Court Opinion

ID: 9784591
Source: CourtListenerOpinion
Date Created: 2023-08-30 20:49:03.163552+00
Date Added: 2024-06-11T07:35:56.619958
License: Public Domain

KAREN KING MITCHELL, Judge.
Appellant Marvin’s Midtown Chiropractic (“Marvin’s” or “the appellant”) argues, and the majority agrees, that Marvin’s has statutory authority2 to assert hospital liens because section 430.225 grants it the light to do so without requiring that it be supported by charity. Because the plain language reading of section 430.225 leads to the opposite result and because the majority’s reading of section 430.225 renders section 430.230 meaningless or, in the alternative, it grants clinics, health practitioners, and other health care institutions significantly greater rights to enforce liens than hospitals, and because it is not clear to me that the legislature intended either result, I respectfully dissent.
Section 430.230 provides:
Every public hospital or clinic, and every privately maintained hospital, clinic or other institution for the care of the sick, which is supported in whole or in *839part by charity, located within the state of Missouri, or any such hospital duly incorporated under the laws of Missouri providing for the incorporation of eleemosynary institutions, shall have a lien upon any and all claims, counterclaims, demands, suits, or rights of action of any person admitted to any hospital, clinic or other institution and receiving treatment, care or maintenance therein for any cause including any personal injury sustained by such person as the result of the negligence or wrongful act of another, which such injured person may have, assert or maintain against the person or persons causing such injury for damages on account of such injury, for the cost of such services....
To facilitate hospitals’ recovery of the value of their services, the statute allows certain health care providers to assert liens against any personal injury claim that a care-recipient may have. SSM Cardinal Glennon Children’s Hosp. v. State, 68 S.W.3d 412, 414 (Mo. banc 2002); §§ 430.230-430.250. However, the right to assert a lien under section 430.230 does not exist unless the health care provider is located in Missouri and falls into one of three categories: (1) a “public hospital or clinic”; (2) a “privately maintained hospital, clinic or other institution for the care of the sick, which is supported in whole or in part by charity”; or (3) a “hospital duly incorporated under the laws of Missouri providing for the incorporation of eleemosynary institutions.” § 430.230.
In 2003, the General Assembly enacted section 430.225. It provides:
2. Clinics, health practitioners and other institutions, as defined in this section, shall have the same rights granted to hospitals in sections 430.230 to 430.250.
§ 430.225.2. Section 430.225.1 defines “clinics, health practitioners and other institutions” as follows:
(2) “Clinic”, a group practice of health practitioners or a sole practice of a health practitioner who has incorporated his or her practice;
(3) “Health practitioner”, a chiropractor licensed pursuant to chapter 331, a podiatrist licensed pursuant to chapter 330, a dentist licensed pursuant to chapter 332, a physical therapist licensed under chapter 334, a physician or surgeon licensed pursuant to chapter 334, or an optometrist licensed pursuant to chapter 336, while acting within the scope of their practice;
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(5) “Other institution”, a legal entity existing pursuant to the laws of this state which delivers treatment, care or maintenance to patients who are sick or injured.
Thus, when the definitions of subsection 430.225.1 are applied to subsection 430.225.2, it becomes evident that all health care providers in Missouri have the “same rights granted to hospitals in section[ ] 430.230.” The issue presented here is whether the rights granted by section 430.225 are preconditioned on the health care provider being a public or charitable institution, as the rights given by section 430.230 are.
The primary rule of statutory interpretation is to ascertain the intent of the legislature by considering the plain and ordinary meaning of the words used in the statute. S. Metro. Fire Prat. Dist. v. City of Lee’s Summit, 278 S.W.3d 659, 666 (Mo. banc 2009). A court will apply rules of construction only when the meaning of the words of the statute is ambiguous or leads to an illogical result defeating the purpose of the legislation. Baldwin v. Dir. of Rev., 38 S.W.3d 401, 405 (Mo. banc 2001). If possible, we will avoid a construction that renders statutory language redundant. In *840re Estate of Hough, 457 S.W.2d 687, 692 (Mo.1970). We will avoid a construction that leads to an absurd result. Anderson v. Ken Kauffman & Sons Excavating, L.L.C., 248 S.W.3d 101, 109 (Mo.App. W.D.2008).
Here, the plain and ordinary meaning of “same rights granted to hospitals in section[ ] 430.230” is not ambiguous. “Same rights” means that, under section 430.225, health care providers have rights that do not differ from the rights that hospitals have under section 430.230. As explained, the rights granted by section 430.230 only exist if the institution is public or charitable. Marvin’s is neither: therefore, under the plain language of the statutes, it has no right to assert a lien. Granting a private, non-charitable institution rights when, under section 430.230, a private, non-charitable hospital would have none would not be granting the former institution the “same rights granted to hospitals in section[] 430.230.” It would be granting the former institutions different — and greater — rights, rights that are subject to fewer qualifications. Thus, applying the majority’s reading of section 430.225 would contravene the plain meaning of “same rights,” and therefore I would reject such a reading.3
Marvin’s argues that, under section 430.230, hospitals have a right to assert liens but that right is limited in that, in order to assert the lien, a hospital must be public, charitable, or supported by charity. Following that characterization, Marvin’s argues, and the majority agrees, that section 430.225’s “same rights” language imports the rights of section 430.230 but not the statute’s limitations. I disagree with this characterization of section 430.230, and, since the premise of the argument fails, I would reject the conclusion that Marvin’s and the majority draw from it.
The statute does not state that all hospitals have the right to assert a lien but that the right is limited by the public-charitable qualification; rather, it is the public or charitable nature of the hospital that gives rise to the right in the first place. “Every public hospital or clinic, and every privately maintained hospital, clinic or other institution ... which is supported in whole or in part by charity ... shall have a lien ....”§ 430.230 (emphasis added). By the plain terms of the statute, hospitals do not have a default right to assert a lien which a public-charitable “limitation” takes away: the right to the lien simply does not exist unless the hospital is public or charitable. Under this lens, the majority’s conclusion that Marvin’s and other clinics, health practitioners and health care institutions have the rights but not the limitations of section 430.230 would fail. Marvin’s has the “same right” given to a hospital by section 430.230. Any right to a lien granted by that section owes its existence to the public or charitable nature of the institution asserting the lien. Since Marvin’s is neither public nor charitable, it has no statutory authority to assert a lien, unless we construe “same right” to mean “different right,” which I would not do. It is not a matter of Marvin’s right being limited: it is a matter of such a right existing, which, as explained, it does not.
Furthermore, the majority opinion implies the grant of a right to assert a lien without the requirement that clinics and health practitioners be located in Missouri. See § 430.230 (“Every public hospital or *841clinic, and every privately maintained hospital, clinic or other institution for the care of the sick, which is supported in whole or in part by charity, located within the state of Missouri (emphasis added). The majority provides no explanation why the legislature would require, as a prerequisite to asserting a lien, “hospitals” to be located in Missouri, see § 430.230, and “other institutions” to at least be incorporated in Missouri, see § 430.225.1(5), while removing any such requirement for “clinics” and “health practitioners.” Thus, the majority’s reading of the statute leads to at least an odd, if not absurd, result.
The majority accepts the appellant’s argument that, unless its reading of the statute is adopted, section 430.225 will be rendered meaningless in that virtually no health practitioners draw any support from charities. But there is no evidence before us that the appellant’s claim on this point is accurate. And even if the claim is accurate, it is not absurd to suppose that, in enacting section 430.225, the legislature intended to encourage charitable activity or reward those health practitioners that currently receive charitable support, even if they are few. That is, section 430.225 may create an incentive for health practitioners to engage in the type of activities likely to draw support from charities. Such a statute is not meaningless.
The majority argues that my reading of section 430.225 creates a “partial[ ] redundancy] to section 430.230, which already provides hospital liens to privately maintained clinics and other institutions supported in whole or in part by charity.” Section 430.225.2 gives clinics, health practitioners, and other institutions all the rights hospitals have under sections 430.230-250. It is true that section 430.230 already covers “clinics” and “other institutions” but section 430.250 does not. The latter section gives hospitals (but not clinics or other institutions) the right to recover from law firms, insurance carriers, or other persons who have (1) received notice of a valid lien; and (2) paid the patient the money owed to the hospital. Thus, section 430.225.2 is not redundant with respect to clinics and other institutions because, absent that section, they would not share the right to recover under section 430.250.
Moreover, granting that my reading of the statutes creates a partial redundancy in that clinics and other institutions are given the same qualified right to assert liens under both section 430.225.2 and section 430.230,4 a redundancy would also flow from the majority’s reading of the statute. Under the majority’s reading of section 430.225.2, section 430.230 will be rendered largely redundant in that none of the preconditions to asserting a hospital lien will have any meaning. That is, that hospitals are themselves “other institutions” as defined by section 430.225.1, and, therefore, under the majority’s reading, hospitals (and, indeed, all health care providers) *842would be exempted from the eligibility requirements that section 430.280 takes great pains to lay out.5 If the legislature had wanted to dispense with the public-charitable precondition entirely, it could have easily amended section 430.230 to so provide, as opposed to enacting a separate section to dispense with the requirement by implication.6
To avoid this partial redundancy created to the majority’s interpretation of section 430.225, “other institutions” must be read narrowly to exclude hospitals. But “hospital” is not defined by section 430.225, and the definition of “other institutions” set out in that section is clearly broad enough to include hospitals. Excluding hospitals from the definition of “other institutions,” in combination with the majority’s interpretation of section 430.225, means that, with the exception of certain private hospitals (including those located in Missouri), all health care providers (even clinics and health practitioners located outside of Missouri) have the right to assert liens. This interpretation of the interplay between sections 430.225 and 430.230, turns on its head the approach to health care liens that existed before the 2003 amendment. That is, before 2003, hospitals were favored over other health care providers in that they were given a greater right to obtain liens. To avoid the majority opinion rendering section 430.230 completely meaningless, hospitals would have to be excluded from the definition of “other institutions” under section 430.225 and thus be granted more restrictive lien rights than all other health care providers. It is not clear to me that the legislature intended this anomalous result.
Conclusion
Section 430.230 gives hospitals a qualified right to assert a lien. It is my view that section 430.225.2 grants all health care providers the same qualified right that hospitals have under section 430.230. The majority holds that section 430.225.2 grants all health care providers (with the possible exception of hospitals) an unqualified right to assert a lien, or a right that is qualified in some, but not all, of the ways that section 430.230’s right is qualified, and thus holds that “same right” means “different right.” I would not apply a construction that rejects the plain meaning of the statute’s language and leads to inevitable anomalies.
The interplay between sections 430.225 and 430.230 is confusing. Even with the guidance provided by the majority opinion, there are questions left unanswered: for example, are hospitals “other institutions” that enjoy an unqualified right to a lien under section 430.225 provided to other health care providers by the majority opinion, or do they enjoy only the qualified lien rights provided in section 430.230? I respectfully suggest that the legislature revisit sections 430.225 and 430.230 to clarify how these two sections are to be read together.

. Marvin’s concedes that, in this case, its authority to assert a lien exists, if at all, by virtue of section 430.225. In other words, it does not allege that the liens were established by agreement. Cf. Marvin’s Midtown Chiropractic Clinic, L.L.C. v. State Farm Mut. Auto. Ins. Co., 142 S.W.3d 751, 755 (Mo.App. W.D.2004).

. Seen another way, Marvin's argument essentially reads section 430.225 as giving it the "same rights granted to public or charitable hospitals in section 430.230." But that is not what the statute says — it grants Marvin's the “same rights” as "hospitals," and “hospitals" may only assert liens under sections 430.230 to 430.250 if they meet specific eligibility criteria.

. This redundancy may be more apparent than real. Prior to the adoption of section 430.225, the prevailing understanding of the Hospital Lien Law was apparently that it provided lien rights solely to hospitals, despite the other entities referenced in section 430.230. See SSM Cardinal Glennon, 68 S.W.3d at 417 (referring to hospitals as "previously the sole beneficiaries of the hospital lien law”); Glenn E. Bradford, Missouri’s Hospital Lien Statute, 59 Mo. Bar J. 22, 26 (2003) (observing that, in opposing the enactment of section 430.225, "[i]t appears that Missouri hospitals are anxious to keep the advantage of the hospital lien solely for themselves”). At a minimum, prior to the adoption of section 430.225 it was not clear that "clinics” or "other institutions” could include establishments providing dental, chiropractic, optometry, or other services now comprehended within the statute by virtue of the broad definition of "health practitioner” in section 430.225.1(3).

. Section 430.235 also takes great pains to lay out the eligibility requirements.

. Such repeals by implication are not favored. See, e.g., Turner v. School Dist. of Clayton, 318 S.W.3d 660, 667 (Mo. banc 2010).