Ex Parte State Health Planning and Dev. Agency
Ex Parte State Health Planning and Dev. Agency
Opinion
The central issue in these appeals is whether vendors that provide mobile lithotripsy1 equipment to hospitals are providing a "health service" requiring a "certificate of need" ("CON") under Ala. Code 1975, §
For a detailed discussion of the facts and procedural posture of these cases, see Prime Lithotripter Operations, Inc., 855 So.2d at 1087. As an initial matter, we note that we agree with the Court of Civil Appeals that this case presents a matter of first impression. 855 So.2d at 1093.
Prime Medical and SHPDA contend that the sale or lease of mobile lithotripsy equipment is a "new institutional health service" under Ala. Code 1975, §
"(a) All new institutional health services which are subject to this article and which are proposed to be offered or developed within the state shall be subject to review under this article. No institutional health services which are subject to this article shall be permitted which are inconsistent with the State Health Plan. For the purposes of this article, new institutional health services shall include any of the following:
". . . .
"(4) Health services proposed to be offered in or through a health care facility or health maintenance organization, and which were not offered on a regular basis in or through such health care facility or health maintenance organization within the 12 month period prior to the time such services would be offered. . . ."
(Emphasis added.)
The definition in
"Clinically related (i.e., diagnostic, curative, or rehabilitative) services, including alcohol, drug abuse, and mental health services customarily furnished on either an in-patient or out-patient basis by health care facilities, but not including the lawful practice of any profession or vocation conducted independently of a health care facility and in accordance with applicable licensing laws of this state."
(Emphasis added.)
The Court of Civil Appeals reached its conclusion by interpreting that statutory language as follows:
Prime Lithotripter Operations, Inc., 855 So.2d at 1095."Section
22-21-263 defines `new institutional health services' in terms that contemplate either the provision of a new service or the acquisition of some physical facility or equipment that will enable a health-care facility or an HMO to provide a service. In other words, facilities or organizations that provide those health services are the focus of the certification requirements. Nothing in §22-21-263 or any other provision of this article requires an entity that merely seeks to sell or lease equipment to a health-care facility (for that facility to then use in providing a service) to obtain a CON."The definition of `institutional health service' in §
22-21-260 (9) uses the clause `including the entities through which such services are offered.' However, that clause refers to the `health-care facilities or Health Maintenance Organizations,' which obviously are `entities.' The term `health services' does not include `entities.' Although the definition is unartfully written, what the Legislature was attempting to communicate was the idea that an `institutional health service' is a service provided in or through a health-care facility or an HMO, and that the health-care facility or HMO includes, for this purpose, those `entities' who contract with or are affiliated with the health-care facility or HMO to be the direct provider of the service to the patient. In other words, a health service will be considered as provided in or through a given health-care facility or an HMO (therefore potentially subjecting that health-care facility or HMO to the CON requirement) even if the direct deliverer of the services to the patient is a physician's professional corporation (`P.C.'), if that P.C. is the `entity in or through which' the health-care facility provides a service to its patients. Because UroVenture and LithoMedTech are not providing a service, but only a piece of equipment, then they are not an `entity' referred to in the clause `including entities in or through which such services are provided.'"We conclude that the health-care facilities and HMOs that provide health services must seek CON review in connection with providing such a service. The sellers or vendors of equipment that health-care facilities and HMOs use in order to provide such services need not obtain a CON."
We find the Court of Civil Appeals' reasoning interpreting §
"`"`It is settled that courts should give great weight to any reasonable construction of a regulatory statute adopted by the agency charged with the enforcement of that statute.'"'" QCC, Inc. v. Hall,
SHPDA, the agency charged with enforcing Alabama's CON laws, has interpreted the phrase "entities in or through which such services are provided" from §
The traditional deference given an administrative agency's interpretation of a statute appropriately exists (1) when the agency is actually charged with the enforcement of the statute and (2) when the interpretation does not exceed the agency's statutory authority (i.e., jurisdiction). See Ex parte Jones Mfg. Co.,
Here, the Court of Civil Appeals, in interpreting the relevant statutes, properly did not give deference to SHPDA's interpretation. SeePrime Lithotripter Operations, Inc., 855 So.2d at 1096. We agree with the Court of Civil Appeals' holding that, although §
Based on the above, we adopt the reasoning of the Court of Civil Appeals and affirm its judgment.
1011707 — AFFIRMED.
1011708 — AFFIRMED.
See, Brown, Johnstone, Harwood, Woodall, and Stuart, JJ., concur.
Moore, C.J., concurs in the result.
Lyons, J., recuses himself.
"Any expenditure by or on behalf of a health care facility or health maintenance organization which . . . is a capital expenditure in excess of one million five hundred thousand dollars ($1,500,000) for major medical equipment except for magnetic resonance imaging equipment only, which shall be reviewable regardless of the expenditure. . . ."
LithoMedTech and UroVenture note that, in the past, the limit in the statute on a capital expenditure was $500,000, an amount far less than it is today, and that the cost of obtaining mobile lithotripsy equipment was far more than it is today. Thus, in the past, the statute was triggered, making the sale of mobile lithotripsy equipment that cost more than $500,000 subject to CON review.
Reference
- Full Case Name
- Ex Parte State Health Planning and Development Agency. (In Re: State Health Planning and Development Agency v. Lithomedtech of Alabama, Llc). Ex Parte Prime Operations, Inc., and Prime Medical Services, Inc. (In Re: Prime Lithotripter Operations, Inc., and Prime Medical Services, Inc. v. Lithomedtech of Alabama, LLC and Prime Lithotripter Operations, Inc., and Prime Medical Services, Inc. v. Uroventure, LLC)
- Cited By
- 3 cases
- Status
- Published