Scottsdale Healthcare, Inc. v. Arizona Health Care Cost Containment System Administration

SUPREME COURT OF ARIZONA

SCOTTSDALE HEALTHCARE, INC., dba ) Arizona Supreme Court
SCOTTSDALE HEALTHCARE – OSBORN, ) No. CV-02-0190-PR
)
Plaintiff-Appellee,) Court of Appeals
) Division One
v. ) No. 1 CA-CV 01-0226
)
ARIZONA HEALTH CARE COST ) Maricopa County
CONTAINMENT SYSTEM ) Superior Court
ADMINISTRATION, an agency of the ) No. CV 98-022481
State of Arizona; and PHYLLIS )
BIEDESS, in her capacity as ) Consolidated with:
Director, )
)
Defendants-Appellants.)
)
BANNER HEALTH SYSTEM, a North )
Dakota non-profit corporation, ) Arizona Supreme Court
dba GOOD SAMARITAN REGIONAL ) No. CV-02-0218-PR
MEDICAL CENTER, )
) Court of Appeals
Plaintiff-Appellee,) Division One
) No. 1 CA-CV 01-0380
v. )
) Maricopa County
ARIZONA HEALTH CARE COST ) Superior Court
CONTAINMENT SYSTEM ) No. CV 99-21939
ADMINISTRATION, an agency of the )
State of Arizona; and PHYLLIS )
BIEDESS, in her capacity as )
Director, )
)
Defendants-Appellants.)
)
BANNER HEALTH SYSTEM, a North )
Dakota non-profit corporation, ) Arizona Supreme Court
dba GOOD SAMARITAN REGIONAL ) No. CV-02-0220-PR
MEDICAL CENTER, )
) Court of Appeals
Plaintiff-Appellee,) Division One
) No. 1 CA-CV 01-0468
v. )
) Maricopa County
ARIZONA HEALTH CARE COST ) Superior Court
CONTAINMENT SYSTEM ) No. CV 99-019370
ADMINISTRATION, an agency of the)
State of Arizona; and PHYLLIS )
BIEDESS, in her capacity as ) O P I N I O N
Director, )
)
Defendants-Appellants.)
)

Appeals from the Superior Court in Maricopa County,
No. CV 98-022481, The Honorable Joseph B. Heilman, Judge, and The
Honorable Mark R. Santana, Judge
No. CV 99-21939, The Honorable Mark R. Santana, Judge
No. CV 99-019370, The Honorable Paul A. Katz, Judge, and
The Honorable F. Pendleton Gaines, III, Judge
REMANDED

Court of Appeals – Division One,
202 Ariz. 365, 45 P.3d 688 (2002)
1 CA-CV 01-0380 (May 30, 2002) (mem. decision)
1 CA-CV 01-0468 (Jun. 4, 2002) (mem. decision)
VACATED

GAMMAGE & BURNHAM, P.L.C Phoenix
By Richard B. Burnham, Cameron C. Artigue,
Susan L. Watchman and Aaron C. Schepler
Attorneys for Consolidated Plaintiffs-Appellees

JOHNSTON & KELLY, P.L.C. Phoenix
By Logan T. Johnston
Attorney for Defendants-Appellants

R Y A N, Justice

¶1 Undocumented aliens are eligible for publicly funded

medical coverage only for an emergency medical condition. See

Ariz. Rev. Stat. (“A.R.S.”) § 36-2905.05(A) (Supp. 1997).1 If a

1
Section 36-2905.05 was repealed in 2001 and replaced by
A.R.S. sections 36-2901.06, -2903.03 (2003). The new statute
applies only to cases arising on or after October 1, 2001. Because
these cases arose before that date we refer to the prior statute.
With respect to the issue in this case, the statutory amendments

2
hospital provides medical treatment for the emergency medical

condition of an undocumented alien, the Arizona Health Care Cost

Containment System (“AHCCCS”) will reimburse the hospital for the

costs of the care. A.R.S. § 36-2905.05 (Supp. 1997). The central

question we must answer in this case is whether an undocumented

alien’s emergency medical condition has necessarily ended when the

initial injury has been stabilized to the point of permitting the

undocumented alien to be transferred from an acute care ward to a

sub-acute care ward.

¶2 This matter involves three consolidated cases: Scottsdale

Healthcare, Inc. v. AHCCCS, 202 Ariz. 365, 45 P.3d 688 (App. 2002);

Banner Health System v. AHCCCS, 1 CA-CV 01-0380 (Ariz. App. May 30,

2002)(mem. decision)(Banner I); and Banner Health System v. AHCCCS,

1 CA-CV 01-0468 (Ariz. App. Jun. 4, 2002)(mem. decision)(Banner

II). All three decisions reversed trial court rulings and upheld

the AHCCCS Director’s determinations that when the undocumented

aliens were transferred from an acute care ward, they were not

suffering from an emergency medical condition, and thus AHCCCS was

not required to reimburse the hospitals for their continuing care

after the transfer. The hospitals petitioned for review. We

consolidated the three cases, see ARCAP 8(b), and granted review

because of the statewide importance of this issue. We have

effected no change in the law. Compare A.R.S. § 36-2905.05(A)
(Supp. 1997), with A.R.S. § 36-2903.03(D) (2003).

3
jurisdiction under Article 6, Section 5(3), of the Arizona

Constitution, A.R.S. section 12-120.24 (2003), and Rule 23 of the

Arizona Rules of Civil Appellate Procedure.

I.

¶3 AHCCCS administers Arizona’s Medicaid program in

accordance with Title XIX of the Social Security Act, 42 U.S.C. §§

1396 to 1396v (2001). See A.R.S. §§ 36-2901 to -2958 (Supp. 1997)

(superseded by A.R.S. §§ 36-2901 to -2975 (2003)). Section 36-

2905.05(A) provides that undocumented aliens are eligible for

AHCCCS coverage “necessary to treat an emergency medical condition

as defined in § 1903(v) of the [S]ocial [S]ecurity [A]ct.” In

relevant part, § 1903(v) of the Social Security Act states the

following:

[T]he term “emergency medical condition” means a medical
condition (including emergency labor and delivery)
manifesting itself by acute symptoms of sufficient
severity (including extreme pain) such that the absence
of immediate medical attention could reasonably be
expected to result in–
(A) placing the patient’s health in serious
jeopardy,
(B) serious impairment to bodily functions, or
(C) serious dysfunction of any bodily organ or
part.

See 42 U.S.C. § 1396b(V)(3) (2000) (codifying § 1903(v) of the

Social Security Act).2

¶4 All the patients involved in these consolidated cases

2
For ease of reference, in the rest of the opinion we
refer to this provision as “the statute” or “§ 1903(v).”

4
were undocumented aliens. The injuries and treatment regimes for

each of the five patients differed greatly.3 But the consistent

thread through all three cases, in terms of interpreting § 1903(v),

is that AHCCCS’s denial of reimbursement to the hospitals coincided

directly with the transfer of patients from an acute care ward to

a rehabilitative type of ward.

¶5 After AHCCCS rejected the hospitals’ grievances of the

denials for reimbursement, hearings were held before administrative

law judges to determine when each patient stopped receiving

treatment for an emergency medical condition, thereby terminating

AHCCCS’s responsibility to reimburse the hospitals. In Scottsdale

Healthcare, the judge recommended that AHCCCS’s denial of the

hospital’s grievance be sustained. In Banner I and Banner II, the

administrative law judges recommended that AHCCCS’s denial of

reimbursement be reversed in whole or in part. In Scottsdale

Healthcare, the AHCCCS Director adopted the recommendation denying

3
At the time of his transfer, the patient in Scottsdale
Healthcare, J.N., was wearing a halo brace to support a surgical
repair to two broken vertebrae in his neck and was unable to sit or
stand on his own. Banner I involved three patients: P.F. was
seriously injured in a car accident and when transferred had
difficulty swallowing and had an impaired cough reflex which placed
him at high risk for aspiration; J.M., when transferred, had to be
fed through a feeding tube, had a tracheostomy, and received
respiratory therapy every four hours; H.L., when transferred, was
partially paralyzed, required a feeding tube, and had cognitive
deficiencies. In Banner II, G.O., as a result of a gunshot wound,
had an open abdominal wound that required multiple surgeries to
close. He was transferred back and forth between acute care and
rehabilitative care clinics. He required a drainage tube and
frequent dressing changes, and was at high risk for infection.

5
reimbursement; in Banner I and Banner II, the Director rejected the

recommendations that the hospitals be reimbursed. The hospitals

appealed to the superior court. The trial courts ruled in favor of

the hospitals, and AHCCCS then appealed the three cases to the

court of appeals.

¶6 The lead decision in the present matter is Scottsdale

Healthcare. The court held that at the time coverage was denied

the patient was not suffering from an “emergency medical condition”

within the meaning of A.R.S. section 36-2905.05(A) and § 1903(v) of

the Social Security Act. Scottsdale Healthcare, 202 Ariz. at 369,

¶ 10, 45 P.3d at 692. The two other cases consolidated for this

opinion relied on Scottsdale Healthcare. See Banner I, slip op. at

¶ 9; Banner II, slip op. at ¶¶ 17-18.

II.

¶7 The hospitals maintain that once a hospital admits an

undocumented alien for treatment of an emergency medical condition,

§ 1903(v) requires AHCCCS to reimburse the hospital for the medical

treatment provided to the undocumented alien until “the treating

physician [has] a reasonable degree of confidence that the patient

and his lay caregivers can manage his medical condition so that

serious adverse consequences are not ‘reasonably likely’ to occur.”

¶8 AHCCCS contends the evidence established that when

transferred, the patients’ conditions in these cases had

stabilized, and thus they were not being treated for emergency

6
medical conditions.

¶9 There is no dispute that when the patients arrived at the

respective hospitals each was suffering from an “emergency medical

condition” within the meaning of § 1903(v). The question is

whether each still suffered from an “emergency medical condition”

at the time of their transfers from an acute care ward or bed. The

answer to this question turns on the determination of when an

emergency medical condition as defined by § 1903(v) ceases, and

therefore AHCCCS’s obligation to pay for medical treatment ends.

Answering the question requires us to interpret the statute.

¶10 We review questions of law involving statutory

interpretation de novo. Forest Guardians v. Wells, 201 Ariz. 255,

258-59, ¶ 9, 34 P.3d 364, 367-68 (2001) (“[I]f the administrative

decision was based on an interpretation of law, it is reviewed de

novo.”). In interpreting a statute, we first look to the language

of the statute itself. Zamora v. Reinstein, 185 Ariz. 272, 275,

915 P.2d 1227, 1230 (1996). Our chief goal is to ascertain and

give effect to the legislative intent. Id. The obvious intent of

§ 1903(v) is to limit publicly funded medical coverage for

undocumented aliens to that necessary to treat “‘emergency medical

conditions’ but not ‘long-term care.’” Mercy Healthcare Ariz.,

Inc. v. AHCCCS, 181 Ariz. 95, 98, 887 P.2d 625, 628 (App. 1994).

¶11 Section 1903(v) has been characterized as “clearly

defin[ing] the scope of coverage.” Id. The statute has also been

7
characterized as “plain in its meaning.” Greenery Rehab. Group,

Inc. v. Hammon, 150 F.3d 226, 233 (2nd Cir. 1998). However, no

bright line can be drawn as to what constitutes an emergency

medical condition because “the unique combination of physical

conditions and the patient’s response to treatment are so varied

that it is neither practical nor possible to define with more

precision all those conditions which will be considered emergency

medical conditions.” Eligibility of Aliens for Medicaid, 55 Fed.

Reg. 36,813, 36,816 (Sep. 7, 1990).

¶12 Before the court of appeals issued its lead decision in

these cases, the courts in Mercy Healthcare and Greenery had

grappled with what § 1903(v) meant by an emergency medical

condition. We initially turn to Mercy Healthcare, the first

decision to interpret the scope of the statute.

¶13 In Mercy Healthcare, the parties had taken positions

similar to those taken by the parties here. The undocumented alien

there had suffered a serious closed head injury. 181 Ariz. at 97,

887 P.2d at 627. After initial treatment at the hospital, the

patient was transferred to a skilled nursing facility. Id. “At

the time of transfer, [the patient] was non-verbal, could not move

his lower extremities, had a gastrointestinal tube for feeding, and

had a tracheostomy.” Id. Mercy Healthcare contended that “if an

undocumented alien initially suffers from an emergency medical

condition, AHCCCS must cover the patient’s treatment so long as the

8
emergency medical condition necessitates uninterrupted care.” Id.

at 98, 887 P.2d at 628. AHCCCS contended that its obligation to

cover an undocumented alien’s medical care ended when the patient’s

condition stabilized. Id.

¶14 The court of appeals rejected both positions. Id. The

court held that the statute required a two-part test. Id.

[T]he statute requires that the medical condition
manifest itself by “an acute symptom (including severe
pain).” The statute then mandates that AHCCCS must cover
services for treatment of that medical condition so long
as absence of immediate treatment for that condition
“could reasonably be expected to result in” one of the
three consequences defined by statute.

Id. at 99, 887 P.2d at 629 (citation omitted). The court expressly

held that “the statute does not limit coverage to services for

treatment while acute symptoms continue.” Id. at 98-99, 887 P.2d

at 628-29 (footnote omitted). The court concluded that the

determination of when a patient’s emergency medical condition no

longer required immediate medical attention is “a material issue of

fact.” Id. at 99, 887 P.2d at 629. Because the matter had been

decided as a result of a motion for summary judgment, id. at 97,

887 P.2d at 627, the court remanded the case for a hearing to

determine when the emergency condition ended.4 Id. at 99, 887 P.2d

at 629.

4
In these cases, unlike in Mercy Healthcare, a full
administrative hearing before an administrative law judge was
conducted during which the facts relevant to the determination of
whether an emergency medical condition persisted could be
ascertained.

9
¶15 Because of the procedural posture of the case, Mercy

Healthcare did not fully develop a test to determine when a patient

no longer is receiving emergency care but instead is receiving

long-term care. Greenery did set forth such a test.

¶16 In Greenery, the patients had “long-term debilitating

conditions requiring ongoing care and daily attention.” 150 F.3d

at 228. The Second Circuit held that the statute was not meant to

cover conditions requiring “ongoing and regimented care.” Id. at

233.5 The court concluded that once “the patients were stabilized

and the risk of further direct harm from their injuries was

essentially eliminated, the medical emergencies ended.” Id. at

232.

¶17 Greenery reasoned that because the statute used the verb

manifesting “in the present progressive tense . . . the statute

plainly requires that the acute indications of injury or illness

must coincide in time with the emergency medical condition.” Id.

at 232. Thus, “emergency medical conditions are sudden, severe and

short-lived physical injuries or illnesses that require immediate

treatment to prevent further harm.” Id. Applying this test to the

5
The patients in Greenery had been transferred to an out-
of-state facility specializing in nursing and rehabilitative care
for persons with brain injuries. 150 F.3d at 228. Greenery
Rehabilitation was seeking Medicaid reimbursement for medical care
provided to three patients in their nursing facilities. Id. at
228-29. Each of those patients had a serious brain injury and had
been under Greenery’s constant care for more than three years. Id.

10
medical conditions of the patients in that case, the court

acknowledged that the patients’ initial injuries “undoubtedly

satisfied the plain meaning of [§ 1903(v)].” Id. But the court

held that once those patients’ initial conditions had stabilized,

the emergency medical conditions had ended. Id. Consequently, the

subsequent “long-term nursing and maintenance care” the patients

received was not care for an emergency medical condition. Id. at

233.

¶18 In Scottsdale Healthcare, the court of appeals relied

heavily on Greenery in interpreting A.R.S section 36-2905.05(A) and

§ 1903(v). 202 Ariz. at 368, ¶ 8, 45 P.3d at 691. Scottsdale

Healthcare agreed with the concept that once a patient was

“stabilized,” any care the patient subsequently received was not

for an emergency medical condition. Id. at 368-69, ¶¶ 9-10, 45

P.3d at 691-92. The court found Mercy Healthcare distinguishable

because “a factual dispute existed [there] as to when the patient

no longer required immediate medical attention.” Id. at 369, ¶ 13,

45 P.3d at 692. The Scottsdale Healthcare court emphasized the

patient in that case, J.N., “was medically stable.” Id.

¶19 But the court in Mercy Healthcare had rejected the notion

that an emergency condition necessarily ends when a patient’s

initial condition has been stabilized. 181 Ariz. at 98, 887 P.2d

at 628. Rather, the court held that the determination of an

“emergency medical condition” does not require that acute symptoms

11
continue, but only that the medical condition had initially

manifested itself by an acute symptom, and that the patient’s

condition was such that the absence of immediate medical treatment

for the initial condition could result in one of the three adverse

consequences listed in the statute. Id. at 99, 887 P.2d at 629.

Consequently, the holdings of Mercy Healthcare and Greenery

conflict as to the importance stabilization of the patient’s

initial injury plays in deciding whether a patient suffers from an

emergency medical condition.

¶20 Greenery’s reliance on stabilization does not find

support in the plain language of the statute.6 More importantly,

we think reliance on the notion of stabilization, at least as

6
In contrast, whether a patient is stable enough to be
transferred from one health care facility to another is a
consideration under the Emergency Medical Treatment and Active
Labor Act (“EMTALA”), which uses the same definition of “emergency
medical condition” as § 1903(v) of the Social Security Act. See 42
U.S.C. § 1395dd(e)(1) (Supp. 2002). The concern under the EMTALA
is a hospital’s duty to treat patients coming to its emergency
room. Bryant v. Adventist Health Sys./West, 289 F.3d 1162, 1165
(9th Cir. 2002). That statute discusses stabilization of the
patient with reference to when a hospital may transfer a patient to
another facility. See 42 U.S.C. § 1395dd(c) (Supp. 2002).
However, § 1395dd does not indicate that an “emergency medical
condition” is no longer present when a patient is stable. Under
the EMTALA, “[t]he term ‘stabilized’ means, with respect to an
emergency medical condition . . . that no material deterioration of
the condition is likely, within reasonable medical probability, to
result from or occur during the transfer of the individual from a
facility.” 42 U.S.C. § 1395dd(e)(3)(B) (Supp. 2002). Thus under
the EMTALA, a patient is “stabilized” if his or her condition will
not materially deteriorate during the short time necessary to
transfer the patient to another facility. But, under § 1903(v) of
the Social Security Act, stabilization is not an express factor in
determining whether an emergency medical condition exists.

12
applied in these cases, fails to account for either the wide

variety of emergency conditions or patients’ responses to

treatment.

¶21 The patient in Banner II presents a clear example of the

problem raised by focusing solely on the stabilization of the

patient’s initial injury as the measure of when an emergency

medical condition has ended. G.O. had suffered a gunshot wound.

The bullet struck a major artery, causing extensive blood loss, and

injuring the patient’s right kidney, appendix, and large and small

intestines. His treatment at the hospital lasted eleven months.

After the first surgery, he had a large, gaping, leaking abdominal

wound that required frequent dressing changes and additional

surgeries. He required tube feedings and continuous monitoring for

infections and the development of fistulas. During his stay at the

hospital, G.O. was occasionally moved from an acute care bed to the

hospital’s sub-acute rehabilitation unit. Of the 329 days G.O.

spent in the hospital, AHCCCS refused payment for the approximately

seventy-nine days G.O. spent in the rehabilitation unit. In

denying reimbursement for those seventy-nine days, AHCCCS reasoned

that each time G.O. was moved off the acute care ward, or was

stable enough to be moved, the emergency medical condition had

ended. However, the administrative law judge found that G.O.’s

condition, even while on the rehabilitation ward, was such that he

required and received life-sustaining, immediate medical treatment,

13
the denial of which would have been reasonably expected to place

his health in serious jeopardy. Accordingly, although G.O.’s

initial injury - the gunshot wound - may have been stabilized, his

resulting condition arguably continued to manifest itself by acute

symptoms of sufficient severity that he still required immediate

medical attention to prevent placing his physical well-being in

serious jeopardy.

¶22 Thus, as evidenced by G.O.’s stay in the hospital, a test

that simply focuses on stabilization of the initial injury to

determine when an emergency medical condition ends is impractical.

Likewise, basing a decision of whether an emergency medical

condition has ended on the type of ward on which the patient

happens to be placed is similarly impractical. Neither the

statute’s plain language nor its intent contemplates that such a

narrow, bright line distinction be drawn between what is an

emergency condition and what is not. The realities of medical

treatment and patients’ responses to treatment do not lend

themselves to such bright line distinctions. Instead, we conclude

that even though an initial injury may be stabilized, that does not

necessarily mean the emergency has ended.

¶23 To determine whether a patient suffers from an emergency

medical condition under § 1903(v), the focus must be on the

patient’s current condition and whether that condition satisfies

the criteria of § 1903(v). The statute first requires that the

14
medical condition be manifesting itself by acute symptoms. We

emphasize the verb manifesting because we agree with Greenery that

the statute uses the present progressive tense of the verb to

indicate that an emergency medical condition must be presently

“revealing itself through acute indications” of injury or illness.

Greenery, 150 F.3d at 232. Second, § 1903(v) requires that these

acute symptoms be sufficiently severe that “the absence of

immediate medical attention” could reasonably be expected to place

the patient’s health in serious jeopardy, or serious impairment to

bodily functions, or serious dysfunction of any bodily organ or

part.

¶24 The key term is “acute,” which denotes that the symptoms

manifesting an emergency medical condition must not only have

arisen rapidly, but, more importantly, that they be short-lived.7

In other words, a medical condition manifesting itself by chronic

symptoms8 is not an emergency medical condition, even though the

absence of medical care might lead to one of the three adverse

consequences listed the statute. Otherwise, AHCCCS would be

responsible for “long-term” care, something Mercy Healthcare held

was not contemplated by the statute. 181 Ariz. 98, 887 P.2d at

7
In medical terminology, acute refers to “a health effect,
usually of rapid onset, brief, not prolonged; sometimes loosely
used to mean severe.” Stedman’s Medical Dictionary 22 (27th ed.
2000).
8
Chronic refers to “a health related state, lasting a long
time.” Stedman’s Medical Dictionary 348 (27th ed. 2000).

15
628.

¶25 Consequently, whether a patient suffers from an emergency

medical condition does not depend upon the type of bed or facility

the patient may be in at any given time. In addition, stability,

in the sense that a patient can be transferred from an acute care

bed, is not the sole or even primary criterion under the statute.

Nor does the statute limit the determination of when an emergency

medical condition has ended to whether “the treating physician has

a reasonable degree of confidence that the patient and his lay

caregivers can manage his medical condition so that serious adverse

consequences are not ‘reasonably likely’ to occur,” as urged by the

hospitals.

¶26 Instead, the focus must be on whether the patient’s

current medical condition - whether it is the initial injury that

led to admission, a condition directly resulting from that injury,

or a wholly separate condition - is a non-chronic condition

presently manifesting itself by acute symptoms of sufficient

severity that the absence of immediate medical treatment could

result in one of the three adverse consequences listed in §

1903(v).9 If the resulting condition is manifested by chronic

9
Our formulation of the proper test for determining the
presence of an emergency medical condition differs from that of the
Greenery court. We find Greenery’s focus on the stability of the
patient, and the immediacy of treatment, too narrowly construes the
statutory language. See 150 F.3d at 32. Greenery appears to imply
an emergency medical condition exists only when an unstable patient
requires constant care. The statute, however, does not focus

16
symptoms it is not an emergency medical condition. Whether a

condition is manifested by acute symptoms or by chronic symptoms is

a question of fact. See Mercy Healthcare, 181 Ariz. at 99, 887

P.2d at 629. As discussed above, it is neither practical nor

possible to define with more precision when an emergency medical

condition has ended. Rather, such determinations should largely be

informed by the expertise of health care providers.

III.

¶27 We now turn to the resolution of these cases. Because

the court of appeals applied a different test in these matters than

the one we announce today, we must vacate those decisions. We

remand these cases to the trial courts for a determination of

whether the facts, as found by the administrative law judges,

satisfy the test we have articulated to determine what constitutes

an emergency medical condition as defined by § 1903(v). In

applying the test we have set forth to these cases, the trial

courts must defer to the facts found by the administrative law

judges. See, e.g., Nutek Info. Sys., Inc. v. Ariz. Corp. Comm’n,

solely on the condition of the patient at one instant in time.
Instead, § 1903(v) takes a forward looking view asking whether “the
absence of immediate medical attention could reasonably be expected
to result in” one of the three adverse consequences listed in the
statute. The statute thus considers both the patient’s current
condition, that is whether the condition is presently manifested by
acute symptoms, and how that current condition may affect the
health of the patient in the days to come. Thus, the term
“immediately” in the context of § 1903(v) contemplates a range of
time frames, as opposed to some fixed standard.

17
194 Ariz. 104, 107, ¶ 14, 977 P.2d 826, 829 (App. 1998). However,

“[a]lthough an agency’s interpretation of a statute . . . is

entitled to great weight,” Golden Eagle Distribs., Inc. v. Ariz.

Dep’t of Econ. Sec., 180 Ariz. 565, 567, 885 P.2d 1130, 1132 (App.

1994), the trial court “determines whether [AHCCCS] properly

interpreted the relevant law” in its application of the statute to

the facts found by the administrative law judges. Id.; see also

Gardiner v. Ariz. Dep’t of Econ. Sec., 127 Ariz. 603, 606, 623 P.2d

33, 36 (App. 1980).

IV.

¶28 We vacate the court of appeals’ decisions in these cases,

and remand the cases to the superior court for further proceedings

consistent with this opinion.

¶29 In their supplemental brief, the hospitals request an

award of attorneys’ fees under A.R.S. section 12-348(A)(2) (2003).

The statute permits an award of fees to a party who has

“prevail[ed] by an adjudication on the merits.” Id. Because we

have remanded these cases, the hospitals have not yet prevailed,

making an award of fees premature.

Michael D. Ryan, Justice

CONCURRING:

Charles E. Jones, Chief Justice

18
Ruth V. McGregor, Vice Chief Justice

Rebecca White Berch, Justice

Note: Justice Stanley G. Feldman sat for oral argument but retired
prior to the filing of the opinion and therefore did not
participate in the opinion.

19