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Shahin v. Memorial Hermann Health System

Court of Appeals of Texas, First District

June 15, 2017

NATALIYA SHAHIN, Appellant
v.
MEMORIAL HERMANN HEALTH SYSTEM, Appellee

         On Appeal from the 333rd District Court Harris County, Texas Trial Court Case No. 2015-61950

          Panel consists of Justices Keyes, Higley, and Lloyd.

          OPINION

          Russell Lloyd Justice

         Nataliya Shahin, appellant, appeals the trial court's order granting Memorial Hermann Health System's plea to the jurisdiction which dismissed her claim for declaratory relief without prejudice. While the trial court did not specify any grounds in the order, appellee's plea to the jurisdiction argued that appellant's claim (1) was not ripe because the statement amount was subject to charitable discount or write-off, and (2) would not resolve any controversy between the parties because she asks only if appellee may charge reasonable rates under the contract, not whether her particular charges were unreasonable. Appellant argues: (1) her claim is ripe because appellee has already determined how much to charge her, and has declared the balance due under threat of collection efforts; and (2) a declaration would resolve a controversy, namely whether appellee may only charge a reasonable value for the medical treatment rather than charging based on its standard "Chargemaster" list price. We affirm.

         Background

         Appellant sought emergency medical care for chest pain from Memorial Hermann Memorial City Medical Center. Appellant is uninsured, and while she discussed payment options with appellee, they did not agree on a method of payment. In her admission paperwork she had assumed responsibility for payment of medical care provided to her, the bill for which totaled $5, 551.75. Appellant paid $300 towards the outstanding charges, but did not make any attempt to seek financial assistance, although such assistance was available.[1] Appellant made no further payments nor submitted any additional paperwork to appellee.

          Appellant's bill was based on appellee's Chargemaster rates, which is a list of services provided by the hospital with a predetermined charge for each service. Appellant filed a declaratory judgment action against appellee seeking a determination that she could only be charged "the reasonable value of the treatment [appellee] provides" and that the "Chargemaster" rates do not reflect the reasonable value of treatment because the hospital accepts lower rates of payment from some private and government insurers. Appellant sought class action certification for those patients who are charged for drugs and services under the Chargemaster rates, but who do not have their bills written off or reduced. Appellee moved to dismiss the case for lack of jurisdiction as the claim (1) was "not ripe" because the statement amount was subject to "charitable discount or full write-off, " and (2) the suit would not resolve any controversy between the parties because appellant asks only if appellee hospital may charge "'reasonable' rates for their medical services, " not whether her particular charges were unreasonable.

         At the hearing the parties and trial court examined the language included in appellant's bill. Appellant argued that the statement "has a due date, it has a balance due, and it has a threat that the account will be continued through collection efforts." In appellant's briefing, she pointed out the following language: "we are asking for payment in full'; 'PAY THIS AMOUNT: $5.251.75'; 'BALANCE DUE: $5.251.75'; 'DUE DATE: 10.9.15'; 'If no response is received, your account will continue through collection efforts.'" The trial court read into the record the following language from the bill:

THE COURT: . . . We offer a variety of payment options, as well as Financial Assistance. If you are unable to pay the balance in full at this time, please contact our office to discuss which options you may qualify for.

         Appellee informed the trial court that at the time of the hearing it had not tried to collect these funds from appellant. The trial court stated that it viewed the medical bill as too contingent to present a controversy that was ripe for adjudication because the medical statement offered options for reduction, and appellee had not immediately demanded payment.

         The trial court made no reference to appellee's second issue asserting that the declaratory judgment action would not adjudicate a controversy between the parties. While appellant sought a declaration that appellees should be required to charge only "reasonable rates, " she did not ask the trial court to determine whether or not the Chargemaster rates were reasonable. Appellee maintains that the rates are reasonable.

         The court's order did not specify any ground for its ruling, and appellant did not request findings of fact and conclusions of law. This appeal followed.

          A. Legal Principles

         A plea to the jurisdiction challenges the subject matter jurisdiction of the court. If the trial court does not have subject matter jurisdiction, the court does not have their authority to consider the matter. See Tex. Dep't of Transp. v. Jones, 8 S.W.3d 636, 638-39 (Tex. 1999). The trial court's ruling on a plea to the jurisdiction is a legal question and it is reviewed under a de novo standard of review. City of Hous. v. HS Tejas, Ltd., 305 S.W.3d 178, 183 (Tex. App.- Houston [1st Dist.] 2009, no pet.) (citing see Tex. Dep't of Parks & Wildlife v. Miranda, 133 S.W.3d 217, 226 (Tex. 2004)). It is the plaintiff's burden to allege facts that affirmatively establish the trial court's subject matter jurisdiction. Tex. Ass'n of Bus. v. Tex. Air Control Bd., 852 S.W.2d 440, 446 (Tex. 1993). In determining whether the plaintiff has met this burden, we look to the allegations in the plaintiff's pleadings, accept them as true, and construe them in favor of the ...


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