Submitted:
October 3, 2001
Filed: November 28, 2001
J. Fox DeMoisey, Esq.
Deborah
Lewis Rodecker, Esq.
DeMoisey & Smither
Charleston,
West Virginia
Louisville, Kentucky
Attorney
for the Appellee
C. Page Hamrick, III, Esq.
Charleston, West Virginia
Attorneys for the Appellant
JUSTICE STARCHER delivered the Opinion of the Court.
2. In
determining whether to entertain and issue the writ of prohibition for cases
not involving an absence of jurisdiction but only where it is claimed that the
lower tribunal exceeded its legitimate powers, this Court will examine five
factors: (1) whether the party seeking the writ has no other adequate means,
such as direct appeal, to obtain the desired relief; (2) whether the petitioner
will be damaged or prejudiced in a way that is not correctable on appeal; (3)
whether the lower tribunal's order is clearly erroneous as a matter of law;
(4) whether the lower tribunal's order is an oft repeated error or manifests
persistent disregard for either procedural or substantive law; and (5) whether
the lower tribunal's order raises new and important problems or issues of law
of first impression. These factors are general guidelines that serve as a useful
starting point for determining whether a discretionary writ of prohibition should
issue. Although all five factors need not be satisfied, it is clear that the
third factor, the existence of clear error as a matter of law, should be given
substantial weight. Syllabus Point 4, State ex rel. Hoover v. Berger,
199 W.Va. 12, 483 S.E.2d 12 (1996).
3. In
order to obtain judicial backing for the enforcement of an administrative subpoena,
the agency must prove that (1) the subpoena is issued for a legislatively authorized purpose, (2) the information sought is relevant
to the authorized purpose, (3) the information sought is not already within
the agency's possession, (4) the information sought is adequately described,
and (5) proper procedures have been employed in issuing the subpoena. If these
requirements are satisfied, the subpoena is presumably valid and the burden
shifts to those opposing the subpoena to demonstrate its invalidity. The party
seeking to quash the subpoena must disprove through facts and evidence the
presumed relevance and purpose of the subpoena. Syllabus Point 1, State
ex rel. Hoover v. Berger, 199 W.Va. 12, 483 S.E.2d 12 (1996).
4. A
finding that probable cause exists to substantiate a complaint made under
the Medical Practice Act is not a necessary prerequisite for the Board of
Medicine to issue a subpoena or a subpoena duces tecum under W.Va. Code,
30-3-7(a)(2) [1980].
In this appeal from the Circuit Court of Kanawha County, an appellant sought a writ of prohibition from the circuit court to quash an administrative subpoena duces tecum issued by a state agency. The appellant contends that an administrative subpoena cannot be issued without the state agency first making a specific determination that probable cause exists to believe a statute or regulation has been violated. The appellant challenged the subpoena primarily because the agency made no probable cause determination that the appellant had engaged in any wrongdoing.
The circuit court denied the
requested writ of prohibition. As set forth below, we affirm the circuit court's
decision.
Appellant Scott James Feathers is a practicing podiatrist with offices in Parkersburg and Hurricane, West Virginia. Dr. Feathers is subject to regulation by the appellee, the West Virginia Board of Medicine (Board). In the instant case, the Board is investigating whether Dr. Feathers has engaged in misconduct under the West Virginia Medical Practice Act, W.Va. Code, 30-3-1 to -17.
The Board's regulations, enacted pursuant to the Medical Practice Act, (See footnote 1) state that it may discipline a physician or podiatrist who has [e]ngaged in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public or any member thereof[.] 11 C.S.R. 1A.12.1.e [2001]. The regulations define dishonorable, unethical or unprofessional conduct as including charging or collecting an excessive, unconscionable fee. 11 C.S.R. 1A.12.2.i [2001]. (See footnote 2)
A former patient of Dr. Feathers complained to the Board, alleging that Dr. Feathers had charged the patient and her insurance company an excessive fee. The Board investigated the patient's complaint, and had an informal conference with Dr. Feathers to discuss the patient's allegations. (See footnote 3)
At that informal conference,
Dr. Feathers presented the Board with a March 9, 2000 opinion letter prepared
by a podiatrist at Dr. Feathers' request. The opinion letter stated that the
podiatrist had reviewed the former patient's file to determine if Dr. Feathers
had committed any violation of the Medical Practice Act. The podiatrist
had reviewed the patient's billing information, and concluded that:
. . . while Dr. Feathers' charges
are more than the base charges that I see in my office and in my area of the
state, these are Dr. Feathers' published charges and therefore there has not
been any violation that I can see from the standpoint of overcharging. . . .
The total charges do amount to quite a bit of money; however, chronic heel pain
can be extremely complicated and I have seen cases which involved much more
financial drain on the insurance companies and patients than this particular
case.
The Board determined that the podiatrist's statement that Dr. Feathers' charges
were more than the base charges that I see in my office and in my area
of the state led the Board to decide that further investigation was needed to determine if Dr. Feathers
was charging his patients excessive fees.
On April 4, 2000, the Board
issued a subpoena duces tecum to Dr. Feathers, directing that he provide certain
documents to the Board. First, the Board requested [c]opies of any and
all written fee schedules and office billing procedure manuals. The
parties agree that Dr. Feathers provided these documents to the Board.
Second, the Board sought copies
of the thirty (30) medical records randomly selected by the Board Investigator.
(See footnote 4)
Dr. Feathers refused to produce these documents. On April 7, 2000, he
filed a petition for a writ of prohibition with the circuit court to quash
the subpoena duces tecum. Dr. Feathers contended that the Board had no authority
to issue the subpoena, because the Board did not make a finding that there
was probable cause to believe Dr. Feathers had violated the Medical Practice
Act. Furthermore, Dr. Feathers argued that the Board simply wanted to engage
in a fishing expedition through his files, violating his patients'
right to privacy.
On June 21, 2000, the circuit
court entered an order denying the requested writ of prohibition. The circuit
court reasoned that the Board did not need probable cause to subpoena records as part of an investigation, and that the Board's regulations
allowed the use of a subpoena to further any investigation by the Board when
the subpoena would likely lead to admissible evidence. The circuit court also
determined that a review of 30 patient records to determine if there were
irregular billing practices would not amount to an unreasonable and oppressive
request. Additionally, the circuit court found that the Board itself is charged
with protecting a patient's right to the confidentiality of medical information
contained in their medical file, and that a doctor cannot assert a patient's
right to confidentiality to limit a legitimate investigation intended to benefit
the public health. The circuit court therefore ordered Dr. Feathers to comply
with the subpoena duces tecum.
Dr. Feathers then filed the
instant appeal.
There are five factors that
a court will consider in determining whether it is appropriate to issue a writ
of prohibition:
Through the passage of W.Va. Code, 30-3-7(a)(2) [1980], the Legislature gave the Board of Medicine the power to issue subpoenas. As we noted in State ex rel. Hoover v. Berger, 199 W.Va. at 17, 483 S.E.2d at 17, the statute places few restrictions on that power. The statute simply provides that [(i)]n carrying out [its] functions, the board may: . . . (2) Hold hearings and conduct investigations, subpoena witnesses and documents and administer oaths. . . . The parameters and constraints on the Board's power to issue subpoenas are to be found in the standards that courts have established to protect constitutional, statutory and common law rights and privileges. 199 W.Va. at 17, 483 S.E.2d at 17.
We made clear in State
ex rel. Hoover v. Berger that an administrative subpoena duces tecum is
not self-executing, but is a direction to produce documents subject to judicial
review and enforcement. Thus, the subject or target of an administrative subpoena
duces tecum may challenge the subpoena before yielding the information sought.
Privileges, privacy rights and the unreasonableness of an administrative subpoena
are available defenses when challenging the enforcement of the subpoena. Id.
We established in State
ex rel. Hoover v. Berger five requirements that an agency must meet for
the judicial enforcement of an administrative subpoena which are tightly
drawn, but are not onerous. Id. If these requirements are met,
the subpoena is presumably valid and the burden shifts to the party opposing the subpoena's
enforcement. We held at Syllabus Point 1 of State ex rel. Hoover v. Berger
that:
In order to obtain judicial
backing for the enforcement of an administrative subpoena, the agency must
prove that (1) the subpoena is issued for a legislatively authorized purpose,
(2) the information sought is relevant to the authorized purpose, (3) the
information sought is not already within the agency's possession, (4) the
information sought is adequately described, and (5) proper procedures have
been employed in issuing the subpoena. If these requirements are satisfied,
the subpoena is presumably valid and the burden shifts to those opposing the
subpoena to demonstrate its invalidity. The party seeking to quash the subpoena
must disprove through facts and evidence the presumed relevance and purpose
of the subpoena.
We made clear in State ex rel. Hoover v. Berger that these requirements
apply to the Board of Medicine in the same way that they apply to subpoenas
issued by other agencies. If
these five factors are satisfied in the instant case, the subpoena issued
by the Board is presumptively valid, and the burden shifts to Dr. Feathers
to disprove, through facts and evidence, the presumed relevance, purpose,
and enforceability of the subpoena. We therefore examine the record presented
below to determine if the circuit court correctly enforced the Board's subpoena.
The record is clear that the
Board has met its burden on the first four requirements in Syllabus Point
1 of State ex rel. Hoover v. Berger. The subpoena was issued for a
legislatively authorized purpose -- to investigate Dr. Feathers' professional
conduct. The 30 randomly selected files were sought to determine whether Dr.
Feathers was charging or collecting an excessive, unconscionable fee.
Moreover, the Board correctly states that
Dr. Feathers made his billing practices toward other patients an issue through
his own expert's opinion that, as a general practice, Dr. Feathers' fees were
more than the base charges of other podiatrists performing the same procedures.
The information sought by the subpoena is not within the Board's possession.
And finally, under the circumstances, the information sought has been adequately
described.
(See footnote 5)
Dr. Feathers' arguments largely
focus on the fifth requirement -- whether proper procedures were employed
by the Board in issuing the subpoena. Dr. Feathers asserts that a prior finding
of probable cause is necessary because, as we suggested in State
ex rel. Hoover v. Berger, without some meritorious justification,
an administrative subpoena duces tecum is not some talisman that dissolves
all rights and privileges of the citizens of this State. 199 W.Va. at
19, 483 S.E.2d at 19. Dr. Feathers argues that the Board -- through a subcommittee
known as the Complaint Committee -- is required to find probable
cause to believe there has been a violation of the law, before it can issue
an investigative subpoena. Dr. Feathers cites to one of the Board's many regulations,
which states:
If the complaint committee
determines that there is reason to believe that the acts alleged occurred
and constitute a violation for which a licensee may be sanctioned by the Board, the complaint committee
shall find probable cause to believe there is a violation of the law or this
rule.
11 C.S.R. 3.10.14 [2001] (emphasis added).
The Board counters that the
relevant statutes and regulations, read together, allow the Board to conduct
an investigation and to use its subpoena power to determine whether any merit
exists in a complaint. The Board argues that a probable cause
determination can ordinarily be made only after an investigation has, to some
degree, been conducted into the substance of the complaint. We agree with
the Board's position.
Our reading of the statutes
and regulations at issue suggests some ambiguity regarding when the Board
must make a probable cause determination. However, [i]t is not for this
Court arbitrarily to read into [those statutes and regulations] that which
it does not say. Just as courts are not to eliminate through judicial interpretation
words that were purposely included, we are obliged not to add to statutes
something the Legislature purposely omitted. Banker v. Banker,
196 W.Va. 535, 546-47, 474 S.E.2d 465, 476-77 (1996).
W.Va. Code, 30-3-7(a)(2)
empowers the Board to [h]old hearings and conduct investigations, [and]
subpoena witnesses and documents in order to regulate the professional
conduct of podiatrists -- without making any requirement of a prior probable
cause finding. Similarly, the Board's regulations, which have been approved
by the Legislature, state that upon receiving a complaint, the Board may investigate
the allegations in the complaint and issue subpoenas to complete that investigation
-- again, without any requirement of a prior probable cause finding.
(See footnote 6) It would be erroneous to
read into these two enactments a probable cause requirement that is in fact
conspicuously absent.
Furthermore, when regulations
enacted by an agency have been legislatively approved, they have the force
of statutes and are interpreted according to ordinary canons of statutory
interpretation. See HCCRA v. Boone Memorial Hospital, 196 W.Va.
326, 472 S.E.2d 411 (1996). Enactments which relate to the same subject matter
are to be construed consistently with one another. See, e.g., Syllabus
Point 1, Owens-Illinois Glass Co. v. Battle, 151 W.Va. 655, 154 S.E.2d
854 (1967).
The Board's regulations, read
consistently with one another, set forth a procedure whereby the Board may
exercise its subpoena power to investigate a complaint before making
a probable cause determination. Under the regulations, in order to investigate
the allegations in a complaint, the Board may conduct an informal meeting
with the doctor targeted by the complaint,
(See footnote 7) or may require the doctor
to file a formal answer.
(See footnote 8) As part of this investigative
process, the Board may use its subpoena authority. Once the Board completes
its investigation of the complaint, the regulations allow the Board to take
one of two actions: dismiss the complaint,
(See footnote 9) or find probable cause to
believe there is a violation of the law
(See footnote 10) and proceed to a public
hearing.
(See footnote 11) If the Board makes a determination that
there is probable cause to believe a violation of the Medical Practices Act has occurred, all of
the Board's proceedings become matters of public record. W.Va. Code,
30-3-14(p) [1999]. The Board must then promptly provide the doctor with information
regarding potential witnesses, copies of statements held by the Board, and
otherwise provide the doctor with discovery.
(See footnote 12)
The argument posited by Dr. Feathers would, in essence, require that probable cause be found once a complaint is filed and before any other action could be taken by the Board. If we were to adopt Dr. Feathers' argument, the Board would be required to make a probable cause determination almost exclusively upon the complaint. Upon making a probable cause determination, all of the allegations in the complaint -- whether supportable or not -- would become matters of (potentially embarrassing) public scrutiny under W.Va. Code, 30-3-14(p). The Board would have to investigate the allegations in the complaint within -- at most -- 20 days. Under Dr. Feathers' position, the Board would be permitted to investigate through the exercise of its subpoena power during this period, and would at the end of 20 days be required to identify those witnesses and exhibits that the Board will use in the hearing on the complaint. See W.Va. Code, 30-3-14(i). We do not believe the Legislature intended to put the medical community and the Board in such a potentially embarrassing and, perhaps, impossible situation.
Read together, the statutes
and regulations governing the Board's disciplinary process clearly evince
a system whereby the Board is permitted to conduct an investigation, and use
its subpoena power as part of that investigation, before making a finding
of probable cause. A finding that probable cause exists to substantiate a
complaint made under the Medical Practice Act is not a necessary prerequisite
for the Board of Medicine to issue a subpoena or a subpoena duces tecum under
W.Va. Code, 30-3-7(a)(2) [1980].
Dr. Feathers also contends
that the Board's subpoena duces tecum is procedurally defective because it
did not specifically exempt from its coverage the files of his patients who
had submitted to HIV testing or the mental health records of his patients.
Dr. Feathers asserts that information concerning the HIV-status and the mental
health of patients is statutorily-protected information that cannot be obtained
through an administrative subpoena.
(See footnote 13) In essence, Dr. Feathers contends that
a patient file covered by the Board's subpoena might contain protected
information -- and therefore, the subpoena as a whole cannot be enforced.
We disagree.
The Board's subpoena in the
instant case does not specifically seek protected information regarding a
patient's HIV status or mental health treatment. However, it is true that
such protected information could come to light when a Board investigator probes
through a patient's file.
After carefully examining the record below, we conclude that the circuit court did not err. Applying the five-part test set forth in Syllabus Point 1 of State ex rel. Hoover v. Berger, the Board of Medicine established a right to have its administrative subpoena judicially enforced, and Dr. Feathers failed to establish through the evidence that the subpoena duces tecum should be quashed. Nothing in the record supports the conclusion that the Board exceeded its jurisdiction in issuing the subpoena duces tecum.
We therefore affirm the circuit
court's June 21, 2000 order, denying Dr. Feathers the requested writ of prohibition.
Affirmed.
cause to believe that acts alleged occurred and may constitute a violation
of any provision of law or this rule. The complaint committee may take such
action as it determines a complaint warrants.
Once a probable cause determination found to exist, the Board is required
to make all of its disciplinary proceedings public; if probable cause does
not exist, then only the charges and findings of fact and conclusions of law
supporting the dismissal become public. W.Va. Code, 30-3-14(p) [1999]
states, in pertinent part:
In every case considered by
the board under this article regarding discipline or licensure . . . the board
shall make a preliminary determination as to whether probable cause exists
to substantiate charges of disqualification . . . If such probable cause is
found to exist, all proceedings on the charges shall be open to the public
who shall be entitled to all reports, records, and nondeliberative materials
introduced at the hearing, including the record of the final action taken[.]
See also, Daily Gazette Co., Inc. v. W.Va. Board of Medicine,
177 W.Va. 316, 352 S.E.2d 66 (1986) (under what was formerly W.Va. Code,
30-3-14(o)[1986], if probable cause exists to substantiate a charge, then
all proceedings on such charges shall be open to the public; if
probable cause does not exist, then the public has a right of access
to the complaint or other document setting for the charges, and the findings
of fact and conclusions of law supporting the dismissal.)