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Mission Hospital Regional Medical Center et al v. Toby Douglas


May 25, 2011


(Super. Ct. No. 05-CS-01398) (Super. Ct. No. 06-CS-01279)

The opinion of the court was delivered by: Nicholson, J.

Mission Hosp. Reg. Med. Center v. Douglas



California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

In Mission Hospital Regional Medical Center v. Shewry (2008) 168 Cal.App.4th 460 (Mission Hospital I), this court ordered a writ of mandate be issued to prohibit the state Department of Health Care Services (the Department) from applying a legislatively enacted rate freeze when determining reimbursements owed to plaintiffs for rendering inpatient care to Medi-Cal patients. By the time the writ issued, the Department had mostly completed its reimbursement determinations.

Plaintiffs then sought to enforce the writ by seeking an order compelling the Department to recalculate its reimbursement determinations and reimburse plaintiffs money they would have received had the rate freeze not been applied. The trial court granted plaintiffs' request.

The Department appeals. We conclude the trial court exceeded its authority by ordering relief that exceeds the scope of our order and that was neither pleaded nor proven by the plaintiffs. We reverse on that basis.


The underlying action's facts and statutory background are detailed in Mission Hospital I and will not be repeated here. For purposes of this appeal, it is important to understand the following:

Plaintiffs, a group of over 100 California hospitals, filed petitions for writs of traditional mandate in 2005 challenging the Legislature's 2004 enactment of a law that froze rates the state would apply to reimburse plaintiffs for inpatient services they rendered to Medi-Cal patients during the state's 2004-2005 fiscal year. The freeze was contained in section 32 of Senate Bill No. 1103 (2003-2004 Reg. Sess.) (Stats. section 32).

Plaintiffs claimed the Legislature adopted Stats. section 32 in violation of federal Medicaid law and the federal and state Constitutions. In particular, plaintiffs alleged the Legislature adopted the rate freeze without complying with notice and hearing requirements imposed by 42 U.S.C. § 1396a(a)(13)(A) (section (13)(A)), and without making certain substantive findings required by 42 U.S.C. § 1396a(a)(30)(A) (section (30)(A)).

Plaintiffs prayed for a writ of mandate declaring Stats. section 32 violated section (13)(A), section (30)(A), federal regulations, the state Medicaid plan, and the federal and state Constitutions. Plaintiffs also prayed for a writ of mandate to prohibit the Department from implementing Stats. section 32 without first complying with all applicable laws. Except to ask for attorney fees, costs of suit, and any other relief the court deemed proper, plaintiffs did not pray for monetary relief or damages.*fn1

By judgment entered December 19, 2006, approximately eight months after the Department began applying Stats. section 32, the trial court rejected most of plaintiffs' allegations. It concluded plaintiffs were entitled to mandamus relief only in so far as Stats. section 32 applied to services the hospitals rendered before Stats. section 32 was enacted. It denied the petitions in all other respects.

On November 19, 2008, we reversed the trial court's judgment in Mission Hospital I. In short, we concluded section (13)(A)'s notice and hearing requirements applied to the Legislature's attempts to set reimbursement rates, and the Legislature had failed to comply with section (13)(A) when it adopted Stats. section 32. Section (13)(A) applied pursuant to the federal Constitution's supremacy clause (U.S. Const., art. VI, cl. 2), and under principles of cooperative federalism on which the federal Medicaid program is based. (Mission Hospital I, supra, 168 Cal.App.4th at pp. 484-492.) We ordered the trial court to issue a writ of mandate prohibiting the Department from utilizing Stats. section 32 in its calculations of plaintiffs' reimbursement rates for the state fiscal year 2004-2005. (Id. at p. 493.)

The Department petitioned the California Supreme Court for review. The Department did not challenge our ruling substantively, but rather challenged the relief we ordered. The Department stated it had already calculated and paid reimbursements in accordance with Stats. section 32. It alleged it had no authority to recalculate and pay different rates to plaintiffs. "Therefore," the Department wrote, "it would appear that the court of appeal's order creates a conflict regarding whether the superior court will properly be able to enjoin [the Department] from utilizing the standards at issue."

The Supreme Court denied review on February 11, 2009. (Mission Hospital I, supra, 168 Cal.App.4th at p. 493.) Our remittitur issued one week later on February 17, 2009.

The trial court issued a peremptory writ of mandate on April 22, 2009. The writ prohibited the Department "from utilizing section 32 of Senate Bill 1103 in your calculations of petitioners' reimbursement rates for the state fiscal year 2004-2005." At a status conference, the court stated any disputes regarding compliance with the writ would be resolved by noticed motion.

By letter dated April 17, 2009, the Department informed plaintiffs how it would comply with the writ. The Department stated it would cease utilizing Stats. section 32 for calculating reimbursements that remained to be determined for the 2004-2005 fiscal year "until after its affirmative defenses of sovereign immunity and mandamus have been finally adjudicated." However, the Department would not provide any retroactive relief. In the Department's opinion, "sovereign immunity precludes petitioners from asserting any claims against the Department and, in essence, renders the court of appeal's decision moot."

On May 13, 2009, plaintiffs filed a motion to enforce the writ. They claimed our decision in Mission Hospital I applied to hospital cost reports for which final settlements had not been issued, and to cost reports for which final settlements had already been issued. They argued our decision thus necessarily mandated the Department not just to cease applying Stats. section 32 to remaining reimbursement calculations, but also to recalculate the reimbursement amounts for 2004-2005 for all plaintiffs and to reimburse them the amounts they would have received for that fiscal year had Stats. section 32 not been applied.

The Department opposed the motion. It claimed the state's sovereign immunity barred the relief plaintiffs sought. It also claimed the requested relief exceeded the authority of a writ of mandate by compelling the Department to do more than cease applying Stats. section 32 in the remaining final settlements.

The trial court granted plaintiffs' motion to enforce the writ on June 19, 2009. It ordered the Department immediately to (1) cease applying Stats. section 32 for inpatient hospital services provided by plaintiffs in the state fiscal year 2004-2005; (2) cease applying Stats. section 32 when conducting audits and issuing final settlements for plaintiffs' costs reports for the same time period; (3) cease collecting any amounts due from plaintiffs resulting from applying Stats. section 32; and (4) recalculate and reissue final settlements on plaintiffs' cost reports without applying Stats. section 32 and refund any amounts due after revising the final settlements without application of Stats. section 32.

The Department appeals this order. It claims (1) the ordered relief is barred by the state's sovereign immunity; (2) the court erred by issuing a writ of mandate where monetary relief was the primary purpose of the petition; (3) the court impermissibly ordered the Department to pay unallocated funds; and (4) the ordered relief exceeds the relief we ordered in Mission Hospital I.


We take up the Department's last ground of appeal first. The Department correctly states the relief ordered by the trial court greatly exceeds our order in Mission Hospital I. In that case, we remanded this matter back to the trial court to "issue a writ of mandate enjoining the Department from utilizing Stats. section 32 in its calculations of plaintiffs' reimbursement rates for the state fiscal year 2004-2005." (Mission Hospital I, supra, 168 Cal.App.4th at p. 493.)

The trial court lacked jurisdiction to authorize additional relief beyond what we ordered. All orders issued by a court to enforce compliance with a writ must be consistent with the terms of the original judgment. (See, e.g., Carroll v. Civil Service Commission (1970) 11 Cal.App.3d 727, 733-734 [enforcement order reversed where it went far beyond terms of original writ].)

The court's authority to issue orders enforcing a writ is admittedly broad. "[I]t is a 'well settled rule that the court which issues a writ of mandate retains continuing jurisdiction to make any orders necessary and proper for the complete enforcement of the writ.' [Citations.] This authority, though codified in [Code of Civil Procedure] section 1097, is an inherent power of a court issuing a writ. In Hobbs v. Tom Reed Gold Min. Co. (1913) 164 Cal. 497, 501, the Supreme Court stated '[ample] power to compel obedience is conferred by section 1097 of the Code of Civil Procedure, although, doubtless, the power would exist in the absence of such express grant.'" (King v. Woods (1983) 144 Cal.App.3d 571, 578.)

But this power does not include the power to issue orders beyond the terms of the writ. If a writ ordered only prospective mandamus relief, it cannot be enforced by ordering an additional award of damages or other form of monetary relief to compensate for past harm where no such harm was pleaded or proven at trial. Such an award does nothing to ensure the terms of the mandamus relief, as specified by the writ, are satisfied.

In Mission Hospital I, we did not order any other type of relief, including financial reimbursement, because plaintiffs never placed that issue before us or the trial court. Their petition sought only prospective declaratory and mandamus relief. A writ of mandate may include an award of monetary relief in the form of damages or otherwise (Code Civ. Proc., § 1095), but only if a petitioner alleges and proves it. (Colthurst v. Fitzgerald (1922) 56 Cal.App. 740, 741.) Plaintiffs' petitions did not seek any type of monetary relief. They did not seek a disgorgement or disbursement of funds in any way.

At oral argument, counsel for plaintiffs admitted the petitions did not seek monetary relief. Counsel also admitted plaintiffs at no time sought to amend their petitions to include a request for monetary relief. However, counsel asserted for the first time that by the time of trial, subsequent papers filed with the trial court had requested disgorgement of funds withheld by the Department under Stats. section 32. Plaintiffs argue this was sufficient to give the court jurisdiction to award monetary relief in its enforcement order.

Plaintiffs did not include this argument in their briefs and thus have forfeited it here. Issues raised for the first time at oral argument are deemed forfeited. (People v. Harris (1992) 10 Cal.App.4th 672, 686.)

Even if plaintiffs had raised the argument in their briefing, they still would not prevail. The request for monetary relief about which counsel spoke appeared in plaintiffs' memorandum of points and authorities filed in the trial court in support of their writ petition. An argument in a memorandum of points and authorities does not amend a pleading. (See Code Civ. Proc., § 473, subd. (a)(1).)

We are sympathetic to plaintiffs' and the trial court's efforts to ensure the state does not enrich itself pursuant to its unlawful acts, which are here established by the Legislature and the Department's decision not to challenge Mission Hospital I substantively in their petition for review. However, the enforcement burden rested on plaintiffs. If they wanted to be reimbursed for monies wrongfully withheld or taken, they were burdened to make all appropriate allegations and pleadings for that to occur. They did not do this in Mission Hospital I.

Because we conclude the trial court lacked jurisdiction in this instance to enforce the writ of mandate by means of ordering monetary relief, we need not address the Department's other arguments and we take no position on them.


The order enforcing the writ of mandate is reversed. Costs on appeal are awarded to the Department. (Cal. Rules of Court, rule 8.278(a).)

We concur: BLEASE, Acting P. J. MAURO, J.

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