{
  "id": 8550639,
  "name": "WAKE COUNTY HOSPITAL SYSTEM, INC., and FORSYTH MEMORIAL HOSPITAL v. NORTH CAROLINA INDUSTRIAL COMMISSION; J. W. BEAN, Chairman; FORREST H. SHUFORD, II, Member; and WILLIAM F. MARSHALL, JR., Member, NORTH CAROLINA INDUSTRIAL COMMISSION",
  "name_abbreviation": "Wake County Hospital System, Inc. v. North Carolina Industrial Commission",
  "decision_date": "1970-05-27",
  "docket_number": "No. 6910SC240",
  "first_page": "259",
  "last_page": "262",
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      "cite": "8 N.C. App. 259"
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  "court": {
    "name_abbreviation": "N.C. Ct. App.",
    "id": 14983,
    "name": "North Carolina Court of Appeals"
  },
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    "name_long": "North Carolina",
    "name": "N.C."
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      "category": "reporters:state_regional",
      "reporter": "S.E.2d",
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    },
    {
      "cite": "276 N.C. 316",
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    {
      "cite": "229 N.C. 472",
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      "category": "reporters:state_regional",
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    {
      "cite": "229 N.C. 465",
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    {
      "cite": "134 S.E. 2d 354",
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      "opinion_index": 0
    },
    {
      "cite": "261 N.C. 234",
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  "last_updated": "2023-07-14T18:36:14.673474+00:00",
  "provenance": {
    "date_added": "2019-08-29",
    "source": "Harvard",
    "batch": "2018"
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  "casebody": {
    "judges": [
      "MallaRD, C.J., and Beitt, J., concur."
    ],
    "parties": [
      "WAKE COUNTY HOSPITAL SYSTEM, INC., and FORSYTH MEMORIAL HOSPITAL v. NORTH CAROLINA INDUSTRIAL COMMISSION; J. W. BEAN, Chairman; FORREST H. SHUFORD, II, Member; and WILLIAM F. MARSHALL, JR., Member, NORTH CAROLINA INDUSTRIAL COMMISSION"
    ],
    "opinions": [
      {
        "text": "PARKER, J.\nBy this action plaintiffs seek to challenge the validity of the schedule of hospital charges approved by defendant Commission in the treatment of compensation cases subject to the provisions of the North Carolina Workmen\u2019s Compensation Act. That Act, in G.S. 97-91, provides:\n\u201cAll questions arising under this article if not settled by agreements of the parties interested therein, with the approval of the Commission, shall be determined by the Commission, except as otherwise herein provided.\u201d\nCharges of hospitals for hospital and nursing services under the Workmen\u2019s Compensation Act are, by G.S. 97-90(a), expressly made subject to the approval of the Commission. G.S. 97-90(b) provides that any person who receives any fee or other consideration on account of services so rendered, unless such consideration is approved by the Commission, shall be guilty of a misdemeanor. It is, therefore, apparent that plaintiffs\u2019 action presents \u2018\u2018questions arising under\u201d the North Carolina Workmen\u2019s Compensation Act, which, by virtue of G.S. 97-91, \u201cshall be determined by the Commission.\u201d G.S. 97-91 is not limited in its application, as appellants contend, solely to questions arising out of an employer-employee relationship or in the determination of rights asserted by or on behalf of an injured employee. Clark v. Ice Cream Co., 261 N.C. 234, 134 S.E. 2d 354, did not so hold. On the contrary the North Carolina Supreme Court has held in Worley v. Pipes, 229 N.C. 465, 50 S.E. 2d 504, and in Matros v. Owen, 229 N.C. 472, 50 S.E. 2d 509, that the sole remedy of a physician to recover for services rendered to an injured employee in cases where the employee and his employer are subject to the Workmen\u2019s Compensation Act is by application to the Industrial Commission in accordance with the Act, with right of appeal to the courts for review, and that this remedy is exclusive. These decisions are equally applicable to charges for hospital services rendered to employees in Workmen\u2019s Compensation cases.\nAppellants further contend that, even if it be conceded that their action presents a question arising under the Workmen\u2019s Compensation Act, they are nevertheless entitled to maintain their action because the allegations of their amended complaint establish that plaintiffs have exhausted their administrative remedies before the Commission. We do not agree. In their amended complaint plaintiffs alleged that \u201creview of the North Carolina Industrial Commission rates was requested by the plaintiffs and a hearing was held at which time information was offered and additional information has been provided to the defendants,\u201d and that the Commission \u201chas refused and continues to refuse to make a decision in regard to said rates.\u201d Even accepting these allegations as true, it is apparent from plaintiffs\u2019 amended complaint that they have not sought and been denied Commission approval of any specific charge made by either of them for hospital services rendered in a Workmen\u2019s Compensation c\u00e1se. Under the authority of G.S. 97-80(a), the Commission has adopted rules for carrying out the provisions of the Workmen\u2019s Compensation Act. Rule VIII of the Industrial Commission refers to the adoption of fee schedules fixing maximum fees which may be fcharged for medical, surgical, hospital, nursing, dental and other treatment rendered to injured employees coming within the provisions of the Act. That rule expressly provides that: \u201cPersons who disagree with the allowance of such fees in any case may make application for and obtain a full review of the matter before the Commission as in all other cases provided.\u201d The rule further provides that the fees prescribed shall govern, \u201cexcept that in special hardship cases where sufficient reason therefor is demonstrated to the Commission, fees in excess of those so published may be allowed.\u201d Plaintiffs\u2019 amended complaint contains no allegation indicating that they have, in this or any other case, followed, much less exhausted, the administrative procedures available to them. \u201c[W]hen the legislature has provided an effective administrative remedy, it is exclusive.\u201d King v. Baldwin, 276 N.C. 316, 172 S.E. 2d 12. For plaintiffs\u2019 failure to exhaust available administrative remedies, defendants\u2019 demurrer was properly sustained.\nAffirmed.\nMallaRD, C.J., and Beitt, J., concur.",
        "type": "majority",
        "author": "PARKER, J."
      }
    ],
    "attorneys": [
      "Hollow ell & Ragsdale, by Edward E. Ragsdale, for 'plaintiff appellant, Wake County Hospital System, Inc.",
      "Roddey M. Lig\u00f3n, Jr., for plaintiff appellant, Forsyth Memorial Hospital.",
      "Attorney General Robert Morgan and Staff Attorney (Mrs.) Christine Y. Denson for defendant appellee."
    ],
    "corrections": "",
    "head_matter": "WAKE COUNTY HOSPITAL SYSTEM, INC., and FORSYTH MEMORIAL HOSPITAL v. NORTH CAROLINA INDUSTRIAL COMMISSION; J. W. BEAN, Chairman; FORREST H. SHUFORD, II, Member; and WILLIAM F. MARSHALL, JR., Member, NORTH CAROLINA INDUSTRIAL COMMISSION\nNo. 6910SC240\n(Filed 27 May 1970)\n1. Master and Servant \u00a7 85\u2014 workmen\u2019s compensation \u2014 jurisdiction of Commission \u2014 challenge to schedule of hospital charges\nAction by nonprofit hospitals which challenged the validity of the schedule of hospital charges approved by the Industrial Commission in the treatment of workmen\u2019s compensation cases presented a question arising under the Compensation Act which was determinable by the Commission. 6.S. 97-91.\n2. Master and Servant \u00a7 85\u2014 compensation cases \u2014 jurisdiction of Commission\nThe section of the Workmen\u2019s Compensation Act providing that all questions arising under the Act shall be determined by the Industrial Commission is not limited in its application solely to questions arising out of an employer-employee relationship or in the determination of rights asserted by or on behalf of an injured employee. G.S. 97-91.\n3. Master and Servant \u00a7 85; Administrative Law \u00a7 2\u2014 compensation case \u2014 challenge to hospital charges \u2014 exhaustion of remedies before Commission\nNonprofit hospitals which sought to challenge the validity of hospital charges approved by the Industrial Commission in the treatment of workmen\u2019s compensation cases were not entitled to maintain their action in the superior court on the ground that they had exhausted their administrative remedies before the Commission, where it was apparent from the hospitals\u2019 amended complaint that they had not sought and been denied Commission approval of any specific charge made by them for hospital services in a compensation case, as provided by Rule VIII of the Commission; therefore, the superior court properly sustained the Commission\u2019s demurrer to the complaint for failure of the hospitals to exhaust their remedies before the Commission.\n4. Administrative Law \u00a7 2\u2014 exclusiveness of administrative remedy\nWhen the legislature has provided an effective administrative remedy, it is exclusive.\nAppeal by plaintiffs from McKinnon, J., February 1969 Regular Civil Session of Wake Superior Court.\nPlaintiffs are nonprofit corporations operating general hospitals on a nonprofit basis in Wake and Forsyth Counties, North Carolina. Defendants are the North Carolina Industrial Commission (the Commission) and its members. Plaintiffs filed this civil action in Wake Superior Court seeking to enjoin enforcement by the Commission of so much of its rules and regulations as limit payment to plaintiff hospitals for hospital services rendered by them in Workmen\u2019s Compensation cases to amounts which plaintiffs allege are \u201cbelow those normally charged by the plaintiff hospitals, and are less than the charges that prevail in the plaintiffs\u2019 respective communities for similar treatment of injured persons of a like standard of living when such treatment is paid for by the injured person.\u201d Plaintiffs allege that the defendant Commission is \u201cwithout legal authority to adopt rules and regulations limiting the amount that can be paid to hospitals in North Carolina, including plaintiff hospitals, in Workmen\u2019s Compensation cases, below that customarily charged by hospitals in the community for like services.\u201d In an amended complaint plaintiffs further allege that review of the rates was \u201crequested by the plaintiffs and a hearing was held at which time information was offered and additional information has been provided to the defendants,\u201d but that the \u201cCommission has refused and continues to refuse to make a decision in regard to said rates.\u201d\nFrom order sustaining defendants\u2019 demurrer interposed upon the grounds that plaintiffs failed to exhaust administrative remedies available under the provisions of the Workmen\u2019s Compensation Act, plaintiffs appealed.\nHollow ell & Ragsdale, by Edward E. Ragsdale, for 'plaintiff appellant, Wake County Hospital System, Inc.\nRoddey M. Lig\u00f3n, Jr., for plaintiff appellant, Forsyth Memorial Hospital.\nAttorney General Robert Morgan and Staff Attorney (Mrs.) Christine Y. Denson for defendant appellee."
  },
  "file_name": "0259-01",
  "first_page_order": 283,
  "last_page_order": 286
}