Jackson HMA, LLC, et al. v. Miss. State Dep't of Health, et al.


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Docket Number: 2011-IA-00196-SCT
Linked Case(s): 2011-IA-00196-SCT

Supreme Court: Opinion Link
Opinion Date: 06-14-2012
Opinion Author: Lamar, J.
Holding: Affirmed

Additional Case Information: Topic: Certificate of need - Applicability of CON statutes - Section 41-7-173(p) - Definition of person - Covered health-care facilities - Section 41-7-191(4)(a)(vi) - Conflicting statutes - Section 37-115-23 - Obtaining needed equipment - Authority of MSDH - Section 41-7-187 - Section 41-7-191(1)(f) - Teaching exception - Section 109.03(3) of 2010 State Health Plan
Judge(s) Concurring: Waller, C.J., Carlson and Dickinson, P.JJ., Randolph, Kitchens, Chandler, Pierce and King, JJ.
Procedural History: Interlocutory Appeal
Nature of the Case: CIVIL - OTHER

Trial Court: Date of Trial Judgment: 01-19-2011
Appealed from: Hinds County Chancery Court
Judge: Patricia D. Wise
Disposition: Denied motions for summary judgment by Appellant and Appellee.
Case Number: G2010-1337 W/4
  Consolidated: 2011-IA-00211-SCT Board of Trustees of State Institutions of Higher Learning and University of Mississippi Medical Center v. Jackson HMA, LLC, Mississippi Baptist Medical Center, Inc. and St. Dominic Jackson Memorial Hospital; Hinds Chancery Court 1st District; LC Case #: G2010-1337 W/4; Ruling Date: 01/19/2011; Ruling Judge: Patricia Wise; Majority Opinion: Lamar, J.

Note: Motion to Strike Exhibits filed by Board of Trustees of State Institutions of Higher Learning and University of Mississippi Medical Center is granted.

  Party Name: Attorney Name:  
Appellant: Jackson HMA, LLC, Mississippi Baptist Medical Center, Inc. and St. Dominic - Jackson Memorial Hospital




THOMAS L. KIRKLAND, JR. ALLISON CARTER SIMPSON ANDY LOWRY R . ANDREW TAGGART JAMIE PLANCK MARTIN JENNA L. BAILEY EDMUND L. BRUNINI, JR. JONATHAN R. WERNE



 

Appellee: Mississippi State Department of Health, University of Mississippi Medical Center and Board of Trustees of State Institutions of Higher Learning OFFICE OF THE ATTORNEY GENERAL BY: HAROLD E. PIZZETTA, III BEA M. TOLSDORF ROBERT E. FAGAN, JR. DONNA BROWN JACOBS CHRISTY D. JONES PAUL N. DAVIS MARK W. GARRIGA JOHN THOMAS NEWSOME, III J. CAL MAYO, JR. KEYLA S. McCULLUM STEPHANIE R. JONES  

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Topic: Certificate of need - Applicability of CON statutes - Section 41-7-173(p) - Definition of person - Covered health-care facilities - Section 41-7-191(4)(a)(vi) - Conflicting statutes - Section 37-115-23 - Obtaining needed equipment - Authority of MSDH - Section 41-7-187 - Section 41-7-191(1)(f) - Teaching exception - Section 109.03(3) of 2010 State Health Plan

Summary of the Facts: The University of Mississippi Medical Center filed an application for a Certificate of Need with the Mississippi Department of Health on February 3, 2009. In its application, UMMC outlined its intent to purchase a new Elekta Synergy Platform Linear Accelerator System and to renovate a portion of the UMMC basement to house the accelerator. UMMC represented that the accelerator would be an important aspect to the planned radiation oncology residency program. The project had been approved by the Board of Trustees of State Institutions of Higher Learning and was to be funded through self-generated patient revenue. MSDH recommended approval of the project on June 17, 2009. On July 8, 2009, Jackson HMA and St. Dominic-Jackson Memorial Hospital filed a request for a public hearing in response to UMMC’s application. MSDH thereafter sought an official opinion from the Attorney General on the issue of the CON statutes’ applicability to UMMC. The AG issued two opinions. In the second opinion, the AG stated that there was no express exemption for UMMC within the CON laws and that “it is within the authority of the Department of Health to make determinations of reviewability under the CON laws and/or enact regulations including provisions in the State Health Plan, which take into consideration UMMC’s status as the state’s only teaching hospital, and which carve out exceptions for equipment and/or services which are deemed necessary or desirable by UMMC.” UMMC then withdrew its application and requested a determination by MSDH of reviewability. MSDH granted UMMC’s request without public hearing, finding that UMMC was not required to obtain a CON for the proposed project under Section 109.03 of the 2010 State Health Plan, which provides that the CON criteria and standards shall not prevent UMMC from acquiring and operating stereotactic radiosurgery equipment justified by UMMC’s teaching and/or research mission. Shortly thereafter, HMA, St. Dominic, and Mississippi Baptist Medical Center, Inc. filed their complaint against MSDH and UMMC in the Hinds County Chancery Court, requesting declaratory relief, temporary and injunctive relief, and/or appeal from the final order of MSDH. UMMC filed a Rule 12(b)(6) motion to dismiss or, in the alternative, a Rule 56 summary judgment motion. The IHL filed a motion to intervene, which the chancellor granted. The Hospitals also filed a summary judgment motion. The chancellor denied both motions. The Supreme Court granted an interlocutory appeal.

Summary of Opinion Analysis: Issue 1: Applicability of CON statutes The Hospitals argue that the CON statutes apply to UMMC because UMMC falls within the CON statutes’ definitions of a covered “person” and “health-care provider.” UMMC and the IHL argue that the CON statutes do not apply to UMMC because it is a “teaching hospital” and does not fall within the CON statutes’ definition of covered health-care facilities. Section 41-7-173(p) defines “person” as “an individual, a trust or estate, partnership, corporation (including associations, joint stock companies and insurance companies), the state or a political subdivision or instrumentality of the state.” UMMC is an instrument of the state. Further, section 41-7-191(4)(a)(vi) states, “[t]he department may issue a certificate or certificates of need for the expansion of child psychiatric beds or the conversion of other beds to child psychiatric beds at the University of Mississippi Medical Center. . . .” This statutory provision demonstrates the Legislature intended the CON statutes to apply to UMMC. Issue 2: Conflicting statutes UMMC and the IHL argue that the CON statutes and UMMC’s creation statutes conflict because the CON statutes require a “person” to apply for a required CON before acquiring major medical equipment, but the statutes creating UMMC provide that, “[t]here shall be built, equipped and operated as a part of the medical school, a teaching hospital . . . . There shall also be acquired and installed all needed equipment and supplies for the proper operation and maintenance of such medical school and hospital and other facilities for the purposes aforesaid . . . .” UMMC also argues that section 37-115-23 allows it to acquire needed equipment without obtaining a CON. However, the CON statutes and UMMC’s creation statutes do not conflict. While UMMC’s creation statutes provide that it shall acquire and install “needed equipment,” the statutes do not define “needed equipment,” nor do they provide the procedure with which UMMC must comply to obtain needed equipment. The CON statutes provide the procedure with which UMMC must comply to obtain needed equipment. Issue 3: Authority of MSDH UMMC and the IHL argue that, even if the CON statutes apply to UMMC, UMMC is not required to obtain a CON for the project at issue under the State Health Plan, as the acquisition of the accelerator is for teaching purposes, not the provision of medical care. As a part of the CON law, the Legislature empowered MSDH to “develop and implement a statewide certificate of need program.” The Legislature, through enactment of section 41-7-187, delegated to MSDH the authority to “adopt by rule and regulation: . . . (b) effective standards to determine when a person, facility or organization must apply for a certificate of need.” While at first blush it may appear that section 41-7-191(1)(f) allows a person to acquire major medical equipment without obtaining a CON in only two situations – for research only and for the replacement of medical equipment for a facility already providing medical services – a closer reading reveals that these are exceptions for situations when MSDH has determined that a CON is required. Thus, it was within the authority of MSDH to adopt the “teaching” exception included at Section 109.03(3) of the 2010 State Health Plan. MSDH acted within its authority in determining that UMMC was not required to obtain a CON before acquiring the linear accelerator at issue.


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