of the class. (5) The class is or may be defined objectively in terms of ascertainable criteria, such that the court may determine the constituency of the class for purposes of the conclusiveness of any judgment that may be rendered in the case. This prerequisite shall not be satisfied if it is necessary for the court 12 to inquire into the merits of each potential class member's cause of action to determine whether an individual falls within the defined class. Once these five prerequisites have been met, La. Code Civ. Proc. art. 591(B) lists three additional criteria, one of which must also be satisfied for certification depending on the type of class action sought. Here, the parties submit the additional requirement that must be met for certification is set forth in La. Code Civ. Proc. art. 591(B)(3), which provides: (3) The court finds that the questions of law or fact common to the members of the class predominate over any questions affecting only individual members, and that a class action is superior to other available methods for the fair and efficient adjudication of the controversy. The matters pertinent to these findings include: (a) The interest of the members of the class in individually controlling the prosecution or defense of separate actions; (b) The extent and nature of any litigation concerning the controversy already commenced by or against members of the class; (c) The desirability or undesirability of concentrating the litigation in the particular forum; (d) The difficulties likely to be encountered in the management of a class action; (e) The practical ability of individual class members to pursue their claims without class certification; (f) The extent to which the relief plausibly demanded on behalf of or against the class, including the vindication of such public policies or legal rights as may be implicated, justifies the costs and burdens of class litigation. The Legislature has specifically provided, emphasizing the commonality and predominance requirements, that class ―[c]ertification shall not be for the purpose of adjudicating claims or defenses dependent for their resolution on proof individual to a member of the class.‖ La. Code. Civ. Proc. art. 591(C); see also Ford, 703 So.2d at 549 (former La. Code Civ. Proc. art. 593.1(C) prohibits class certification when too many individual liability issues exist that could not be tried separately). Nevertheless, where certification is maintained, ―the court shall retain jurisdiction over claims or defenses dependent for their resolution on proof 13 individual to a member of the class.‖ La. Code Civ. Proc. art. 591(C). Thus, ―the mere fact that varying degrees of damages may result from the same factual transaction and same legal relationship or that class members must individually prove their right to recover does not preclude class certification.‖ Bartlett v. Browning-Ferris Industries Chemical Services, Inc., 99-0494 (La. 11/12/99), 759 So.2d 755, 756. The burden of establishing the statutory criteria have been satisfied falls on the party seeking to maintain the class action. Dupree, 09-2602 at p. 10, 51 So.3d at 682. Thus here, the plaintiffs were required to prove the five prerequisites of La. Code Civ. Proc. art. 591(A), namely numerosity, commonality, typicality, adequacy of the representative parties, and objectively definable class. Likewise, they were required to prove common questions of law or fact predominate over individual issues and the class action is superior to any other method for resolving the controversy fairly and efficiently under La. Code Civ. Proc. art. 591(B). Because the appellate court ruled solely on the superiority, or lack thereof, of the class action to resolve the common question regarding the legality of Minden‘s lien practices under the Balance Billing Act, we begin our review by addressing this criteria. However, to properly do so, we find it necessary to first review our holding in Anderson from which these recent class actions arise. In Anderson, this Court was asked to determine whether an individual plaintiff is afforded a private right of action under the Balance Billing Act. Similar to our plaintiffs herein, the plaintiff in Anderson alleged she was injured in an automobile accident caused by a third party, after which she received medical treatment at an Ochsner facility. Although Anderson was insured by UnitedHealthcare and presented proof of insurance, Ochsner refused to file a claim 14 with her insurer. Instead, Ochsner sent a letter to her attorney, asserting a medical lien for the full amount of undiscounted charges. Thereafter, Anderson filed a putative class action against Ochsner, seeking, among other remedies, damages arising from Ochsner‘s billing practices and claiming Ochsner‘s actions violated the Balance Billing Act. In response, Ochsner filed a motion for summary judgment, arguing no private right of action exists under the Balance Billing Act. The trial court denied Ochsner‘s motion for summary judgment, and the appellate court denied writs. Anderson v. Ochsner Health System, 13-798 (La. App. 5 Cir. 11/21/13), __ So.3d __. After examining the relevant statutes, we found Ochsner‘s act of sending a lien letter to Anderson‘s attorney constituted ―maintaining an action at law.‖ Anderson, 13-2970 at p. 11. Specifically, we reasoned La. Rev. Stat. § 9:4752 authorizes health care providers to recover ―reasonable charges or fees‖ from third party tortfeasors through the use of ―medical liens,‖ providing: A health care provider … that furnishes services or supplies to any injured person shall have a privilege for the reasonable charges or fees … on the net amount payable to the injured person … out of the total amount of any recovery or sum had, collected, or to be collected, whether by judgment or by settlement or compromise, from another person on account of such injuries, and on the net amount payable by any insurance company under any contract providing for indemnity or compensation to the injured person…. La. Rev. Stat. § 9:4752. Pursuant to La. Rev. Stat. § 9:4753(A), the liens become effective ―if, prior to the payment of insurance proceeds, or to the payment of any judgment, settlement, or compromise on account of injuries, a written notice ... is delivered by certified mail, return receipt requested, or by facsimile transmission with proof of receipt of transmission by the interested health care provider ...‖ to the ―injured person....‖ Because La. Rev. Stat. § 9:4754 then makes anyone who interferes with the privilege liable for the amount of the privilege, we found a lien 15 in this context operates automatically as a matter of law with legal consequences attaching when the lien is ignored, and thus, its use constituted an action at law. Anderson, 13-2970 at p. 11. Having found an action at law existed, we then turned to the language in the Balance Billing Act granting a right to sue: No contracted health care provider may maintain any action at law against an enrollee or insured for a health insurance issuer liability or for payment of any amount in excess of the contracted reimbursement rate for such services. In the event of such an action, the prevailing party shall be entitled to recover all costs incurred, including reasonable attorney fees and court costs…. La. Rev. Stat. § 22:1874(B). Concluding the explicit right to recover ―all costs incurred‖ inclusive of attorney fees and court costs was a clear recognition that a private cause of action is available, we found: Anderson is expressly given a private right of action under these facts by virtue of La. R.S. 22:1874(B). Having found an express right of action affording Anderson an avenue for recourse, we purposefully extend our holding to find an implied right of action as well. In so doing, we are cognizant that offenders may interpret a limited holding to mean that other methods of demanding payment from insured patients are allowed under the Balance Billing Act. We intentionally address and forego that possibility. Anderson, 13-2970 at p. 11. Though numerous actions similar to Anderson‘s and plaintiffs‘ herein have recently been filed, the Second Circuit viewed the lack of any jurisprudence ―whatsoever‖ in regard to the actual merits of a claim brought under the Balance Billing Act as an insurmountable obstacle. The Third Circuit, however, has taken a completely contrary view, in their own words, ―respectfully disagree[ing] with the second circuit‘s assertion that ‗novel and untested legal theories‘ are involved in the determination of whether a billing practice violates La. R.S. 22:1874.‖ Vallere, 14-261 at p. 8, 151 So.3d at 989. 16 In Vallere, an insured, just like our plaintiffs here, sought class certification against the hospital where she was treated for injuries sustained in an automobile accident, alleging that hospital‘s lien practice also violated the Balance Billing Act. After the trial court certified the class, the defendants challenged the certification on appeal by advancing the novel and untested argument relied upon by the Second Circuit. However, the Third Circuit summarily rejected the claim in light of its previous decision in Desselle upon which the trial court in this case relied. Vallare, 14-261 at p. 8, 151 So.3d at 989-90. Interestingly, the Desselle plaintiffs were also insureds who brought a class action under the Balance Billing Act, challenging the lien/billing practices of the health care provider that rendered them assistance following their automobile accidents—Acadian Ambulance. The Third Circuit affirmed certification of the class therein, Deselle, 11-742 at p. 14, 83 So.3d at 1253, and this Court denied writs two years before we rendered our decision in Anderson. Deselle v. Acadian Ambulance Service, Inc., 12-518 (La. 4/13/12), 85 So.3d 1253. This along with Baker’s recognition that ―plaintiffs have armed themselves with [Anderson’s] language and have brought lawsuits all across this State against hospitals such as [Minden], alleging violations under the Act,‖ led the Vallare court to conclude the issue is hardly novel. Vallare, 14-261 at p. 8, 151 So.3d at 989-90 (quoting Baker, 49,122 at p. 13, 146 So.3d at 928). We agree. Clearly, Anderson held insureds in these circumstances have a direct action against their health care providers under the Balance Billing Act for ―all costs incurred.‖ Anderson, 13-2970 at p. 11. More importantly, though, we note with significance class action certification is purely procedural. What is of primary concern in the certification proceeding is simply whether the plaintiffs have met the statutory requirements to become a class action, not the merits of the 17 underlying litigation. Eisen, supra; see also supra note 2. It is the Second Circuit‘s focus upon the merits of the common issue that ultimately led it into legal error and resulted in its inappropriate analysis. Rather, a court‘s focus on review must be on the requirements and whether the evidence establishes the procedural device is appropriate. As to the superiority requirement, the record shows there is little proof on liability or causation necessary in this case individual to each plaintiff. Their claims do not require highly individualized inquiries into the cause of the damages. The alleged damages were caused by Minden‘s acting pursuant to its collection policy and procedure. The eventual question for the factfinder is whether or not Minden‘s actions violated the Balance Billing Act. Once the factfinder determines Minden‘s actions pursuant to its collection policy did or did not violate the Balance Billing Act, liability and causation for all class members is decided. Thus, this case fundamentally revolves around the interplay of Minden‘s collection policy with the Balance Billing Act, the resolution of which will be conclusive to all. If the court eventually resolves this single, paramount issue in plaintiffs‘ favor, the remaining issues individual to class members relate to the calculation of damages. It is only then the court will need to determine what damages are awardable under the Balance Billing Act. If the court resolves the paramount issue in defendant‘s favor, any question regarding damages will be rendered moot. Moreover, there is no indication the consideration of the billing issue, particular to the plaintiffs, would require individual trials or be unduly burdensome. To the contrary, the evidence shows many claims may be small or nominal in nature, rendering individual actions financially impractical, if not impossible. Accordingly, we find the evidence does reasonably show the class action is the superior method for adjudication as the common question herein 18 would be most efficiently answered in the context of a class action suit. We therefore find the trial court did not manifestly err in its findings as to this issue. Likewise, we find no error in its factual findings on the remaining five prerequisites—numerosity, commonality, typicality, adequacy of representation, and definability. Numerosity The first requirement for class certification, often referred to as ―numerosity,‖ is determined based upon the facts and circumstances of each individual case. This requirement reflects the basic function of the class action as a device for allowing a small number of persons to protect or enforce rights or claims for the benefit of many where it would be inequitable and impracticable to join every person sharing an interest in the rights or claims at issue in the suit. Kent A. Lambert, ―Certification of Class Actions in Louisiana,‖ 58 La.L.Rev. 1085, 1114 (Summer 1998). There is no set number above which a class is automatically considered so numerous as to make joinder impractical as a matter of law. Dumas v. Angus Chemical Co., 25,632 (La. App. 2 Cir. 3/30/94), 635 So.2d 446, 450, writ denied, 94-1120 (La. 6/24/94), 640 So.2d 1349; O’Halleron v. L.E.C., Inc., 471 So.2d 752, 755 (La. App. 1st Cir. 1985). Likewise, the numerosity element may not be met by simply alleging a large number of potential claimants exist. Boyd v. Allied Signal, Inc., 03-1840, pp. 11-12 (La. App. 1 Cir. 12/30/04), 898 So.2d 450, 457, writ denied, 05-0191 (La. 4/1/05), 897 So.2d 606. While the determination of numerosity is in part based upon the number of putative class members, it is also based upon considerations of judicial economy in avoiding a multiplicity of lawsuits, financial resources of class members, and the size of the individual claim. Davis v. American Home Products Corp., 02-0942, p. 19 (La. App. 4 Cir. 3/26/03), 19 844 So.2d 242, 257, writ denied, 03-1180 (La. 6/27/03), 847 So.2d 1279. Ultimately, to meet this requirement, the plaintiff must show joinder is impractical, but, at the same time, there is a definable group of aggrieved persons. Dumas, 635 So.2d at 450. Grace Askew, Minden‘s representative, testified Minden subjected the liability accident billing procedure to well over 100 patients during the relevant time period of 2004-2011. She further indicated, given proper parameters, the hospital‘s computerized billing system could provide a list of patients who fit the class definition. Although Minden argues plaintiffs did not introduce any evidence the scenario encountered by each of the three named plaintiffs occurred more than 100 times, we agree with the trial court a sufficient number of potential class members exist so as to make joinder impracticable, and given many of the claims may be small or nominal in nature, we likewise find the numerosity element has been satisfied. Commonality The commonality prerequisite requires a party seeking class certification to show that ―[t]here are questions of law or fact common to the class.‖ La. Code Civ. Proc. art. 591(A)(2). However, the mere existence of common questions alone will not satisfy the commonality requirement. Price v. Martin, 11-853, p. 10 (La. 12/6/11), 79 So.3d 960, 969. Rather, plaintiffs seeking to satisfy this requirement must demonstrate their ―claims depend on a common contention, and that common contention must be one capable of class-wide resolution—one where the ‗determination of its truth or falsity will resolve an issue that is central to the validity of each one of the claims in one stroke.‘‖ Id. (quoting Wal-Mart Stores, Inc. v. Dukes, 131 S.Ct. 2541 (2011). 20 The record is fairly straightforward in a factual sense as to this prerequisite and again reasonably supports the trial court‘s finding. Each plaintiff in the instant case will have been injured in an automobile accident and will have received treatment at Minden. Each will be covered by a health insurance policy issued by a health insurance provider with whom Minden was a contracted health care provider. As to each patient, Minden will have determined a third party was at fault in the accident, and pursuant to its collection policy, Minden will have pursued payment at a rate exceeding the contracted rate with the health insurer. Notwithstanding, the plaintiffs responded to the demand differently, each claim shares a common issue that is central to the validity of all the claims: whether Minden‘s collection policy violates the Balance Billing Act. Accordingly, the record reasonably supports the trial court‘s finding plaintiffs met the commonality burden. Typicality The third element is whether the claims or defenses of the representative parties are typical of the claims or defenses of the class. La. Code Civ. Proc. art. 591(A)(3). This element determines whether a sufficient relationship exists between the injury to the named plaintiff and the conduct affecting the class, so that the court may properly attribute a collective nature to the challenged conduct. Lambert, supra, at 1094. A plaintiff‘s claim is typical if it rises out of the same event, practice, or course of conduct giving rise to the claims of the other class members and those claims arise from the same legal theory. Id.; Deselle, 11-742 at p. 9, 83 So.3d at 1251. Although Minden argued the testimony of the named plaintiffs shows it did not act uniformly as to all patients and that plaintiffs are insured by different insurers with different agreements with the hospital, Minden‘s representative 21 testified the complained-of procedure was uniform across-the-board from 2000 to 2011. Her testimony does reasonably support both the trial court‘s belief the hospital consistently applied this collection policy to all patients involved in automobile accidents wherein a third party was found to be at fault and its finding the typicality element was satisfied. Adequacy of Representation The fourth element plaintiffs must establish is whether the representative parties will fairly and adequately protect the interest of the class. The following are ―factors which may be relevant‖ to this inquiry: (1) The representative must be able to demonstrate that he or she suffered an actual-vis-à-vis hypothetical-injury; (2) The representative should possess first hand knowledge or experience of the conduct at issue in the litigation; (3) The representative‘s stake in the litigation, that is, the substantiality of his or her interest in winning the lawsuit, should be significant enough, relative to that of other class members, to ensure that representative's conscientious participation in the litigation; and (4) The representative should not have interests seriously antagonistic to or in direct conflict with those of other class members, whether because the representative is subject to unique defenses or additional claims against him or her, or where the representative is seeking special or additional relief. Lambert, supra, at 1117; Howard v. Willis-Knighton Medical Center, 40,634, pp. 36-37 (La. App. 2 Cir. 3/8/06), 924 So.2d 1245, 1265, writ denied, 06-850 (La. 6/14/06), 929 So.2d 1268; see also Desselle, 11-742 at p. 10, 83 So.3d at 1251 (three prong test consists of (1) the absence of conflicting or antagonistic claims between the representatives and other class members; (2) the representatives‘ sufficient interest in the outcome to insure vigorous advocacy; and (3) competent, experienced, and qualified counsel). 22 The trial court concluded it is Minden‘s collection policy, not necessarily the individual damages suffered as the result of this policy, that is at the center of this case. The evidence does show all the plaintiffs have an interest in the outcome as they have been subjected to the same collection policies giving rise to this suit and have testified they are dedicated to the prosecution of this case. In the absence of conflicting or antagonistic claims between the representatives and the putative class members, we agree with the trial court the named plaintiffs adequately represent the class. Definability Under the final requirement, plaintiffs must show the class is or may be defined objectively in terms of ascertainable criteria, such that the court may determine the constituency of the class for purposes of the conclusiveness of any judgment rendered in the case. La. Code Civ. Proc. art. 591(A)(5). We find the trial court‘s definition clearly meets this requirement. Minden‘s own billing documents will serve in defining the class as these documents can be utilized to identify those insureds Minden has pursued under the complained-of collection policy. Accordingly, we find the trial court did not abuse its vast discretion in certifying the class.