Submitted on Briefs: April 1, 2015.
Released for Publication: May 28, 2015.
APPEAL FROM: District Court of the First Judicial District, In and For the County of Lewis and Clark, Cause No. DDV 2011-913. Honorable James P. Reynolds, Presiding Judge.
For Appellant: John M. Morrison, Morrison, Sherwood, Wilson, & Deola PLLP, Helena, Montana; Lawrence A. Anderson, Attorney at Law, P.C., Great Falls, Montana.
For Appellee: Randy J. Cox; Thomas J. Leonard; Randy J. Tanner, Boone Karlberg, P.C., Missoula, Montana.
BETH BAKER. We concur: JAMES JEREMIAH SHEA, PATRICIA COTTER, JIM RICE. Justice Beth Baker delivered the Opinion of the Court. Justice Laurie McKinnon, dissenting.
Beth Baker, Justice.
[¶1] Jessica Gazelka sued St. Peter's Hospital in the First Judicial District Court, Lewis and Clark County, alleging that the Hospital discriminated against her based on her lack of health insurance. We address the following issues on appeal:
[379 Mont. 143] 1. Whether the District Court erred in determining that Gazelka has standing.
2. Whether the District Court erred in awarding the Hospital summary judgment on the merits.
[¶2] We affirm the District Court's determination that Gazelka has standing, and vacate and remand the District Court's order granting summary judgment.
PROCEDURAL AND FACTUAL BACKGROUND
[¶3] In early 2010, Gazelka had no health insurance when she was involved in a motor vehicle accident in Helena. She received treatment from the Hospital. The driver of the vehicle that struck Gazelka had a Safeco vehicle insurance policy with a $100,000 general liability limit. In accordance with Ridley v. Guar. Nat'l Ins. Co., 286 Mont. 325, 951 P.2d 987 (1997), Safeco paid the Hospital for some of Gazelka's medical bills. When Safeco settled for the $100,000 liability limit, the Ridley payments were deducted from the settlement funds that Gazelka received.
[¶4] In early 2011, Gazelka again was uninsured and received treatment from the Hospital. She did not pay for the treatment. The Hospital referred Gazelka's account to a debt collector, which sued Gazelka and received a judgment against her.
[¶5] In September 2011, Gazelka filed suit against the Hospital, alleging that the Hospital violated Montana anti-trust laws and Article II, Section 4 of the Montana Constitution by discriminating against her on the basis of her uninsured status. Gazelka's complaint centers on preferred provider agreements (PPAs). PPAs are agreements between insurers and healthcare providers regarding the amount and the manner of payment that providers will accept as satisfaction for treatment rendered to insured persons. The undisputed evidence shows that the Hospital has PPAs with several insurers. Thus, Gazelka alleges that while the initial amount the Hospital charges to a patient remains the same regardless of the patient's insurance status, the actual amount the Hospital will accept as full compensation for its services ...