Court Opinion

ID: 9747645
Source: CourtListenerOpinion
Date Created: 2023-08-27 15:25:33.896133+00
Date Added: 2024-06-11T07:25:25.216916
License: Public Domain

Judge FURMAN
concurring in part and dissenting in part.
I respectfully dissent from the portion of the majority's opinion that concludes the trial court erred in granting summary judgment in favor of the Board.
CCHI did not provide any facts to indicate the 2001 and 2008 rules adopted by the Board violated the "reasonable cost-based fee" requirements under HIPAA and Colorado's Patient Records Act (CPRA). CCHI relies instead on the implication that the 2001 and 2008 rules are ipso facto a violation of such "reasonable, cost-based fee" requirements because the Board did not conduct a cost study. Such reasoning is not logically valid.
The syllogism stating CCHI's position is as follows: If the Board bases the rule on a cost study, the rule satisfies the "reasonable, cost-*533based fee" requirements under HIPAA and CPRA. The Board did not base the rules on a cost study. The rules, therefore, do not satisfy HIPAA's and CPRA's "reasonable, cost-based fee" requirements. However, the truth of the conclusion-that the rules satisfy HIPAA and CPRA-cannot logically be ruled out by denying the truth of the assertion-that the Board did not base the rules on a cost study. See Crouse-Hinds Co. v. InterNorth, Inc., 634 F.2d 690, 702 n. 20 (2d Cir.1980) ("The proposition that 'A implies B' is not the equivalent of 'non-A implies non-B," and neither proposition follows logically from the other. The process of inferring one from the other is known as 'the fallacy of denying the antecedent.'"); see also D. Lind, Logic and Legal Reasoning 222, 248 (2007). Therefore, I respectfully conclude CCHI did not meet its burden of proving the rules invalid, and the Board was entitled to summary judgment. Accordingly, I would affirm the district court's grant of summary judgment in favor of the Board.
This case requires us to decipher the interplay of our review of an order granting summary judgment and our review of a challenge to an agency rule. I begin by doing so.
We review de novo the district court's grant of summary judgment. A.C. Excavating v. Yacht Club II Homeowners Ass'n, 114 P.3d 862, 865 (Colo.2005). "Summary judgment is appropriate when the pleadings and supporting documents clearly demonstrate that no issues of material fact exist and the moving party is entitled to judgment as a matter of law." Id. "[TJhe nonmoving party is entitled to the benefit of all favorable inferences reasonably drawn from the undisputed facts; all doubts must be resolved against the moving party." Brodeur v. Am. Home Assurance Co., 169 P.3d 139, 146 (Colo.2007).
The parties agree, as they did before the district court, that no issues of material fact exist. Accordingly, we may resolve the case based on the law which governs judicial review of agency rules. Section 24-4-106(11)(e), C.R.S.2009, provides that "[the standard for review as set forth in subsection (7) of this section shall apply to appeals brought under this subsection (11)."
Section 24-4-106(7), C.R.S8.2009, in turn, requires the reviewing court to hold an agency rule unlawful
[)f it finds that the ageney action is arbitrary or capricious, a denial of statutory right, contrary to constitutional right, power, privilege, or immunity, in excess of statutory jurisdiction, authority, purposes, or limitations, not in accord with the procedures or procedural limitations of this article or as otherwise required by law, an abuse or clearly unwarranted exercise of discretion, based upon findings of fact that are clearly erroneous on the whole record, unsupported by substantial evidence when the record is considered as a whole, or otherwise contrary to law.
However, "[rlules adopted by an agency are presumed to be valid. Any challenging party has a heavy burden to establish invalidity of the rule by demonstrating that the agency violated constitutional or statutory law, exceeded its authority, or lacked a basis in the record for the rule." Colo. Ground Water Comm'n v. Eagle Peak Farms, Ltd., 919 P.2d 212, 217 (Colo.1996) (citations omitted).
The district court granted the Board's motion for summary judgment because CCHI did not carry its burden of proving the rules' invalidity. The district court found:
[CCHI] asserts that the Board's adoption of the Amendments was contrary to State and Federal Law and should be declared void. Specifically, [CCHI] argues that in establishing the fees medical providers may charge individuals and their personal representative for copying medical records, the Board violated HIPAA's "cost-based" requirement by failing to utilize a cost study, and also that the Board wrongly permitted the ... recovery of costs for ancillary services for those making those photocopies. [The Board] responds that the Amendments were reasonable and lawful, therefore valid.
With respect to the adoption of the 2001 Amendment, the Board states that [HI-PAA] regulations concerning copy costs had been suspended by Executive Order and were not effective until April 2008. *534Moreover, [CCHI] has offered no substantial evidence of Board violation in the establishment of the 2001 copy costs. The Court agrees and finds that [CCHI] has not established that the Board acted in an unconstitutional manner, exceeded its authority or acted in a manner contrary to the statutory requirements.
As for the 2008 Amendment, the Board increased the cost of copying medical records charged to the representative of an individual, "other than a personal representative as defined in [HIPAA]." The Board contends that no changes were made to the cost of copying medical records for individuals or their personal representatives and therefore, the amended copy costs do not violate HIPAA. Moreover, even if HIPAA was implicated, the Board argues that it complied with its responsibility to promulgate rules interpreting the "reasonable-cost-based" requirement, by basing copy fees on a nation[al] average of states that also comply with [HIPAA]. Finally, the Board contends that State law only mandates that healthcare facilities provide a copy of ree-ords upon payment at a reasonable cost. C.R.S. § 25-1-801(1)(b)(I). The amended fee only applies to persons other than HI-PAA protected individuals and their personal representatives. The fact that the increased fees take into account ancillary costs do not make the charges unreasonable. The Court agrees and finds that [CCHI] has failed to demonstrate that HI-PAA applies to the 2008 Amendment, that the Board's fee-setting methodology is unreasonable, or that the Board acted outside its established authority.
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Based on the above, the Court hereby DENIES [CCHI's] Motion for Summary Judgment and GRANTS [the Board's] Cross-Motion for Summary Judgment.
Because the Board has no burden to prove the 2001 rules and the 2008 amendments valid, and CCHI did not provide any facts to indicate the result reached by the Board in adopting those rules violated HIPAA's or CPRA's "reasonable, cost-based fee" requirements, I would affirm the district court's granting of summary judgment in favor of the Board. See Colo. Ground Water, 919 P.2d at 217 ("challenging party has a heavy burden to establish invalidity of the rule"); A.C. Excavating, 114 P.3d at 865 ("Summary judgment is appropriate when the pleadings and supporting documents clearly demonstrate that no issues of material fact exist and the moving party is entitled to judgment as a matter of law.").
Moreover, the parties agree that CCHI's cost study was one option the Board could have used in promulgating its rules, but the Board did not consider this option because CCHI's proposal to the Board was untimely. However, the Board permitted CCHI to submit a timely proposal in the future. I conclude that is the better approach.