SHALEEN FOWLER, ET AL.
MORRISTOWN-HAMBLEN HOSPITAL ASSOCIATION, ET AL.
Session April 16, 2019
from the Circuit Court for Hamblen County No. 2016-CV-101
Thomas J. Wright, Judge.
plaintiffs, individually and as a proposed class action,
alleged violations of Tennessee Code Annotated section
68-11-262. The defendants asserted as a defense that
Tennessee Code Annotated section 1-3-119 precludes any
private right of action under section 68-11-262. Pursuant to
Rule 24.04 of the Tennessee Rules of Civil Procedure, the
plaintiffs submitted a notice of claim that the statute was
unconstitutional and violated Article I, section 17 of the
Tennessee Constitution. The State of Tennessee was allowed to
intervene in a limited capacity to defend the
constitutionality of that statute. In its consideration of
the motion to dismiss for failure to state a claim upon which
relief can be granted, the trial court held that the statute
did not violate the "Open Courts" Clause of Article
I, section 17. This holding necessitated a finding that
Tennessee Code Annotated section 68-11-262 did not give a
private right of action and, therefore, the plaintiffs did
not have a cause of action. Accordingly, the motion to
dismiss for failure to state a claim was granted and the
plaintiffs' complaint was dismissed with prejudice in its
entirety. The plaintiffs now appeal the finding that
Tennessee Code Annotated section 1-3-119 does not violate
Article I, section 17 of the Tennessee Constitution. The
defendants challenge the trial court's decision that
Plaintiffs fell within the meaning of "uninsured
patient" in Tennessee Code Annotated section 68-11-262.
We affirm the judgment of the trial court.
R. App. P. 3 Appeal as of Right; Judgment of the Circuit
Court Affirmed; Case Remanded
Braxton Terry, Morristown, Tennessee, and W. Lewis Jenkins,
Jr., Dyersburg, Tennessee, for the appellants, Shaleen Fowler
and Melissa Turner Livesay.
E. Koontz and Richard T. Klingler, Chattanooga, Tennessee,
and F. Michael Fitzpatrick, Knoxville, Tennessee, for the
appellees, Morristown-Hamblen Hospital Association and
Herbert H. Slatery, III, Attorney General and Reporter,
Andree Sophia Blumstein, Solicitor General, and Melissa
Broadhag, Senior Assistant Attorney General, for the
intervenor-appellee, State of Tennessee.
W. McClarty, J., delivered the opinion of the court, in which
D. Michael Swiney, C.J., and Richard H. Dinkins, J., joined.
W. MCCLARTY, JUDGE.
Shaleen Fowler ("Appellant Fowler") and Melissa
Turner Livesay ("Appellant Livesay") (collectively
"Appellants") were involved in unrelated automobile
accidents in 2014. Each of Appellants was treated at
Morristown-Hamblen County Healthcare
("Morristown-Hamblen") for their injuries. Covenant
Health ("Covenant") (collectively with
Morristown-Hamblen as "Appellees") performs all
billing and collection for patients who receive services at
Morristown-Hamblen. Each of Appellants was treated as an
"uninsured person" within the meaning of that term
in Tennessee Code Annotated section 68-11-262. They allege
that Appellees charged them in excess of the statutory rate
applicable to uninsured persons in violation of section
68-11-262, which provides in part as follows:
(a) Each healthcare facility licensed under this chapter
shall be prohibited from requiring an uninsured patient to
pay for services in an amount that exceeds one hundred
seventy-five percent (175 %) of the cost for the services
provided, calculated using the cost to charge ratio in the
most recent joint annual report.
(b) As used in this section, the following terms shall have
the meaning indicated:
(3) "Uninsured patient" means a person with no
public or private source of payment for medical services,
including, but not limited to, [M]edicare, TennCare, a
contract of insurance, an employer-sponsored health plan, or
other enforceable obligation under which a person is
responsible for payment for healthcare services provided to
the patient. . . .
Tenn. Code Ann. § 68-11-262.
response to Appellants' complaint in this matter,
Appellees filed a motion to dismiss for failure to state a
claim on which relief can be granted pursuant to Rule
12.02(6) of the Tennessee Rules of Civil Procedure. They
asserted, inter alia, that "(a) the
[Appellants] have failed to plead facts sufficient to bring
them within the scope of Tenn. Code Ann. § 68-11-262;
… (c) even if the [Appellants] are within the scope of
Tenn. Code Ann. § 68-11-262, there is no private right
for recovery under Tenn. Code Ann. § 68-11-262;
…." Appellants responded that the Tennessee Rules
of Civil Procedure only require a plaintiff asserting a
violation of a statute refer to the statute and that there is
no requirement to show detailed factual allegations a
plaintiff falls within the coverage of a statute. Appellants
further argued that there is an implied private right of
action in Tennessee Code Annotated section 68-11-262 because
uninsured persons are the direct and intended beneficiaries
of the statute pursuant to precedent set by our Supreme
Court. One of the central disagreements between
the parties at this point was whether recovery from tort
damages falls within the meaning of "payment for medical
services" under section 68-11-262. Appellees noted that
Appellants received settlements from the insurors of the
tortfeasors in their respective automobile accidents.
According to Appellees, a patient who has been injured by a
tortfeasor has an "enforceable obligation" under
which the tortfeasor is required to pay for medical services
rendered to a patient. Appellees argued that a person is
"uninsured" under section 68-11-262 only if there
is no source of payment for healthcare services.
Appellees' later claimed defense that Tennessee Code
Annotated section 1-3-119 precludes a private right of action
in this case, Appellants, pursuant to Rule 24.04 of the
Tennessee Rules of Civil Procedure, submitted a notice of
claim that section 1-3-119 is unconstitutional and violates
the Open Courts Clause in Article I, section 17 of the
Code Annotated section 1-3-119, passed by the legislature in
2012, provides as follows:
(a) In order for legislation enacted by the general assembly
to create or confer a private right of action, the
legislation must contain express language ...