George Washington MacNeil v. Crestview Hospital Corporation, a Florida for Profit Corporation D/B/A Etc.
CourtDistrict Court of Appeal of Florida
Date FiledMarch 12, 2020
Docket1D18-1958
StatusPublished
📰 News Coverage: Read the LAWS.com news report on this case
Full Opinion
FIRST DISTRICT COURT OF APPEAL
STATE OF FLORIDA
_____________________________
No. 1D18-1958
_____________________________
GEORGE WASHINGTON MACNEIL,
individually and on behalf of all
others similarly situated,
Appellant,
v.
CRESTVIEW HOSPITAL
CORPORATION, a Florida For
Profit Corporation doing
business as North Okaloosa
Medical Center,
Appellee.
_____________________________
On appeal from the Circuit Court for Okaloosa County.
Terrance R. Ketchel, Judge.
March 12, 2020
RAY, C.J.
This is an appeal of a final order dismissing with prejudice the
putative class action complaint of George Washington MacNeil for
a declaratory judgment and supplemental relief against Crestview
Hospital Corporation, d/b/a North Okaloosa Medical Center (the
“Hospital”). The complaint seeks a declaration as to whether the
Hospital charged MacNeil and other similarly situated patients
unreasonable rates for medical services in violation of section
627.736(5)(a), Florida Statutes (the “PIP statute”). The trial court
dismissed the complaint with prejudice, reasoning that the PIP
statute does not create a private cause of action for an insured to
challenge the reasonableness of a health care provider’s charges,
and therefore any declaration would amount to an improper
advisory opinion. For the reasons that follow, we affirm.
I.
In his one-count complaint, MacNeil alleges that he was
transported by ambulance to the Hospital’s emergency care
department after a motor vehicle accident. He had personal injury
protection (“PIP”) insurance at the time, providing for $10,000 in
medical and disability benefits. Following treatment and
discharge, he received an invoice charging $41,484 for four CT
scans, in addition to charges for other procedures.
MacNeil contends that the charges for the CT scans were
unreasonable under the PIP statute, which provides that hospitals
rendering treatment to an injured person covered by PIP
insurance “may charge the insurer and injured party only a
reasonable amount” for necessary services that “may not exceed
the amount the [hospital] customarily charges.” § 627.736(5)(a),
Fla. Stat. (2017). He alleges that because of the unreasonable
charges for the CT scans, he suffered “significant financial injury.”
Specifically, he alleges that PIP covers only 80% of the reasonable
charges up to $10,000, so he is responsible for the remaining 20%.
He further alleges that the charges prematurely exhausted his PIP
benefits, causing him to be liable for additional medical services
rendered by third-party providers that would have otherwise been
fully or partially covered by his PIP benefits. He seeks a
determination as to the reasonableness of the Hospital’s charges
as well as their legality under the PIP statute.
The Hospital moved to dismiss the complaint arguing that (1)
no private right of action exists under the PIP statute between an
insured and a health care provider under the facts alleged; (2)
MacNeil failed to state a cause of action for declaratory relief; and
(3) the scope and operation of the PIP statute should be decided by
the Legislature, not the judiciary. For his part, MacNeil responded
that (1) a private cause of action is not necessary to sue for
2
declaratory relief, and (2) the PIP statute created a private cause
of action.
After briefing and argument from counsel, the trial court
granted the Hospital’s motion to dismiss, concluding that
“[MacNeil] cannot seek a declaratory judgment directly under
section 627.736 and no amended set of allegations could cure [the]
defect.” The court held that a declaratory judgment action is
unavailable to MacNeil because the PIP statute lacks an express
or implied private cause of action to enforce its provisions,
rendering any declaratory judgment an improper “advisory
opinion.” This appeal followed.
II.
Under Florida’s Declaratory Judgment Act, “[t]he circuit and
county courts have jurisdiction within their respective
jurisdictional amounts to declare rights, status, and other
equitable or legal relations whether or not further relief is or could
be claimed.” § 86.011, Fla. Stat. (2017). The courts may render
declaratory judgments on the existence, or nonexistence:
(1) Of any immunity, power, privilege, or right; or
(2) Of any fact upon which the existence or nonexistence
of such immunity, power, privilege, or right does or may
depend, whether such immunity, power, privilege, or
right now exists or will arise in the future. Any person
seeking a declaratory judgment may also demand
additional, alternative, coercive, subsequent, or
supplemental relief in the same action.
Id. Additionally, any person “whose rights, status, or other
equitable or legal relations are affected by a statute . . . may have
determined any question of construction or validity arising under
such statute . . . and obtain a declaration of rights, status, or other
equitable or legal relations thereunder.” § 86.021, Fla. Stat. (2017).
By its express terms, the Declaratory Judgment Act must be
liberally administered and broadly construed. § 86.101, Fla. Stat.
(2017).
3
Yet while the scope of a court’s jurisdiction to issue a
declaratory judgment is broad, “it does have limits—one of which
is that courts will not render advisory opinions or give legal
advice.” Golfrock, LLC v. Lee Cty., 247 So. 3d 37, 40 (Fla. 2d DCA
2018) (citing May v. Holley, 59 So. 2d 636, 639 (Fla. 1952)). Thus,
to state a cause of action for declaratory judgment the plaintiff
must show that
(1) there is a bona fide dispute between the parties; (2)
the plaintiff has a justiciable question as to the existence
or nonexistence of some right, status, immunity, power or
privilege, or as to some fact upon which existence of such
a claim may depend; (3) the plaintiff is in doubt as to the
claim; and (4) there is a bona fide, actual, present need
for the declaration.
Ribaya v. Bd. of Trs. of the City Pension Fund for Firefighters &
Police Officers in the City of Tampa, 162 So. 3d 348, 352 (Fla. 2d
DCA 2015). The extrastatutory elements requiring a “bona fide
dispute” between the parties and a “bona fide need” for the
declaration ensure that the proceeding is “judicial in nature” and
falls “within the constitutional powers of the courts.” See May, 59
So. 2d at 639; see also Ribaya, 162 So. 3d at 353 (cautioning that
“chapter 86 is a statute with ‘special objectives’ that should not be
‘perverted’ by permitting its use as a ‘catch-all’”).
III.
MacNeil argues on appeal that the trial court erred by
dismissing his complaint for the sole reason that the PIP statute
does not contain a private cause of action. He contends that the
court’s decision directly conflicts with this Court’s holding in City
of Apalachicola v. Franklin Cty., 132 So. 3d 1217 (Fla. 1st DCA
2014).
In City of Apalachicola, the city sued the county for
declaratory and injunctive relief, alleging that the county had
failed to comply with requirements of the Florida Governmental
Conflict Resolution Act, chapter 164, Florida Statutes. 132 So. 3d
at 1218. The city sought a declaration that the county had to
participate in the conflict resolution procedures established by the
Act. Id. The trial court dismissed the complaint with prejudice
4
because, it ruled, the Act does not create a private cause of action.
Id. at 1218-19. On appeal, this Court determined that “[t]he circuit
court erred in construing the complaint as asserting a cause of
action for relief pursuant to the [Act]. Instead, the complaint seeks
declaratory relief, and adequately states a cause of action for such
relief.” Id. at 1219. The Court reasoned that the Act expressly
provides that if the entities fail to resolve their conflict through the
statutory procedures, the entities ‘“may avail themselves of any
otherwise available legal right,”’ and that “[a] declaratory
judgment is an ‘otherwise available legal right.”’ Id. (quoting
§ 164.1056, Fla. Stat.).
We do not read City of Apalachicola to stand for the broad
proposition that an individual can sue for declaratory relief
alleging a violation of any statute under which he has no private
right of action to enforce its provisions. Nor does City of
Apalachicola articulate a per se rule that the existence of a private
cause of action is never relevant when determining whether a
justiciable claim exists to support a declaratory judgment. In
short, City of Apalachicola does not disturb the long-standing
requirement that there must be a “bona fide, actual, present, and
practical need for the declaration”—in other words, there must be
“some immunity, power, privilege or right of the complaining
party” dependent upon the issue to be resolved by declaration. See
May, 59 So. 2d at 639.
Notwithstanding the lack of a private right of action under the
PIP statute to determine the reasonableness of the Hospital’s
charges and the legality of its conduct, * MacNeil contends that he
is entitled to a declaration on these matters because of the
existence of unspecified, potentially available civil remedies for the
Hospital’s violation of the statute. Cf. Herrera v. JFK Med. Ctr.
Ltd. P’ship, 87 F. Supp. 3d 1299, 1308 (M.D. Fla. 2015) (holding
that an insured could challenge the reasonableness of a hospital’s
charges under the PIP statute under common law theories of
* MacNeil does not challenge the trial court’s determination
that the PIP statute does not create an express or implied cause of
action for an insured to sue a healthcare provider for allegedly
unreasonable charges.
5
breach of contract, breach of the implied covenant of good faith and
fair dealing, and a violation of FDUTPA), partially rev’d on other
grounds, 648 F. App’x 930 (11th Cir. 2016).
For support, MacNeil relies in part on Adventist Health
System/Sunbelt, Inc. v. Blue Cross & Blue Shield, 934 So. 2d 602
(Fla. 5th DCA 2006). In Adventist Health, a hospital brought a
declaratory judgment action seeking an interpretation of a statute
requiring the defendant HMO to reimburse the hospital for
emergency medical treatment rendered to subscribers of the HMO.
934 So. 2d at 603. The crux of the dispute involved the amount the
HMO had to pay the hospital under the statute. Id. The Fifth
District reversed the lower court’s dismissal of the action, holding
that a declaratory action interpreting the statute was proper
because a private cause of action exists to enforce the statute’s
terms. Id. at 604. The court went on to note that
even assuming a statutory cause of action may not be
implied, common law theories are available for redress
through the courts. Because a civil remedy exists,
whether arising from statute or common law, a request
for declaratory relief is authorized because an actual
dispute, not merely a hypothetical one, exists between the
parties.
Id. (internal citation omitted). In so ruling, the court distinguished
one of its prior cases, The Florida Physicians Union, Inc. v. United
Healthcare of Florida, Inc., 837 So. 2d 1133 (Fla. 5th DCA 2003),
where the statute being construed did not expressly or impliedly
create a private cause of action to enforce its provisions. There, the
Fifth District held that the lower court properly dismissed an
action seeking a declaration that the defendant had violated the
statute’s terms, finding that the request for declaratory judgment
was “merely hypothetical and thus not cognizable.” Id.
Apart from Adventist Health, in all the cases cited by MacNeil
to support his claim that he is entitled to declaratory relief because
of the existence of other potentially available civil remedies, the
party seeking declaratory relief has also pleaded the other
claims—thus demonstrating that a justiciable controversy existed.
See Westside EKG Assocs. v. Found. Health, 932 So. 2d 214, 220
(Fla. 4th DCA 2005) (holding that service providers could bring
6
third-party beneficiary breach of contract and declaratory
judgment claims against HMO for violating the prompt pay
provision of the HMO Act); Lutz v. Protective Life Ins. Co., 951 So.
2d 884, 890 (Fla. 4th DCA 2007) (reversing dismissal of complaint
for declaratory judgment even though the statutes at issue did not
create a private cause of action where plaintiff also alleged breach
of contract); Payne v. Humana Hosp. Orange Park, 661 So. 2d 1239,
1242 (Fla. 1st DCA 1995) (holding that plaintiff stated a cause of
action for return of money had and received and for declaratory
judgment); Merkle v. Health Options, Inc., 940 So. 2d 1190, 1200
(Fla. 4th DCA 2006) (reversing dismissal of claim for declaratory
relief where a private cause of action was implied under statute
and where plaintiff sued for unjust enrichment, quantum meruit,
and account stated).
In contrast, MacNeil asserted no other cause of action below
that would show that a justiciable controversy exists on which to
predicate a declaratory judgment claim. He never alleged that he
was in doubt about his rights under any contract or that another
cause of action depended upon a determination of the
reasonableness of the charges under the PIP statute. “Absent a
showing of at least a colorable right which would be affected by the
requested declaration, dismissal is required.” Webster v. Inch, 286
So. 3d 847, 848 (Fla. 1st DCA 2019). We therefore agree with the
trial court that any declaration on whether the Hospital charged
unreasonable amounts under the PIP statute would constitute an
improper advisory opinion.
AFFIRMED.
ROBERTS, J., concurs; JAY, J., concurs with opinion.
_____________________________
Not final until disposition of any timely and
authorized motion under Fla. R. App. P. 9.330 or
9.331.
_____________________________
JAY, J., concurring.
7
I fully concur in Judge Ray’s majority opinion. I write
separately to explain why I agree with affirming the dismissal of
MacNeil’s complaint without granting him leave to amend.
Appellate cases approving the dismissal with prejudice of an
initial complaint are “rare bird[s] in the judicial aviary,” Wells
Fargo Bank, N.A., v. Bohatka, 112 So. 3d 596, 601 (Fla. 1st DCA
2013), but every so often, one raises its uncommon head. This is
such a case.
MacNeil did not argue that he was entitled to file a new
pleading; instead, his quarrel was focused on the propriety of the
dismissal of his original complaint. By not mentioning amendment
in either of his briefs, he waived any argument that he should have
been given an opportunity to file an amended pleading. While it is
tempting to hypothesize why this argument was never made, we
must avoid advancing “‘theories . . . which counsel either
intentionally or unintentionally . . . chose[] not to mention.’” Doe v.
Baptist Primary Care, Inc., 177 So. 3d 669, 673 (Fla. 1st DCA 2015)
(quoting Polyglycoat Corp. v. Hirsch Distribs., Inc., 442 So. 2d 958,
960 (Fla. 4th DCA 1983) (on motion for rehearing)). It is not our
function “‘to rebrief an appeal.’” Id. We “‘work within the
framework of the briefs’” provided. Id.
While courts “liberally allow[] parties to amend their
pleadings, . . . the burden should be on the parties to make . . . a
request.” Parker-Cyrus v. Justice Admin. Comm’n, 160 So. 3d 926,
928 (Fla. 1st DCA 2015). Appellate courts should not act as
“standby counsel for the parties.” D.H v. Adept Cmty. Servs., Inc.,
271 So. 3d 870, 888 (Fla. 2018) (Canady, C.J., dissenting). With
limited exceptions, our decisions are confined “to the issues raised
. . . .” Torres v. State, 44 Fla. L. Weekly D2307, D2308 (Fla. 5th
DCA Sept. 12, 2019) (Eisnaugle, J., concurring). If we bend this
rule, we “undermine an important rule of judicial restraint.” Id.
Here, MacNeil’s appellate papers are devoid of any argument
that he was entitled to amend his complaint. To the extent that
the right to amend was discussed at oral argument, it was outside
the briefing process. Accordingly, the amendment issue was
waived. See Bainter v. League of Women Voters of Fla., 150 So. 3d
1115, 1126 (Fla. 2014) (“‘Basic principles of due process’—to say
nothing of professionalism and a long appellate tradition—‘suggest
8
that courts should not consider issues raised for the first time at
oral argument’ and ‘ought not consider arguments outside the
scope of the briefing process.’”) (citation omitted); see also
CogniTest Corp. v. Riverside Publ’g Co., 107 F.3d 493, 499 n.5 (7th
Cir. 1997) (“In a footnote to its reply brief, CogniTest argues that
leave of court to file its amended pleading was not required
because it had an absolute right under Fed. R. Civ. P. 15(a) to
amend its pleading once ‘as a matter of course at any time before
a responsive pleading is served.’ . . . Yet CogniTest did not invoke
that right before the district court, nor did it do so here in its
opening brief. Thus, the issue has been waived.”).
_____________________________
Richard Bennett and Peter Bennett of Bennett & Bennett, Coral
Gables, Joshua A. Glickman and Shawn A. Heller of Social Justice
Law Collective, PL, Dunedin, and Ginny G. Powell and Gillis
Edward Powell, Jr. of Powell, Powell & Powell, Crestview, for
Appellant.
Alan D. Lash, Lorelei J. Van Wey, Michael L. Ehren, and Jonathan
L. Williams of Lash & Goldberg LLP, Weston, for Appellee.
9