5 Fla. L. Weekly Supp. 28a
Insurance — Personal injury protection — Liens — Hospitals — For purposes of law authorizing hospital liens for entities operating public hospitals in Palm Beach County, public hospital is an institution owned by public and devoted chiefly to public uses and purposes — Insurer erred by insisting that hospital had lien and that lien should be protected by tendering check for remaining PIP benefits payable to both insured and hospital — Question certified: Does a hospital operating in Palm Beach County need to be a “public hospital” in order to claim under or be entitled to a lien under Chapter 57-1688, Laws of Florida, 1957; and if so, what is a “public hospital” under the law? — Court retains jurisdiction to determine what effect insured’s assignment to hospital has on insurer’s obligation to pay lost wage benefits to plaintiff
Order resolving assignment issue at 5 Fla. L. Weekly Supp. 126a
LORENE A. ECCLESTON, Plaintiff v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. In the County Court in and for Palm Beach County, Civil Division. Case No. MC 95-15524 RB. May 8, 1997. Nancy Perez, Judge. Counsel: Joseph R. Fields, Jr., West Palm Beach, for Plaintiff. Michael S. Smith, West Palm Beach, for Defendant.
ORDER ON PLAINTIFF’S AND DEFENDANT’S MOTIONS FOR SUMMARY JUDGMENT
THIS MATTER came before the Court on March 27, 1997 on the motions for summary judgment filed by Plaintiff, LORENE A. ECCLESTON (ECCLESTON) and Defendant, STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY (STATE FARM). The Court considered the motions, argument of counsel, the pleadings, Plaintiff’s memorandum of law, the stipulations of the parties, the case law and being otherwise fully advised in the premises, the court finds as follows:
THE FACTS
This case was originally filed as a two count claim seeking damages under PIP/no fault law and a declaratory decree as to whether Wellington Regional Medical Center is a “public hospital” within the meaning of Florida’s special law, Chapter 57-1688, Laws of Florida (1957) (CH 57-1688). Defendant, STATE FARM has raised, as an affirmative defense to Plaintiff’s claim for PIP benefits, that she assigned those benefits to Wellington Regional Medical Center and, therefore, STATE FARM owes nothing to Plaintiff. The issue to be resolved in this order is whether Wellington is a “public hospital”, and thus entitled to a lien under the aforementioned law.
At the hearing on the parties’ motions for summary judgment, counsel for the parties stipulated that, should this court rule that Wellington is a public hospital, then the case is, for the most part over, as Plaintiff’s claims against STATE FARM are premised upon Wellington not being a public hospital. However, in the event this Court rules that Wellington is not a public hospital, then the case will proceed to STATE FARM’s affirmative defense of Plaintiff’s assignment.
The parties have stipulated to the following facts:
a. Wellington is a hospital that is not owned by any governmental agency;
b. Plaintiff was admitted to Wellington for non-emergency surgery on July 13, 1995;
c. Assuming adequate financial arrangements are made, Wellington is open to the public for medical services; and
d. Wellington has not filed a “lien” document in the Public Records of Palm Beach County, Florida, regarding Plaintiff’s hospitalization.
The parties, at the hearing on these motions, further indicated to the court the following facts which may or may not be relevant to the determination of these particular issues:
a. Date of accident — April 24, 1995;
b. PIP/no fault application received — May 11, 1995;
c. Lost wages partially paid — May 30, 1995;
d. Wage lost form received by STATE FARM — June 14, 1995;
e. Hospital “assignment” — July 12, 1995;
f. Hospitalization necessitated to injuries caused by the 4/24/95 accident — July 13, 1995;
g. STATE FARM’s receipt of hospital bill — July 27, 1995.
Prior to suit being filed, STATE FARM presented Plaintiff a check for the remaining PIP/no fault and medical payments coverage, made payable to Plaintiff and Wellington. This format gives rise to the issue before this Court. Plaintiff claims she has the right to have the payment issued solely to her because the hospital is not within the ambit of the lien law.
In this case, it is undisputed that the hospital never actually recorded a lien with the Clerk of court. Tardy filing of a hospital lien does not invalidate the lien, but only results in the hospital being an unsecured creditor until the time the lien is filed although the lien attaches at the time of admission. Public Health Trust of Dade County v. Carroll, 509 So.2d 1232 (Fla. 4th DCA 1987); State Farm Mutual Automobile Insurance Company v. Palm Springs General Hospital, Inc. Of Hialeah, 232 So.2d 737 (Fla. 1970).
Tendering a check made payable to both the hospital and the insured was entirely proper, if there was a lien. Margiotta v. State Farm Mutual Automobile Insurance Company, 622 So.2d 135 (Fla. 4th DCA 1993); Fernandez v. South Carolina Insurance Company, 408 So.2d 753 (Fla. 3rd DCA 1982).
THE LAW
In order to decide whether summary judgment is appropriate, this court must first interpret the phrase “public hospital” in Chapter 57-1688 Laws of Florida (1957). Chapter 57-1688 is a special law enacted in 1957, authoring hospital liens for “[e]very individual, partnership, firm, association, corporation, institution and government unit, and every combination of any of the foregoing, operating a public hospital in Palm Beach County…”. The statute does not define the term “public hospital.” Plaintiff argues it means a hospital owned and operated by the government or one of its subdivisions. STATE FARM, on the other hand, argues that “public hospital” simply means one that is open to and provides services to the public. “[W]hen the language of a statute is clear and unambiguous and conveys a clear and definite meaning, there is no occasion for resorting to the rules of statutory interpretation and construction; the statute must be given its plain and obvious meaning.” Holly v. Auld, 450 So.2d 217, 129 (Fla. 1984). A statute cannot be clear and unambiguous if its terms are subject to more than one meaning. Auld at 219. Since the term “public hospital” is subject to the two differing definitions, the court must resort to extrinsic aids and rules of statutory construction to discern the legislative intent. Id.
Since 1953, Florida’s Legislature has enacted 11 special laws granting liens to certain hospitals operating within particular counties.1 Palm Beach county’s hospital lien law is different than other special laws in that in Section 1, the word “Public” appears before the word “hospital”. Only Indian River has a lien law with this difference. The Court was provided with no legislative history concerning the lien law. Independent attempts were made by the court to locate a substantive legislative history, but none was found.
Although there has been a significant amount of litigation regarding hospital liens, this Court has not found, and there does not appear to be any case in which the issue of the insertion of the word “public” before the word “hospital” has been litigated.
Plaintiff relies upon several cases, including West Coast Hospital Ass’n v. Hoare, 64 So.2d 293 (Fla. 1953) and Kondos v. Underwriters Guarantee Ins. Co., Case No. 93-8647 (15th Judicial Circuit, January 24, 1995); AP 93-8647 AY (Appellate Case No.); as providing guidance on what the term means. In addition, Plaintiff relies upon numerous Florida statutes, enacted before and after Chapter 57-1688, and statutes from other states.
Hoare was decided by the Florida Supreme Court in 1953, approximately four (4) years prior to the enactment of Chapter 57-1688. In Hoare, the Supreme Court explained the difference between a public and private hospital:
Private hospital. A private hospital is one funded and maintained by private persons or a corporation, the state or municipality having no voice in the management or control of its property or the formation of rules for its government.
Public Hospital. A hospital created and endowed by the government for general charity is a public corporation; and a public hospital may be defined in general as an institution owned by the public and devoted chiefly to public uses and purposes.
Hoare at 296-297 (citation omitted). See also, Burris v. Morton F. Plant Hospital, 204 So.2d 521 (Fla. 2d DCA 1966).
Plaintiff argues the definition of “public hospital” in Hoare should govern here because it was decided before the enactment of Chapter 57-1688 and therefore, presumably the legislature was aware of it in drafting Chapter 57-1688. Indeed, it is a well established principle of statutory construction that the legislature is presumed to know the existing law when it enacts a statute. Foley v. State, 50 So.2d 179 (Fla. 1951).
Plaintiff further relies upon an appellate decision from this district. Kondos v. Underwriters Guarantee Ins. Co., Case No. CL 93-8647 (15th Judicial Cir. January 24, 1995), is factually similar to this case and agreed with the definition set out in Hoare. In Kondos, an insured, who was injured in an auto accident and received medical treatment from Boca Raton Community Hospital, filed suit against his insurer for the money remaining in his PIP benefits for his lost wages. The insurer objected on the ground the hospital had filed a Claim of Lien against the proceeds. Thereafter, the insurer filed a Motion for Summary Judgment relying upon Chapter 57-1688 and a form, signed by the insured, which assigned his insurance benefits to the hospital. The county court granted summary judgment in favor of the insurer.
On appeal, the appellate panel reversed. The panel stated that “[u]pon remand, it is incumbent upon the trial court to determine, whether Boca Raton Community Hospital comes under the auspices of Chapter 57-1688”. In order to make that determination, it was necessary for the trial court to decide whether Boca Raton Community was a “public hospital”. The panel went on to provide guidance to the trial court in making its decision, noting “the enactment [of Chapter 57-1688] is a manifestation of the legislature’s concern for the public welfare to ensure that a public hospital receive compensation for their services and that they should not be reluctant to treat indigent. This law provides the benefit of permitting the bill for medical services rendered by a “public hospital” to proceed to the head of the payment line. A “public hospital” has been defined “…in general as an institution owned by the public and devoted chiefly to public uses and purposes.” Thus, the Kondos panel agreed with the definition of “public hospital” provided by Hoare.
The Defendant, STATE FARM, relies on In Re Guardianship of Hernandez, 45 Fla. Supp. 147 (Fifteenth Judicial Circuit December 6, 1990) where a hospital, relying upon Chapter 57-1688 filed a lien for emergency medical services rendered to a minor injured in an accident. The minor’s guardian argued the hospital was not entitled to a statutory lien under Chapter 57-1688 because it was not “operating a public hospital in Palm Beach County, Florida.”
The late Judge Vaughan J. Rudnick disagreed and rules that the words “operating a public hospital” in Chapter 57-1688 mean a hospital “open to the public as recipients of its medical services and not [] limited or restricted to any particular class of or within the community.” In so holding, Judge Rudnick reasoned that the controlling factor in statutory construction is legislative intent, “by which the court must be guided and give effect even though it might contradict the strict letter of the statute.”
Judge Rudnick further reasoned it was inconceivable that the legislative body would limit the lien to only those “medical centers that are owned, endowed, funded and managed by the government or one of its subdivision … Such a position is of little or no assistance to a person horribly injured or deathly ill in need of immediate emergency treatment. Of paramount importance to such a person is making available state of the art medical attention as quickly as possible with secondary attention addressing how the medical bills will ultimately be paid.”
Judge Rudnick expressly rejected the notion that the definition of “public hospital” set forth in West Coast Hospital Ass’n v. Hoare, 65 So.2d 293 (Fla. 1953), could be used as evidence of the legislature’s intent. The judge found Hoare was of no assistance because it was factually distinguishable.
There is a conflict between the Kondos and Hernandez opinion. Kondos is a circuit court appellate decision with greater precedential value than an Order. See e.g., Pardo v. State, 596 So.2d 665 (Fla. 1992) (in the absence of interdistrict conflicts, district court of appeal decisions bind all trial courts). Additionally, the reasoning in Kondos follows the rules of statutory construction while the opinion that in Hernandez does not.
In addition to the Kondos ruling, the court relies on the intent of the Legislature and the courts of this State in determining whether the insertion of the word “public” before the word “hospital” is relevant to the determination on whether Wellington was entitled to a lien.
The term “public hospital” appears in a least 7 different chapters within the Florida Statutes.2 The most recent reference was in 1996 when the Legislature amended Florida’s public records laws to provide exemptions for “public hospitals”.
The Florida Legislature also appears to make a distinction between the term “hospital” and “public hospital”. See F.S. §212.055(5). But see F.S. §196.197 where public hospital and hospital are used within the same paragraph. A review of the Statutes indicates that when referring to a “public hospital” they mean one “owned by the public and devoted chiefly to public uses and purposes.”3
The distinction between public hospital and private hospital has arisen in a plethora of cases. The following cases illustrate that the Florida courts use the term “public hospital” as a term of art: Sarasota Herald Tribune v. Community Health, 582 So.2d 730 (Fla. 2d DCA 1991); Mastroianni v. Memorial Medical Center, 606 So.2d 759 (Fla. 1st DCA 1992); Bates v. Sahasranaman, 522 So.2d 545 (Fla. 4th DCA 1988); Public Health Trust of Dade County v. Valcin, 507 So.2d 596 (Fla. 1987); Dade County v. American Hospital of Miami, 502 So.2d 1230 (Fla. 1987); Eldred v. North Broward Hospital District, 498 So.2d 911 (Fla. 1986); Whack v. Seminole Memorial Hospital, 456 So.2d 561 (Fla. 5th DCA 1984); Hospital Board of Directors of Lee County v. McCray, 456 So.2d 936 (Fla. 2d DCA 1984); Hospital Board of Directors of Lee County v. Durkis, 426 So.2d 50 (Fla. 2d DCA 1982); Monyek v. Parkway General Hospital, 273 So.2d 430 (Fla. 3rd DCA 1973); and Williams v. Turrentine, 266 So.2d 81 (Fla. 4th DCA 1972).4
It is clear from the foregoing uses of the term “public hospital” that the term “public hospital” is a term of art of which this Court presumes the Legislature was aware when it passed the Palm Beach County hospital lien law.
In fact, the Palm Beach County Health Care District appears to be the entity which maintains and operates “public hospitals” within Palm Beach County. See Palm Beach County Health Care District v. Everglades Memorial Hospital, 658 So.2d 577 (Fla. 4th DCA 1995).
The fight over hospital liens has arisen before this Court on a multitude of occasions. This Court has several cases before it dealing with the applicability of Palm Beach County’s hospital lien law.
As noted earlier, the legislature is presumed to know the law when it enacts a statute. Palm Beach and Indian River’s special acts were passed in the middle of the twenty-year period. As such, the Legislature knew the other special acts applied generally to hospitals but chose to use the term “public hospital” for those two counties. When the Legislature uses specific words in one statute that is has not used in another, it is indicative of its legislative intent.
Final support for the definition of public hospital is found in comparing Chapter 57-1688 to statutes in other states. The law review article5 written by Meta Calder notes that forty-one states and the District of Columbia have general laws authorizing hospital liens. Of those forty-one, seven states “take the more traditional approach and limit the lien to non-profit, charitable, or publicly owned and operated hospitals”.
Applying the definition of “public hospital” in Kondos and Hoare, supra, to the facts of this case, it is clear there is no genuine issue of material fact that Wellington is not a “public hospital”.6
Based on the foregoing, it is hereby
ORDERED AND ADJUDGED as follows:
1. Based upon the historic use of the term “public hospital”, this court finds that Wellington is not a public hospital at the time of Plaintiff’s admission and, therefore, Defendant, STATE FARM is in error by insisting that the “lien” be protected by tendering a check for all available remaining benefits payable to Plaintiff and Wellington.
2. Based on the parties’ stipulations as presented to this court, both in writing and verbally at the hearing on these motions, this case will now proceed as to what effect Plaintiff’s July 12, 1995, “assignment” to Wellington has on Defendant, STATE FARM’S obligation to pay lost wage benefits to Plaintiff.
3. Plaintiff’s motion for summary judgment is granted, and Defendants’ motion for summary judgment is denied.
4. Pursuant to Fla.R.Appl.P. 9.160, this Court certifies to the Fourth District Court of Appeal the following question as being of great public importance:
Does a hospital operating in Palm Beach County need to be a “public hospital” in order to claim under or be entitled to a lien under Chapter 57-1688, Laws of Florida, 1957; and if so, what is a “public hospital” under the law?
5. The Court retains jurisdiction of the parties to address the issue of attorney’s fees and costs upon the resolution of the “assignment” issue.
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1These laws, although containing subtle differences, all provide for liens upon the recovery of insurance benefits and/or tort claim proceeds for medical services provided to patients. Those 11 hospital lien laws are as follows:
County Cite
Volusia County Ch. 29591, 1953, Fla. Laws 3184 Broward County Ch. 30615, 1955, Fla. Laws 307 Escambia County Ch. 30733, 1955, Fla. Laws 964 Marion County Ch. 3095, 1955, Fla. Laws 2241 Seminole County Ch. 31274, 1955, Fla. Laws 3355 Jackson County Ch. 57-1420, 1957, Fla. Laws 1797 Orange County Ch. 57-1644, 1957, Fla. Laws 2689 Palm Beach County Ch. 57-1688, 1957, Fla. Laws 2827 Indian River County Ch. 59-1389, 1959, Fla. Laws 1715 Bradford County Ch. 61-1897, 1961, Fla. Laws 455 Sarasota County Ch. 61-2868, 1961, Fla. Laws 4418
2Florida Statutes 119.16; 155.04(1); 155.05; 155.06; 155.12; 155.20; 155.23; 155.25(1); 155.25(2); 196.197; 212.055(5); 395.301(3); 395.3035(1); 395.3035(2); 395.3035(2)(a); 395.3035(2)(b); 410.402; and 732.918.
3The Florida Administrative Code also uses the term “public hospital” in several areas. This term appears in Title 10, Chapter 10 D-101; Title 12, Chapter 12 A-1; and Title 59, Chapter 59 A-3.
4In addition, doctors have generated litigation over their privileges at hospitals. There appears to be a difference in physician privileges and rights at public versus private hospitals. In general, see Mizell v. North Broward Hospital District, 175 So.2d 583 (Fla. 2d DCA 1965); Dade County v. Trombly, 102 So.2d 394 (Fla. 3rd DCA 1958); Hodkin v. Perry, 88 So.2d 139 (Fla. S. Ct. 1956); and Bryant v. City of Lakeland, 158 Fla. 151 (Fla. 1946).
5Calder, Florida’s Hospital Lien Laws, 21 FSU Law Review 341 (1993).
6The parties stipulated to the fact that Wellington is not owned by any governmental agency and that it is open to the public for medical services assuming adequate financial arrangements are made. As such, it is not owned by nor devoted chiefly to public purposes. Additionally, on 3/5/97, Defendant, STATE FARM, admitted correspondence from Wellington’s attorney indicating “It is not, not has it ever been, my client’s position that they are a `public’ hospital”.
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