LUIS CARABALLO et al. v. ELECTRIC BOAT CORPORATION et al., SC 19182

Compensation Review Board

 

      Workers’ Compensation; Health Care; Whether Employer’s Liability for Hospital Services Rendered to Employee is Limited by § 31-294d (d) to Hospital’s Actual Cost or Whether Employer Must Pay Rates Published by Hospital Pursuant to § 19a-646.  In these four consolidated workers’ compensation cases, the claimants sustained compensable work related injuries and received hospital treatment.  The hospitals sought payment from the claimants’ employers in accordance with the schedule of charges that hospitals are required to file with the Office of Health Care Access.  They claimed that General Statutes § 19a-646 prohibited them from giving a discount or charging different rates than the published charges absent a specifically negotiated agreement with a payer to do so.  The employers claimed that their liability for the hospital services rendered to the claimants is limited by § 31-294d (d) of the Workers’ Compensation Act to “the amount it actually costs the hospital to render the service, as determined by the commissioner . . . .”  The difference between the actual costs and the published rates is substantial.  The workers’ compensation commissioner found that the language of § 31-294d (d) that limits an employer’s liability to what it “actually costs” the hospital to render the services was implicitly repealed and that the employers must pay the hospitals’ published charges.  The commissioner relied on language from Burge v. Stonington, 219 Conn. 581 (1991), in which the Supreme Court stated that No. 73-117 of the 1973 Public Acts, which established a commission on hospitals and health care, effectively preempted the entire field of hospital rate setting and, as a result, implicitly repealed the “actually costs” language then set out in § 31-294.  The employers appealed to the Workers’ Compensation Review Board, which reserved the case to the Appellate Court pursuant to General Statutes § 31-324, and the Supreme Court transferred the matter to itself.  The employers argue that the language from Burge concerning Public Act 73-117 on which the commissioner relied was dictum, as the issue before the Burge court turned on the interplay of § 31-294 with a different statutory scheme governing hospital rates and liability for payment that has since been repealed.  The employers further argue that if Burge held that Public Act 73-117 implicitly repealed the “actually costs” language from § 31-294, that holding should be overruled because it was in error.  The employers further claim that if the “actually costs” language in § 31-294 was implicitly repealed by Public Act 73-117, the language was revived or reenacted by subsequent legislation and is a viable part of § 31-294d (d) today.  Finally, the employers claim that the “actually costs” language contained in § 31-294d (d) does not irreconcilably conflict with § 19a-646 and that if the two statutes cannot be reconciled, then § 31-294d (d) should control.