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Aguila v. Kennestone Hospital, Inc.

Court of Appeals of Georgia, Third Division

October 31, 2019

AGUILA
v.
KENNESTONE HOSPITAL, INC.

          DILLARD, P. J., GOBEIL and HODGES, JJ.

          Hodges, Judge.

         Rudy Aguila sued Kennestone Hospital, Inc. for fraud, negligent misrepresentation, and violations of the Racketeer Influenced and Corrupt Organizations ("RICO") Act arising from a hospital lien Kennestone filed following its treatment of Aguila. See OCGA § 44-14-470 et seq. Kennestone filed a motion to dismiss Aguila's complaint, arguing, inter alia, that Aguila failed to demonstrate that Kennestone made a false statement in its verified statement in support of the lien.[1]See OCGA § 44-14-471 (a) (2). The trial court granted Kennestone's motion, and Aguila appeals. Because we conclude that this case is controlled adversely to Kennestone by our recent decision in Clouthier v. The Medical Center of Central Ga., No. A19A0848, 2019 Ga.App. LEXIS 515 (decided Sept. 20, 2019), we reverse the trial court's order granting Kennestone's motion to dismiss. However, we remand this case to permit the trial court the opportunity to consider Kennestone's remaining grounds in support of its motion to dismiss.

         Under Georgia law,

[a] motion to dismiss for failure to state a claim upon which relief may be granted should not be sustained unless (1) the allegations of the complaint disclose with certainty that the claimant would not be entitled to relief under any state of provable facts asserted in support thereof; and (2) the movant establishes that the claimant could not possibly introduce evidence within the framework of the complaint sufficient to warrant a grant of the relief sought. If, within the framework of the complaint, evidence may be introduced which will sustain a grant of the relief sought by the claimant, the complaint is sufficient and a motion to dismiss should be denied. In deciding a motion to dismiss, all pleadings are to be construed most favorably to the party who filed them, and all doubts regarding such pleadings must be resolved in the filing party's favor.

(Footnotes omitted; emphasis supplied.) Anderson v. Flake, 267 Ga. 498, 501 (2) (480 S.E.2d 10) (1997). To that end,

minimum pleading requirements are found in OCGA § 9-11-8 (a) (2) (A), which requires that the complaint contain "[a] short and plain statement of the claims showing that the pleader is entitled to relief," and we have held that the touchstone is fair notice - "this short and plain statement must include enough detail to afford the defendant fair notice of the nature of the claim and a fair opportunity to frame a responsive pleading."

(Citations omitted.) Aetna Workers' Comp Access v. Coliseum Medical Center, 322 Ga.App. 641, 651 (4) (746 S.E.2d 148) (2013).

         So viewed, the record reveals that Aguila sustained injuries in a July 30, 2011 motor vehicle collision. An ambulance transported Aguila to Kennestone for treatment, where he was treated in the emergency room, admitted to the hospital, and subsequently released. At some point, Kennestone learned that Aguila's injuries were the result of a collision in which a third party could be liable; as a result, it filed a hospital lien pursuant to OCGA § 44-14-471 in the amount of $16, 053.25. Aguila alleged that the lien was "for the full 'chargemaster' rate or 'sticker price' which does not represent a reasonable charge for the treatment [he] received, and . . . Kennestone [knew] it." Kennestone offered to reduce the lien and, ultimately, Aguila satisfied the lien for $11, 700.

          Aguila then filed the present action seeking damages from Kennestone for fraud, negligent misrepresentation, violations of the RICO Act, punitive damages, and attorney fees. Aguila averred that Kennestone accepted the chargemaster rate for only 27% of its patients and that, as a result, the true value of Aguila's treatment was $4, 353.25. Kennestone answered and filed a motion to dismiss, primarily asserting that Aguila failed to demonstrate that Kennestone made a false statement in its OCGA § 44-14-471 verified statement in support of its lien.[2] Following a hearing, the State Court of Cobb County granted Kennestone's motion, concluding that Aguila failed to demonstrate that Kennestone made a false statement when it filed its hospital lien. This appeal followed.

         1. In a single enumeration of error, Aguila argues that the trial court erred in granting Kennestone's motion to dismiss because the trial court incorrectly held that Kennestone did not make a false or misleading statement in its verified statement in support of its lien. This question is controlled by our recent decision in the functionally identical case of Clouthier, 2019 Ga.App. LEXIS 515.

         In Clouthier, a plaintiff sued his treating hospital alleging that the hospital's "lien and charges were for the 'full chargemaster rate' or 'sticker price' of his medical procedures, 'which [did] not represent a reasonable charge for the treatment received.'" (Footnote omitted.) 2019 Ga.App. LEXIS at *3 - *4. As a result, "Clouthier claimed that [the hospital] knew that the lien amount was not reasonable" and asserted causes of action for fraud, negligent misrepresentation, and RICO Act violations. Id. at *4. The trial court granted the hospital's motion to dismiss, and Clouthier appealed.

         We reversed the trial court's order dismissing the case, emphasizing that

we are at the motion-to-dismiss stage, prior to the completion of discovery, and we are not considering whether Clouthier's claims will ultimately prove meritorious or the likelihood that Clouthier will indeed be able to introduce evidence to support his claims. "If, within the framework of the complaint, evidence may be introduced which will sustain a grant of relief to the plaintiff, the complaint is sufficient." Thus, "it is the rare case in which a motion to dismiss for failure to state a claim, as opposed to a motion for summary judgment, will provide an appropriate procedural device for securing summary adjudication of the issues raised in a complaint . …"

(Citations omitted; emphasis in original.) Clouthier, 2019 Ga.App. LEXIS 515 at *2 - *3. Applying that standard, we concluded that it did not "appear to a legal certainty that Clouthier would be entitled to no relief under any state of facts which could be proved in support of his claims" and that, therefore, Cloutheir had stated claims for fraud, negligent ...


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