GENESIS CENTER PLC V BLUE CROSS BLUE SHIELD
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STATE OF MICHIGAN
COURT OF APPEALS
GENESIS CENTER, PLC, FLOYD GOODMAN,
M.D., GREGORY MESSENGER, M.D., DAVE
DETRISAC, M.D., GREG UITVLUGT, M.D.,
JOE MASHNI, M.D., FRANK ROSENBAUM,
M.D., HAROLD STERLING, JR., D. P. M., JOHN
THROCKMORTON, D.P.M., URVISH SHAH,
M.D., KENNETH STEPHENS, D.O., CAROL
BEALS, M.D., DIVYAKANT GANDHI, M.D.,
HERBERT ROSS, D.O., KURT RICHARDSON,
M.D., RICHARD FERRO, D.O. and PHILLIP
STORM, M.D.,
FOR PUBLICATION
December 15, 2000
9:30 a.m.
Plaintiffs-Appellants,
v
No. 214867
Wayne Circuit Court
LC No.98-808842 CZ
BLUE CROSS AND BLUE SHIELD OF
MICHIGAN,
Defendant-Appellee.
Updated Copy
February 2, 2001
Before: Bandstra, C.J., and Saad and Meter, JJ.
PER CURIAM.
Plaintiffs appeal as of right from a circuit court order denying their motion for partial
summary disposition and granting defendant Blue Cross and Blue Shield of Michigan's
(BSBSM) motion for summary disposition pursuant to MCR 2.116(C)(8) and (I)(2). We affirm.
I. FACTS AND PROCEDURE
Plaintiff Genesis Center, P.L.C. (Genesis) is a freestanding outpatient surgical center in
Lansing whose physician-owners (the individual plaintiffs) perform nonemergency surgeries,
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which are billed in two separate components: a surgeon's fee and a facility charge. Although the
physicians' services are payable under BCBSM policies, Genesis' facility charges are not covered
because Genesis is not a participating provider facility. As a result, Genesis applied to BCBSM
to participate in its surgical facility program. BCBSM denied Genesis' application, finding that
Genesis did not show "evidence of necessity" (EON) because "there remains an excess of
operating room capacity in Ingham County." Plaintiffs then filed a complaint and a request for
declaratory judgment, alleging that BCBSM's action violated its enabling statute, the Nonprofit
Health Care Corporation Reform Act, MCL 550.1101 et seq.; MSA 24.660(101) et seq. After
plaintiffs filed a motion for partial summary disposition pursuant to MCR 2.116(C)(10),
defendant moved for entry of summary disposition pursuant to MCR 2.116(C)(8) and (I)(2),
arguing, inter alia, that (1) the Nonprofit Health Care Corporation Reform Act does not provide
for a private cause of action against a nonprofit health care corporation by a health care provider;
(2) the EON requirement does not conflict with the Public Health Code; (3) the act expressly
authorized BCBSM to establish standards such as EON for provider participation, and (4) such
authorization does not constitute an illegal delegation of governmental authority.1 The trial court
denied plaintiffs' motion for partial summary disposition and granted defendant's motion for
summary disposition. The court ruled as a matter of law that plaintiffs did not have standing
because they had no private right of action against BCBSM.
II. ANALYSIS
We conclude that the trial court did not err in holding that plaintiffs could not sue
BCBSM for an alleged violation of the Nonprofit Health Care Corporation Reform Act, MCL
550.1101 et seq.; MSA 24.660(101) et seq. Under BPS Clinical Laboratories v Blue Cross &
Blue Shield of Michigan (On Remand), 217 Mich App 687, 698; 552 NW2d 919 (1996), Detroit
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Area Agency on Aging v Office of Services to the Aging, 210 Mich App 708, 716-717; 534 NW2d
229 (1995), and MCL 550.1402(11); MSA 24.660(402)(11), plaintiffs did not have standing to
bring a cause of action directly against BCBSM to enforce the act. We agree with, and adopt as
our own, the following analysis of this identical issue, set forth in this Court's recent decision in
Blakewoods Surgery Center v BCBSM, unpublished opinion per curiam of the Court of Appeals,
issued July 14, 2000 (Docket No. 213666):
In BPS Clinical Laboratories v Blue Cross & Blue Shield of Michigan (On
Remand), 217 Mich App 687, 698; 552 NW2d 919 (1996), this Court, citing MCL
550.1619(2) and (3); MSA 24.660(619)(2) and (3), held that "[o]nly the Attorney
General and the Insurance Commissioner are entitled to enforce the [NHCCRA]
directly against a health care corporation." The panel further ruled that "[t]he only
private right of action directly against a health care corporation authorized by the
[NHCCRA] is an action by a subscriber against a health care corporation for
damages." Id., citing MCL 550.1402(11); MSA 24.660(402)(11). If a health care
provider claims that a health care corporation has violated the act, the recourse
provided in the statute is to "commence an action in the Ingham Circuit Court to
compel the Insurance Commissioner to enforce the act." Id. Additionally, a
health care provider can petition the attorney general to commence an action to
enjoin violations of the act. See MCL 550.1619(1) and (2); MSA 24.660(619)(1)
and (2). The act contains no provision, however, for a private right of action such
as that brought in the instant case.
Moreover, the NHCCRA created new rights and duties that did not exist at
common law. In such situations, this Court has held:
"Where a new right or a new duty is imposed by statute, the remedy
provided by the statute for enforcement of the right or for nonperformance of the
duty is exclusive unless the remedy is plainly inadequate. Plaintiff was not
precluded from communicating its concerns to the Attorney General's office or to
the local prosecutor. These parties, being specifically designated by the
Legislature to act in situations such as these, are sufficiently capable of forwarding
plaintiff 's grievance in the appropriate forum when the circumstances so dictate.
Because plaintiff is not without an adequate remedy, we conclude that it lacked
standing to raise the . . . issue in the trial court." [Blakewoods, supra, slip op at 2,
quoting Detroit Area Agency on Aging, supra at 716-717 (citations omitted).]
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Although Blakewoods is an unpublished opinion and, therefore, not precedentially
binding, MCR 7.215(C), because we find its analysis persuasive and dispositive of this matter,
we adopt its holding and rationale.
Accordingly, the trial court did not err in dismissing plaintiffs' claims on the basis that
they did not have standing to bring a cause of action directly against defendant.2
Affirmed.
/s/ Richard A. Bandstra
/s/ Henry William Saad
/s/ Patrick M. Meter
1
Defendant also notes that plaintiffs' complaint is virtually identical to a complaint filed in
Blakewoods Surgery Center v BCBSM, unpublished opinion per curiam of the Court of Appeals,
issued July 14, 2000 (Docket No. 213666). There, our Court held that there is no private right of
action under the act against BCBSM, that BCBSM’s use of the EON criteria was authorized by
statute, was constitutional, and does not conflict with the Public Health Code.
2
Having disposed of this matter on the standing issue, we need not address the other issues
raised by the parties.
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