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Slip opinions are the", "paragraph_id": "para_3" }, { "text": "written opinions that are originally filed by the court.", "paragraph_id": "para_4" }, { "text": "A slip opinion is not necessarily the court’s final written decision. Slip opinions", "paragraph_id": "para_5" }, { "text": "can be changed by subsequent court orders. For example, a court may issue an", "paragraph_id": "para_6" }, { "text": "order making substantive changes to a slip opinion or publishing for precedential", "paragraph_id": "para_7" }, { "text": "purposes a previously “unpublished” opinion. Additionally, nonsubstantive edits", "paragraph_id": "para_8" }, { "text": "(for style, grammar, citation, format, punctuation, etc.) are made before the", "paragraph_id": "para_9" }, { "text": "opinions that have precedential value are published in the official reports of court", "paragraph_id": "para_10" }, { "text": "decisions: the Washington Reports 2d and the Washington Appellate Reports. An", "paragraph_id": "para_11" }, { "text": "opinion in the official reports replaces the slip opinion as the official opinion of", "paragraph_id": "para_12" }, { "text": "the court.", "paragraph_id": "para_13" }, { "text": "The slip opinion that begins on the next page is for a published opinion, and it", "paragraph_id": "para_14" }, { "text": "has since been revised for publication in the printed official reports. The official", "paragraph_id": "para_15" }, { "text": "text of the court’s opinion is found in the advance sheets and the bound volumes", "paragraph_id": "para_16" }, { "text": "of the official reports. Also, an electronic version (intended to mirror the", "paragraph_id": "para_17" }, { "text": "language found in the official reports) of the revised opinion can be found, free of", "paragraph_id": "para_18" }, { "text": "charge, at this website: https://www.lexisnexis.com/clients/wareports.", "paragraph_id": "para_19" }, { "text": "For more information about precedential (published) opinions, nonprecedential", "paragraph_id": "para_20" }, { "text": "(unpublished) opinions, slip opinions, and the official reports, see", "paragraph_id": "para_21" }, { "text": "https://www.courts.wa.gov/opinions and the information that is linked there.", "paragraph_id": "para_22" }, { "text": "IN THE SUPREME COURT OF THE STATE OF WASHINGTON", "paragraph_id": "para_23" }, { "text": "CERTIFICATION FROM THE UNITED )", "paragraph_id": "para_24" }, { "text": "STATES DISTRICT COURT FOR ) No. 104182-9", "paragraph_id": "para_25" }, { "text": "THE WESTERN DISTRICT OF ) (certified 2:24-cv-01589-LK)", "paragraph_id": "para_26" }, { "text": "WASHINGTON IN )", "paragraph_id": "para_27" }, { "text": ")", "paragraph_id": "para_28" }, { "text": "MIKRAE E. PRESTON, ) En Banc", "paragraph_id": "para_29" }, { "text": ")", "paragraph_id": "para_30" }, { "text": "Plaintiff, )", "paragraph_id": "para_31" }, { "text": ")", "paragraph_id": "para_32" }, { "text": "v. )", "paragraph_id": "para_33" }, { "text": ")", "paragraph_id": "para_34" }, { "text": "SB&C, LTD., aka SKAGIT BONDED )", "paragraph_id": "para_35" }, { "text": "COLLECTORS, LLC, )", "paragraph_id": "para_36" }, { "text": ")", "paragraph_id": "para_37" }, { "text": "Defendant. )", "paragraph_id": "para_38" }, { "text": ")", "paragraph_id": "para_39" }, { "text": "Filed: April 30, 2026", "paragraph_id": "para_40" }, { "text": "JOHNSON, J.—The District Court for the Western District of Washington", "paragraph_id": "para_41" }, { "text": "certified a question of state law arising in a class action lawsuit alleging violation of", "paragraph_id": "para_42" }, { "text": "the Washington Consumer Protection Act (CPA), ch. 19.86 RCW; the WashingtonFILE", "paragraph_id": "para_43" }, { "text": "IN CLERK’S OFFICE", "paragraph_id": "para_44" }, { "text": "SUPREME COURT, STATE OF WASHINGTON", "paragraph_id": "para_45" }, { "text": "APRIL 30, 2026THIS OPINION WAS FILED", "paragraph_id": "para_46" }, { "text": "FOR RECORD AT 8 A.M. ON", "paragraph_id": "para_47" }, { "text": "APRIL 30, 2026", "paragraph_id": "para_48" }, { "text": "SARAH R. PENDLETON", "paragraph_id": "para_49" }, { "text": "SUPREME COURT CLERKFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_50" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_51" }, { "text": "2", "paragraph_id": "para_52" }, { "text": "Collection Agency Act (CAA), ch. 19.16 RCW; and the federal Fair Debt Collection", "paragraph_id": "para_53", "court_paragraph": 2 }, { "text": "Practices Act (FDCPA), 15 U.S.C. § 1692.1 After some, but not all, of the plaintiff’s", "paragraph_id": "para_54" }, { "text": "claims were dismissed, the federal court certified the following question to the", "paragraph_id": "para_55" }, { "text": "Washington Supreme Court:", "paragraph_id": "para_56" }, { "text": "Do the requirements of RCW 70.170.060(8)(a) apply to a collection agency", "paragraph_id": "para_57" }, { "text": "collecting on a hospital debt, as opposed to a hospital itself?", "paragraph_id": "para_58" }, { "text": "Ord. Certifying Question to Wash. Sup. Ct. (Order) at 22.", "paragraph_id": "para_59" }, { "text": "We answer yes and hold that they do. Collection agencies collecting on", "paragraph_id": "para_60" }, { "text": "hospital debt are required to provide patients with notice of charity care2 under the", "paragraph_id": "para_61" }, { "text": "plain language of RCW 70.170.060(8)(a) and the policy of the charity care act.3", "paragraph_id": "para_62" }, { "text": "FACTS AND PROCEDURAL HISTORY4", "paragraph_id": "para_63" }, { "text": "In 2017, plaintiff Mikrae Preston received medical care at Skagit Valley", "paragraph_id": "para_64" }, { "text": "Hospital and was subsequently billed for that care. At the time Preston received care,", "paragraph_id": "para_65" }, { "text": "her alleged income fell within the limit that would allow her to qualify for charity", "paragraph_id": "para_66" }, { "text": "1 Three amicus briefs were filed in this case. Columbia Legal Services et al. and National", "paragraph_id": "para_67" }, { "text": "Association of Consumer Advocates et al. filed briefs on behalf of Preston. ACA International", "paragraph_id": "para_68" }, { "text": "filed a brief on behalf of SB&C.", "paragraph_id": "para_69" }, { "text": "2 Charity care is a program developed by the Washington State Legislature that requires hospitals", "paragraph_id": "para_70" }, { "text": "to provide financial aid to help people pay hospital bills. Hospital Patient Information and", "paragraph_id": "para_71" }, { "text": "Charity Care, WASH. DEP’T OF HEALTH, https://doh.wa.gov/data-statistical-reports/healthcare-", "paragraph_id": "para_72" }, { "text": "washington/hospital-and-patient-data/hospital-patient-information-and-charity-care", "paragraph_id": "para_73" }, { "text": "[https://perma.cc/K99K-LDW4].", "paragraph_id": "para_74" }, { "text": "3 To avoid confusion between the different statutes discussed in this case, the charity care act will", "paragraph_id": "para_75" }, { "text": "be referred to exclusively as “charity care act” to avoid confusion with the CAA, which is the", "paragraph_id": "para_76" }, { "text": "Collection Agency Act.", "paragraph_id": "para_77" }, { "text": "4 The facts assumed in analyzing the state law question come from the pleadings filed in the", "paragraph_id": "para_78" }, { "text": "district court and submitted to us as part of the case record.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_79" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_80" }, { "text": "3", "paragraph_id": "para_81" }, { "text": "care. Under the Washington charity care act, ch. 70.170 RCW, a hospital is required", "paragraph_id": "para_82", "court_paragraph": 3 }, { "text": "to determine whether a patient is eligible for charity care and, if so, assist them in", "paragraph_id": "para_83" }, { "text": "applying for charity care coverage. RCW 70.170.060(5). This screening must", "paragraph_id": "para_84" }, { "text": "precede collection efforts directed at the patient. RCW 70.170.060(10)(a), (c).", "paragraph_id": "para_85" }, { "text": "Preston alleges the hospital did not determine whether she was eligible for coverage", "paragraph_id": "para_86" }, { "text": "before billing her for medical services and thereafter attempting to collect.", "paragraph_id": "para_87" }, { "text": "The hospital in this case assigned its claim to Skagit Bonded Collectors LLC", "paragraph_id": "para_88" }, { "text": "(SB&C), a debt collection agency. SB&C filed a lawsuit to collect on the claim and", "paragraph_id": "para_89" }, { "text": "was granted a judgment against Preston. SB&C’s collection complaint did not", "paragraph_id": "para_90" }, { "text": "include any disclosures about Washington’s charity care program. Preston alleges", "paragraph_id": "para_91" }, { "text": "she did not learn about the availability of charity care until she appeared in the suit", "paragraph_id": "para_92" }, { "text": "after SB&C obtained the judgment for the full balance of the hospital debt.", "paragraph_id": "para_93" }, { "text": "A few months after judgment was entered, Preston applied and was approved", "paragraph_id": "para_94" }, { "text": "for a 30 percent reduction in the balance of her bill to Skagit Valley Hospital. SB&C", "paragraph_id": "para_95" }, { "text": "informed her that it would not honor the reduction because the Skagit Regional", "paragraph_id": "para_96" }, { "text": "Health financial assistance policy provided that accounts for which a court has", "paragraph_id": "para_97" }, { "text": "awarded judgment are not eligible for financial assistance.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_98" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_99" }, { "text": "4", "paragraph_id": "para_100" }, { "text": "Preston filed this complaint5 in Skagit County Superior Court, naming SB&C", "paragraph_id": "para_101", "court_paragraph": 4 }, { "text": "as the only defendant. Her complaint alleged both per se and non-per-se CPA", "paragraph_id": "para_102" }, { "text": "violations. Specifically, Preston alleged violations of the CPA, CAA, and FDCPA.", "paragraph_id": "para_103" }, { "text": "SB&C removed the action to the United States District Court for the Western District", "paragraph_id": "para_104" }, { "text": "of Washington and filed a motion to dismiss and an alternative motion to certify a", "paragraph_id": "para_105" }, { "text": "question to this court. The district court granted SB&C’s motion to dismiss in part", "paragraph_id": "para_106" }, { "text": "and deferred in part, granting the alternative motion to certify the question to this", "paragraph_id": "para_107" }, { "text": "court.", "paragraph_id": "para_108" }, { "text": "The district court dismissed some of Preston’s claims and retained others", "paragraph_id": "para_109" }, { "text": "pending this court’s answer to the certified question. Specifically, the district court", "paragraph_id": "para_110" }, { "text": "dismissed Preston’s claims under the CAA.6 The court then divided the remaining", "paragraph_id": "para_111" }, { "text": "claims into a “failure-to-screen” theory and a “failure-to-notify” theory. The federal", "paragraph_id": "para_112" }, { "text": "court dismissed the “failure-to-screen” theory, finding that nothing in the charity care", "paragraph_id": "para_113" }, { "text": "act conditions the assignment or collection of hospital debt by a collection agency", "paragraph_id": "para_114" }, { "text": "on the hospital’s compliance with the charity care screening requirements. Order at", "paragraph_id": "para_115" }, { "text": "5 The complaint includes class action allegations representing multiple classes that are yet to be", "paragraph_id": "para_116" }, { "text": "certified. Clerk’s Papers Doc. 1-1, at 9.", "paragraph_id": "para_117" }, { "text": "6 The CAA claim was dismissed because the notice requirement applicable directly to collection", "paragraph_id": "para_118" }, { "text": "agencies went into effect over a year after the events took place and did not apply to SB&C at the", "paragraph_id": "para_119" }, { "text": "time alleged. The district court also found insufficient facts to establish SB&C was a “debt", "paragraph_id": "para_120" }, { "text": "buyer” under the CAA, so the disclosure requirements did not apply. Order at 15.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_121" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_122" }, { "text": "5", "paragraph_id": "para_123" }, { "text": "13. The district court reserved ruling on the remaining CPA and FDCPA7 claims to", "paragraph_id": "para_124", "court_paragraph": 5 }, { "text": "await this court’s answer to the certified question.", "paragraph_id": "para_125" }, { "text": "Preston alleged SB&C’s failure to give notice regarding the availability of", "paragraph_id": "para_126" }, { "text": "charity care is unfair and deceptive under the Washington CPA. Clerk’s Papers (CP)", "paragraph_id": "para_127" }, { "text": "Doc. 1-1, at 14-16. She also alleged that SB&C falsely represented the character,", "paragraph_id": "para_128" }, { "text": "amount, and legal status of the debt it sought to collect in violation of the FDCPA.", "paragraph_id": "para_129" }, { "text": "CP Doc. 1-1, at 16-17.", "paragraph_id": "para_130" }, { "text": "ANALYSIS", "paragraph_id": "para_131" }, { "text": "A federal court may certify a question of local law to the Washington", "paragraph_id": "para_132" }, { "text": "Supreme Court when, in the federal court’s opinion, “it is necessary to ascertain the", "paragraph_id": "para_133" }, { "text": "local law of this state in order to dispose of such proceeding and the local law has", "paragraph_id": "para_134" }, { "text": "not been clearly determined.” RCW 2.60.020. These questions of law are reviewed", "paragraph_id": "para_135" }, { "text": "de novo based on the certified record provided by the federal court. Kellogg v.", "paragraph_id": "para_136" }, { "text": "Nat’l R.R. Passenger Corp., 199 Wn.2d 205, 215, 504 P.3d 796 (2022).", "paragraph_id": "para_137" }, { "text": "The federal court retains jurisdiction over the underlying case. When an", "paragraph_id": "para_138" }, { "text": "issue is not within the question certified and is within the province of the federal", "paragraph_id": "para_139" }, { "text": "court, this court will not reach the issue. Greenberg v. Amazon.com, Inc., 3 Wn.3d", "paragraph_id": "para_140" }, { "text": "434, 470-71, 553 P.3d 626 (2024). In this case, the federal court has asked us to", "paragraph_id": "para_141" }, { "text": "7 References to the CPA are to the Washington Consumer Protection Act, whereas the FDCPA is", "paragraph_id": "para_142" }, { "text": "the federal Fair Debt Collection Practices Act. The FDCPA is the federal counterpart to the CAA,", "paragraph_id": "para_143" }, { "text": "not the CPA, despite the similarity in acronyms.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_144" }, { "text": "6", "paragraph_id": "para_145" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_146", "court_paragraph": 6 }, { "text": "determine whether the requirements under RCW 70.170.060(8)(a) apply to", "paragraph_id": "para_147" }, { "text": "collection agencies collecting on hospital debt based on Preston’s CPA and FDCPA", "paragraph_id": "para_148" }, { "text": "claims. Although Preston’s Washington CPA and federal FDCPA claims were both", "paragraph_id": "para_149" }, { "text": "not dismissed, we limit our analysis to the state law claim. The federal law issue", "paragraph_id": "para_150" }, { "text": "remains in the province of the federal court. We answer yes and hold that under the", "paragraph_id": "para_151" }, { "text": "plain language of RCW 70.170.060(8)(a) and the public policy of the charity care", "paragraph_id": "para_152" }, { "text": "act, “other written communications concerning billing” applies to collection", "paragraph_id": "para_153" }, { "text": "agencies collecting on hospital debt. Here, the failure to provide notice of charity", "paragraph_id": "para_154" }, { "text": "care when collecting on hospital debt violates the public policy of the charity care", "paragraph_id": "para_155" }, { "text": "act and may provide evidence of a non-per-se CPA violation.", "paragraph_id": "para_156" }, { "text": "The Washington CPA declares “unfair or deceptive acts or practices in the", "paragraph_id": "para_157" }, { "text": "conduct of any trade or commerce” unlawful. RCW 19.86.020. To prevail in a CPA", "paragraph_id": "para_158" }, { "text": "action, a plaintiff must establish five distinct elements: (1) an unfair or deceptive", "paragraph_id": "para_159" }, { "text": "act or practice (2) occurring in trade or commerce, (3) public interest impact, (4)", "paragraph_id": "para_160" }, { "text": "injury to the plaintiff in their business or property, and (5) causation. Hangman", "paragraph_id": "para_161" }, { "text": "Ridge Training Stables, Inc. v. Safeco Title Ins. Co., 105 Wn.2d 778, 780, 719 P.2d", "paragraph_id": "para_162" }, { "text": "531 (1986). The first two elements may be established by showing that the alleged", "paragraph_id": "para_163" }, { "text": "act constitutes a per se unfair trade practice, which exists where the legislature", "paragraph_id": "para_164" }, { "text": "declares that a statutory violation constitutes an unfair or deceptive act. For", "paragraph_id": "para_165" }, { "text": "example, specific statutory requirements under the CAA and FDCPA create per seFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_166" }, { "text": "7", "paragraph_id": "para_167" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_168", "court_paragraph": 7 }, { "text": "CPA violations. Panag v. Farmers Ins. Co. of Wash., 166 Wn.2d 27, 53, 204 P.3d", "paragraph_id": "para_169" }, { "text": "885 (2009).", "paragraph_id": "para_170" }, { "text": "But this is not the exclusive way the first two elements can be established. In", "paragraph_id": "para_171" }, { "text": "Klem v. Washington Mutual Bank, we held that falsifying dates by a notary", "paragraph_id": "para_172" }, { "text": "employee of the trustee in a nonjudicial foreclosure is an unfair or deceptive act", "paragraph_id": "para_173" }, { "text": "under the CPA. 176 Wn.2d 771, 793-95, 295 P.3d 1179 (2013). This was true even", "paragraph_id": "para_174" }, { "text": "though it had not been legislatively declared a per se CPA violation. Similarly, in", "paragraph_id": "para_175" }, { "text": "Greenberg, we held that even though price gouging is not regulated by statute in", "paragraph_id": "para_176" }, { "text": "Washington, it can constitute an unfair or deceptive act in violation of the CPA. 3", "paragraph_id": "para_177" }, { "text": "Wn.3d at 454. The legislature declared the CPA “shall be liberally construed that", "paragraph_id": "para_178" }, { "text": "its beneficial purposes may be served.” RCW 19.86.920. Accordingly, the rule our", "paragraph_id": "para_179" }, { "text": "cases establish is that an unfair or deceptive act or practice under the CPA may be", "paragraph_id": "para_180" }, { "text": "predicated on a per se violation of a statute or an unfair act or practice not", "paragraph_id": "para_181" }, { "text": "regulated by statute but constituting a violation of the public interest. The above", "paragraph_id": "para_182" }, { "text": "cases illustrate how a non-per-se CPA violation, such as that presented by the", "paragraph_id": "para_183" }, { "text": "certified question, can be pursued.", "paragraph_id": "para_184" }, { "text": "A plaintiff can pursue a non-per-se CPA claim absent a clear statutory", "paragraph_id": "para_185" }, { "text": "violation. In other words, in this case, SB&C’s conduct does not need to violate the", "paragraph_id": "para_186" }, { "text": "charity care act, or any other statute for that matter, to constitute an unfair or", "paragraph_id": "para_187" }, { "text": "deceptive act or practice. Preston can succeed in a non-per-se CPA claim byFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_188" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_189" }, { "text": "8", "paragraph_id": "para_190" }, { "text": "proving each of the five distinct elements set out in Hangman Ridge. Here, our", "paragraph_id": "para_191", "court_paragraph": 8 }, { "text": "analysis is limited to the first element: whether SB&C’s failure to provide any", "paragraph_id": "para_192" }, { "text": "notice of benefits available under the charity care act can constitute an unfair or", "paragraph_id": "para_193" }, { "text": "deceptive act or practice. Conduct can be unfair or deceptive where it violates the", "paragraph_id": "para_194" }, { "text": "public interest. Unfair or deceptive conduct that violates the public interest may be", "paragraph_id": "para_195" }, { "text": "based on actions contrary to a comprehensive statutory scheme, like, as alleged in", "paragraph_id": "para_196" }, { "text": "this case, the charity care act. The policy of this statutory scheme is expressly", "paragraph_id": "para_197" }, { "text": "included in a specific provision of the act establishing the legislature’s intent where", "paragraph_id": "para_198" }, { "text": "it stated:", "paragraph_id": "para_199" }, { "text": "(2) The legislature finds that rising health care costs and access", "paragraph_id": "para_200" }, { "text": "to health care services are of vital concern to the people of this state. It", "paragraph_id": "para_201" }, { "text": "is, therefore, essential that strategies be explored that moderate health", "paragraph_id": "para_202" }, { "text": "care costs and promote access to health care services.", "paragraph_id": "para_203" }, { "text": "(3) The legislature further finds that access to health care is", "paragraph_id": "para_204" }, { "text": "among the state’s goals and the provision of such care should be", "paragraph_id": "para_205" }, { "text": "among the purposes of health care providers and facilities. Therefore,", "paragraph_id": "para_206" }, { "text": "the legislature intends that charity care requirements and related", "paragraph_id": "para_207" }, { "text": "enforcement provisions for hospitals be explicitly established.", "paragraph_id": "para_208" }, { "text": "RCW 70.170.010. The legislature found that access to health care is essential—", "paragraph_id": "para_209" }, { "text": "necessitating a process by which those otherwise unable to pay for their medical", "paragraph_id": "para_210" }, { "text": "services can access charity care.", "paragraph_id": "para_211" }, { "text": "SB&C would have us limit their liability to requirements that exist under the", "paragraph_id": "para_212" }, { "text": "CAA, that is, to recognize only per se CPA claims. But this is contrary to what we", "paragraph_id": "para_213" }, { "text": "stated in Panag when we recognized that “the CPA is intended to provide broaderFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_214" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_215" }, { "text": "9", "paragraph_id": "para_216" }, { "text": "protection than exists under the common law or statute.” 166 Wn.2d at 54. In", "paragraph_id": "para_217", "court_paragraph": 9 }, { "text": "Panag, two consolidated cases involving automobile accidents were resolved", "paragraph_id": "para_218" }, { "text": "where the drivers claimed underinsured motorist benefits from their insurer. The", "paragraph_id": "para_219" }, { "text": "insurers hired a collection agency, which sent collection notices that appeared to", "paragraph_id": "para_220" }, { "text": "represent an amount due but were actually subrogation claims. We held that a CPA", "paragraph_id": "para_221" }, { "text": "claim may be predicated on the deceptive characterization of an unadjudicated", "paragraph_id": "para_222" }, { "text": "insurance subrogation claim, even though this practice was not directly regulated", "paragraph_id": "para_223" }, { "text": "by the FDCPA or CAA. We explained that", "paragraph_id": "para_224" }, { "text": "debt collection affects the public interest, and collection agencies are", "paragraph_id": "para_225" }, { "text": "subject to strict regulation to ensure they deal fairly and honestly with", "paragraph_id": "para_226" }, { "text": "alleged debtors. The strong public policy underlying state and federal", "paragraph_id": "para_227" }, { "text": "law regulating the practice of debt collection also applies where", "paragraph_id": "para_228" }, { "text": "collection practices do not fall within the laws’ prohibitions.", "paragraph_id": "para_229" }, { "text": "Panag, 166 Wn.2d at 54.", "paragraph_id": "para_230" }, { "text": "Where conduct is beyond the scope of the CAA, that does not mean it is", "paragraph_id": "para_231" }, { "text": "exempt from suit under the broader scope of the CPA. SB&C argues that the", "paragraph_id": "para_232" }, { "text": "current notice requirement under the CAA forecloses any CPA claim for their", "paragraph_id": "para_233" }, { "text": "alleged conduct because it is redundant with the charity care notice requirements.", "paragraph_id": "para_234" }, { "text": "They assert that the 2019 amendment to the CAA alone requires collection", "paragraph_id": "para_235" }, { "text": "agencies to include “a notice that the debtor may be eligible for charity care from", "paragraph_id": "para_236" }, { "text": "the hospital, together with contact information for the hospital.” RCWFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_237" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_238" }, { "text": "10", "paragraph_id": "para_239" }, { "text": "19.16.250(29)(a). Because the event here occurred before the enactment of the", "paragraph_id": "para_240", "court_paragraph": 10 }, { "text": "CAA notice requirement, SB&C argues the addition of this requirement must mean", "paragraph_id": "para_241" }, { "text": "it was not previously actionable in this type of case where collection agencies", "paragraph_id": "para_242" }, { "text": "failed to give notice of charity care benefits when collecting on hospital debt. We", "paragraph_id": "para_243" }, { "text": "disagree. That argument assumes the only way a collection agency can violate the", "paragraph_id": "para_244" }, { "text": "CPA is through a per se violation. The fact that no notice requirement existed under", "paragraph_id": "para_245" }, { "text": "the CAA at the time this claim arose does not foreclose the argument that SB&C’s", "paragraph_id": "para_246" }, { "text": "failure to provide such notice was unfair or deceptive under the CPA, even where it", "paragraph_id": "para_247" }, { "text": "is not a per se violation. The addition of specific requirements or prohibited", "paragraph_id": "para_248" }, { "text": "practices under the CAA does not mean those actions were previously lawful. As", "paragraph_id": "para_249" }, { "text": "examples, the CAA also now prohibits impersonating a police officer, engaging in", "paragraph_id": "para_250" }, { "text": "the unauthorized practice of law, and communicating “in such a manner as to", "paragraph_id": "para_251" }, { "text": "harass, intimidate, threaten, or embarrass a debtor.” RCW 19.16.250(4), (5), (13).", "paragraph_id": "para_252" }, { "text": "These prohibited practices were not lawful before being added as specific", "paragraph_id": "para_253" }, { "text": "requirements under the CAA. Similarly, the charity care notice requirement under", "paragraph_id": "para_254" }, { "text": "the CAA, enacted in 2019, does not indicate that collection agencies previously", "paragraph_id": "para_255" }, { "text": "had no charity care notice obligations.", "paragraph_id": "para_256" }, { "text": "Despite the intensive regulation of collection agencies, the CPA is intended", "paragraph_id": "para_257" }, { "text": "to be broad enough to reach “unfair or deceptive conduct that inventively evades", "paragraph_id": "para_258" }, { "text": "regulation.” Panag, 166 Wn.2d at 49. SB&C’s argument would narrow the CPA toFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_259" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_260" }, { "text": "11", "paragraph_id": "para_261" }, { "text": "apply only to those situations where a CAA requirement establishes a per se", "paragraph_id": "para_262", "court_paragraph": 11 }, { "text": "violation. That argument ignores the breadth of the CPA. Here, before charity care", "paragraph_id": "para_263" }, { "text": "notice was expressly required under the CAA, SB&C’s failure to provide such", "paragraph_id": "para_264" }, { "text": "notice could still be unfair or deceptive under the CPA. A violation of the", "paragraph_id": "para_265" }, { "text": "underlying policy of the charity care act can constitute a non-per-se CPA violation.", "paragraph_id": "para_266" }, { "text": "The parties argue that Fairway Collection, LLC v. Turner should be", "paragraph_id": "para_267" }, { "text": "instructive to our conclusion in this case. 29 Wn. App. 2d 204, 540 P.3d 805", "paragraph_id": "para_268" }, { "text": "(2023). It is not. The analysis in Fairway is not dispositive here because it dealt", "paragraph_id": "para_269" }, { "text": "exclusively with per se CPA violations. Here, we analyze only Preston’s non-per-se", "paragraph_id": "para_270" }, { "text": "claim under the CPA. In Fairway, the Court of Appeals held that genuine issues of", "paragraph_id": "para_271" }, { "text": "material fact existed as to whether Fairway violated the FDCPA and the CAA,", "paragraph_id": "para_272" }, { "text": "which both constitute per se CPA violations.8 The court did not address whether", "paragraph_id": "para_273" }, { "text": "failure to provide notice was unfair or deceptive under the CPA because the court", "paragraph_id": "para_274" }, { "text": "did not separately address the plaintiff’s non-per-se CPA claims. Fairway, 29 Wn.", "paragraph_id": "para_275" }, { "text": "App. 2d at 226 n.24. Further, the court did not state that Fairway was required to", "paragraph_id": "para_276" }, { "text": "provide the exact notice under RCW 70.170.060(8)(a), rather that the failure to", "paragraph_id": "para_277" }, { "text": "provide any notice could amount to a violation of the FDCPA. Similarly, our", "paragraph_id": "para_278" }, { "text": "8 The issue of whether RCW 70.170.060(8)(a) applied to collection agencies was not before the", "paragraph_id": "para_279" }, { "text": "court in Fairway. Like Preston, the plaintiff brought claims under the CPA, CAA, and FDCPA.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_280" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_281" }, { "text": "12", "paragraph_id": "para_282" }, { "text": "holding here means that the failure to provide any notice may be unfair or", "paragraph_id": "para_283", "court_paragraph": 12 }, { "text": "deceptive under the CPA.", "paragraph_id": "para_284" }, { "text": "The broader policy underlying the charity care act requires repeated", "paragraph_id": "para_285" }, { "text": "disclosures of the availability of charity care benefits. Its provisions are aimed at", "paragraph_id": "para_286" }, { "text": "implementing practices whereby eligible low-income patients can have their", "paragraph_id": "para_287" }, { "text": "medical costs reduced to mitigate the financial burden of health care. This", "paragraph_id": "para_288" }, { "text": "advances the goal of ensuring access to health care services regardless of ability to", "paragraph_id": "para_289" }, { "text": "pay. Without notice of the act’s potential benefits, the statutory purpose could be", "paragraph_id": "para_290" }, { "text": "denied. The statute requires hospitals to “develop, implement, and maintain a", "paragraph_id": "para_291" }, { "text": "policy which shall enable indigent persons access to charity care.” RCW", "paragraph_id": "para_292" }, { "text": "70.170.060(5). Under the statute, an “initial determination of sponsorship status", "paragraph_id": "para_293" }, { "text": "shall precede collection efforts directed at the patient.” RCW 70.170.060(10)(c).", "paragraph_id": "para_294" }, { "text": "Related regulations require that eligibility be determined “at the time of admission", "paragraph_id": "para_295" }, { "text": "or as soon as possible following the initiation of services to the patient.” WAC 246-", "paragraph_id": "para_296" }, { "text": "453-020(1)(b). In 2018 and 2019, the legislature amended the charity care act and", "paragraph_id": "para_297" }, { "text": "the CAA to include additional notice requirements regarding the availability of", "paragraph_id": "para_298" }, { "text": "charity care. RCW 70.170.060(8)(a); RCW 19.16.250(29)(a). The policy of the", "paragraph_id": "para_299" }, { "text": "charity care act is not to regulate hospitals; it is to deal with medical debt and its", "paragraph_id": "para_300" }, { "text": "effect on eligible patients. The consumer—in this case, the patient—is entitled to", "paragraph_id": "para_301" }, { "text": "notice of possible benefits under the charity care act to address the legislature’sFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_302" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_303" }, { "text": "13", "paragraph_id": "para_304" }, { "text": "concern regarding medical debt. If we concluded that assignment to a collection", "paragraph_id": "para_305", "court_paragraph": 13 }, { "text": "agency deprived eligible patients of that benefit, the policy behind the charity care", "paragraph_id": "para_306" }, { "text": "act would be eliminated. We hold that the requirements of RCW 70.170.060(8)(a)", "paragraph_id": "para_307" }, { "text": "apply to a collection agency collecting on hospital debt. Failure to do so can violate", "paragraph_id": "para_308" }, { "text": "the public policy of the charity care act.", "paragraph_id": "para_309" }, { "text": "Preston argues that even if the notice requirements in the charity care act did", "paragraph_id": "para_310" }, { "text": "not apply directly to collection agencies collecting on hospital debt, it applies to", "paragraph_id": "para_311" }, { "text": "them as an assignee of the hospital. We agree. The requirements of the charity care", "paragraph_id": "para_312" }, { "text": "act do not disappear on assignment. Rather, the assignee “‘steps into the shoes’” of", "paragraph_id": "para_313" }, { "text": "the assignor and the assignment carries with it all applicable statutory rights and", "paragraph_id": "para_314" }, { "text": "liabilities. Puget Sound Nat’l Bank v. Dep’t of Revenue, 123 Wn.2d 284, 292, 868", "paragraph_id": "para_315" }, { "text": "P.2d 127 (1994) (quoting Est. of Jordan v. Hartford Accident & Indem. Co., 120", "paragraph_id": "para_316" }, { "text": "Wn.2d 490, 495, 844 P.2d 403(1993)). While there may be differences in the exact", "paragraph_id": "para_317" }, { "text": "statutory responsibilities of hospitals as compared to collection agencies, the policy", "paragraph_id": "para_318" }, { "text": "of the charity care act indicates that providing notice of charity care entirely", "paragraph_id": "para_319" }, { "text": "underpins the benefits that the statute should provide. Without notice, access to", "paragraph_id": "para_320" }, { "text": "benefits under the charity care act disappear. The act’s notice requirement reads:", "paragraph_id": "para_321" }, { "text": "All hospital billing statements and other written communications", "paragraph_id": "para_322" }, { "text": "concerning billing or collection of a hospital bill by a hospital must", "paragraph_id": "para_323" }, { "text": "include the following or a substantially similar statement prominently", "paragraph_id": "para_324" }, { "text": "displayed on the first page of the statement in both English and the", "paragraph_id": "para_325" }, { "text": "second most spoken language in the hospital’s service area:For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_326" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_327" }, { "text": "14", "paragraph_id": "para_328" }, { "text": "You may qualify for free care or a discount on your hospital bill,", "paragraph_id": "para_329", "court_paragraph": 14 }, { "text": "whether or not you have insurance. Please contact our financial", "paragraph_id": "para_330" }, { "text": "assistance office at ... (website) ... and ... (phone number) ....", "paragraph_id": "para_331" }, { "text": "RCW 70.170.060(8)(a). In interpreting a statute, the court’s fundamental objective", "paragraph_id": "para_332" }, { "text": "is to ascertain and carry out the legislature’s intent. Dep’t of Ecology v. Campbell &", "paragraph_id": "para_333" }, { "text": "Gwinn, LLC, 146 Wn.2d 1, 9, 43 P.3d 4 (2002). If the statute’s meaning is plain,", "paragraph_id": "para_334" }, { "text": "then the court must carry out that plain meaning. Here, the statute says, “All", "paragraph_id": "para_335" }, { "text": "hospital billing statements and other written communications concerning billing or", "paragraph_id": "para_336" }, { "text": "collection of a hospital bill by a hospital” must contain notice of charity care. RCW", "paragraph_id": "para_337" }, { "text": "70.170.060(8)(a) (emphasis added). This plain language shows what the legislature", "paragraph_id": "para_338" }, { "text": "intended: patients must be notified of charity care before being billed or the", "paragraph_id": "para_339" }, { "text": "potential benefits are lost. The legislature could not have intended for the", "paragraph_id": "para_340" }, { "text": "assignment of hospital debt to eliminate the notice requirement. Thus, collection", "paragraph_id": "para_341" }, { "text": "agencies assigned hospital debt fall under “other written communications”", "paragraph_id": "para_342" }, { "text": "concerning hospital bills.", "paragraph_id": "para_343" }, { "text": "Where a hospital fails to provide the required notice, it does not follow that", "paragraph_id": "para_344" }, { "text": "the assignee—the collection agency—can receive an assignment greater than what", "paragraph_id": "para_345" }, { "text": "the assignor—the hospital—can convey. This would deprive the patient of the", "paragraph_id": "para_346" }, { "text": "benefit of charity care in violation of the statutory policy. The sample notice", "paragraph_id": "para_347" }, { "text": "provided in the statute need not be recited verbatim to comply with theFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_348" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_349" }, { "text": "15", "paragraph_id": "para_350" }, { "text": "requirements under RCW 70.170.060(8)(a). Rather, the law states that “a", "paragraph_id": "para_351", "court_paragraph": 15 }, { "text": "substantially similar statement” is acceptable. RCW 70.170.060(8)(a). But as the", "paragraph_id": "para_352" }, { "text": "hospital’s assignee, the statutory duty to provide notice of charity care passes to the", "paragraph_id": "para_353" }, { "text": "collection agency.", "paragraph_id": "para_354" }, { "text": "CONCLUSION", "paragraph_id": "para_355" }, { "text": "We answer yes to the certified question and conclude that the requirements", "paragraph_id": "para_356" }, { "text": "of RCW 70.170.060(8)(a) apply to a collection agency collecting on hospital debt.", "paragraph_id": "para_357" }, { "text": "The statute’s plain language includes “other written communications concerning", "paragraph_id": "para_358" }, { "text": "billing” in the types of communication required to provide notice of charity care.", "paragraph_id": "para_359" }, { "text": "RCW 70.170.060(8)(a). The policy underlying the charity care act establishes that", "paragraph_id": "para_360" }, { "text": "patients are entitled to notice of charity care so those eligible can access financial", "paragraph_id": "para_361" }, { "text": "aid designated to them before paying their bill. This illustrates that the charity care", "paragraph_id": "para_362" }, { "text": "notification requirement applies to all billing concerning hospital debt. Further, the", "paragraph_id": "para_363" }, { "text": "general principles of debt assignment require that the statutory rights and liabilities", "paragraph_id": "para_364" }, { "text": "pass from assignor to assignee—the obligations under the charity care act do not", "paragraph_id": "para_365" }, { "text": "disappear upon assignment.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_366" }, { "text": "16", "paragraph_id": "para_367" }, { "text": "Preston v. SB&C, Ltd., No. 104182-9", "paragraph_id": "para_368", "court_paragraph": 16 }, { "text": ":(\u0003&21&85\u001d\u0003", "paragraph_id": "para_369" }, { "text": "-RKQVRQ\u000f\u0003-\u0011-RKQVRQ\u000f\u0003-\u0011", "paragraph_id": "para_370" }, { "text": "Yu, J.P.T.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_371" }, { "text": "Preston v. SB&C, Ltd.", "paragraph_id": "para_372" }, { "text": "No. 104182-9", "paragraph_id": "para_373" }, { "text": "MADSEN, J.P.T.* (dissenting)—The federal district court certified one", "paragraph_id": "para_374" }, { "text": "question to us: whether the requirements of RCW 70.170.060(8)(a) apply to a collection", "paragraph_id": "para_375" }, { "text": "agency collecting on a hospital debt. The majority answers yes. To reach this", "paragraph_id": "para_376" }, { "text": "conclusion, the majority stretches the statute to encompass debt collection agencies and,", "paragraph_id": "para_377" }, { "text": "through an inaccurate application of assignment law, imposes on those agencies what the", "paragraph_id": "para_378" }, { "text": "legislature intended to be a hospital-only duty. The majority also spends the bulk of its", "paragraph_id": "para_379" }, { "text": "time exploring Mikrae Preston’s Consumer Protection Act (CPA) “unfair or deceptive”", "paragraph_id": "para_380" }, { "text": "trade practice claim and comments that failure to adhere to the charity care act’s policies", "paragraph_id": "para_381" }, { "text": "may provide evidence of such non-per-se CPA claims—issues that are not before us.", "paragraph_id": "para_382" }, { "text": "Ch. 19.86 RCW; ch. 70.170 RCW.", "paragraph_id": "para_383" }, { "text": "I would limit our analysis to the certified question and answer no, the plain", "paragraph_id": "para_384" }, { "text": "language of RCW 70.170.060(8)(a) applies only to hospitals collecting on a hospital debt.", "paragraph_id": "para_385" }, { "text": "∗ Justice Barbara Madsen is serving as a justice pro tempore of the Supreme Court pursuant to Washington", "paragraph_id": "para_386" }, { "text": "Constitution article IV, section 2(a).For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_387" }, { "text": "No. 104182-9", "paragraph_id": "para_388" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_389" }, { "text": "2", "paragraph_id": "para_390" }, { "text": "DISCUSSION", "paragraph_id": "para_391", "court_paragraph": 2 }, { "text": "1. The Charity Care Act Notification Statute", "paragraph_id": "para_392" }, { "text": "The certified question asks whether the requirements of RCW 70.170.060(8)(a)", "paragraph_id": "para_393" }, { "text": "apply to a collection agency collecting on a hospital debt, so I would start there, applying", "paragraph_id": "para_394" }, { "text": "our traditional tools of statutory interpretation.", "paragraph_id": "para_395" }, { "text": "The meaning of a statute is a question of law we review de novo. Dep’t of", "paragraph_id": "para_396" }, { "text": "Ecology v. Campbell & Gwinn, LLC, 146 Wn.2d 1, 9, 43 P.3d 4 (2002). The court’s", "paragraph_id": "para_397" }, { "text": "fundamental objective is ascertaining and carrying out the legislature’s intent. Id. If the", "paragraph_id": "para_398" }, { "text": "statute’s language is plain on its face, then we give effect to that plain meaning as an", "paragraph_id": "para_399" }, { "text": "expression of legislative intent. Id. at 9-10.", "paragraph_id": "para_400" }, { "text": "Where the statutory language is plain and unambiguous, courts will not construe", "paragraph_id": "para_401" }, { "text": "the statute but will glean legislative intent from the statutory terms. HomeStreet, Inc. v.", "paragraph_id": "para_402" }, { "text": "Dep’t of Revenue, 166 Wn.2d 444, 451-52, 210 P.3d 297 (2009) (quoting Agrilink Foods,", "paragraph_id": "para_403" }, { "text": "Inc. v. Dep’t of Revenue, 153 Wn.2d 392, 396, 103 P.3d 1226 (2005)). A court “‘is", "paragraph_id": "para_404" }, { "text": "required to assume the Legislature meant exactly what it said and apply the statute as", "paragraph_id": "para_405" }, { "text": "written.’” Id. at 452 (quoting Duke v. Boyd, 133 Wn.2d 80, 87, 942 P.2d 351 (1997)).", "paragraph_id": "para_406" }, { "text": "We employ traditional rules of grammar in discerning plain language. State v. Bunker,", "paragraph_id": "para_407" }, { "text": "169 Wn.2d 571, 578, 238 P.3d 487 (2010).", "paragraph_id": "para_408" }, { "text": "RCW 70.170.060(8)(a) provides, in relevant part:", "paragraph_id": "para_409" }, { "text": "All hospital billing statements and other written communications", "paragraph_id": "para_410" }, { "text": "concerning billing or collection of a hospital bill by a hospital must include", "paragraph_id": "para_411" }, { "text": "the following or a substantially similar statement . . .For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_412" }, { "text": "No. 104182-9", "paragraph_id": "para_413" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_414" }, { "text": "3", "paragraph_id": "para_415" }, { "text": "You may qualify for free care or a discount on your hospital bill, whether", "paragraph_id": "para_416", "court_paragraph": 3 }, { "text": "or not you have insurance. Please contact our financial assistance office at", "paragraph_id": "para_417" }, { "text": ". . . (website) . . . and . . . (phone number).", "paragraph_id": "para_418" }, { "text": "(Emphasis added.)", "paragraph_id": "para_419" }, { "text": "The phrase “by a hospital” is critical. Here, “by a hospital” operates as a", "paragraph_id": "para_420" }, { "text": "prepositional phrase indicating the relationship between two parts of the sentence—the", "paragraph_id": "para_421" }, { "text": "object of the preposition (hospital billing and other written communications) and the", "paragraph_id": "para_422" }, { "text": "source or means acting on that object (by the hospital). THE CHICAGO MANUAL OF", "paragraph_id": "para_423" }, { "text": "STYLE §§ 5.172, .176, at 279-80 (17th ed. 2017). In short, RCW 70.170.060(8)(a) states", "paragraph_id": "para_424" }, { "text": "that all billing and collections communications made by a hospital must include a", "paragraph_id": "para_425" }, { "text": "specific notification about charity care.", "paragraph_id": "para_426" }, { "text": "The specific notification language required by the statute also supports this", "paragraph_id": "para_427" }, { "text": "reading. Subsection (8)(a) references “our financial assistance office.” RCW 70.170.060", "paragraph_id": "para_428" }, { "text": "(emphasis added). As the defendant points out, there is no law or regulation requiring a", "paragraph_id": "para_429" }, { "text": "third-party collection agency to provide financial assistance or maintain a financial", "paragraph_id": "para_430" }, { "text": "assistance office. Def.’s Opening Br. at 10. The reference to such an office can", "paragraph_id": "para_431" }, { "text": "reasonably apply only to a hospital.", "paragraph_id": "para_432" }, { "text": "By its plain terms, RCW 70.170.060(8)(a) is limited to billing communications", "paragraph_id": "para_433" }, { "text": "sent or made by a hospital and not a debt collection agency. The majority, however,", "paragraph_id": "para_434" }, { "text": "comes to the opposite conclusion. Though the majority asserts its conclusion is", "paragraph_id": "para_435" }, { "text": "supported by the plain language, its reasoning tells a different story—elevating what the", "paragraph_id": "para_436" }, { "text": "majority sees as good public policy over the plain language of the statute.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_437" }, { "text": "No. 104182-9", "paragraph_id": "para_438" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_439" }, { "text": "4", "paragraph_id": "para_440" }, { "text": "The majority’s statutory interpretation comes after it recites the policy goals of the", "paragraph_id": "para_441", "court_paragraph": 4 }, { "text": "charity care act and then relies exclusively on a single word. The majority references the", "paragraph_id": "para_442" }, { "text": "terms “‘other written communications concerning billing or collection of a hospital bill", "paragraph_id": "para_443" }, { "text": "by a hospital,’” majority at 13-14 (emphasis added) (quoting RCW 70.170.060(8)(a)),", "paragraph_id": "para_444" }, { "text": "apparently agreeing with Preston’s argument that the “or” is disjunctive and “by a", "paragraph_id": "para_445" }, { "text": "hospital” modifies only the “collection of a hospital bill.” Pl.’s Answering Br. at 40-41.", "paragraph_id": "para_446" }, { "text": "But application of this “last antecedent rule” leads to a nonsensical result.", "paragraph_id": "para_447" }, { "text": "As previously discussed, subsection (8)(a) mandates that a billing notification", "paragraph_id": "para_448" }, { "text": "include a website and phone number for a financial aid office. Yet collection agencies", "paragraph_id": "para_449" }, { "text": "are not required to have, and are unlikely to have, such offices. The majority’s", "paragraph_id": "para_450" }, { "text": "interpretation means that collection agencies will use subsection (8)(a)’s notification", "paragraph_id": "para_451" }, { "text": "language when informing patients about charity care—telling patients to contact financial", "paragraph_id": "para_452" }, { "text": "aid offices that do not exist. Lawmakers could not have intended this absurd result, and", "paragraph_id": "para_453" }, { "text": "we have declined to “apply the [last antecedent] rule . . . if applying the rule would result", "paragraph_id": "para_454" }, { "text": "in an absurd or nonsensical interpretation.” Bunker, 169 Wn.2d at 578.", "paragraph_id": "para_455" }, { "text": "The majority does not address this absurdity. Rather, it proceeds to the broad", "paragraph_id": "para_456" }, { "text": "public policy goals of the charity care act. See majority at 12-13 (“While there may be", "paragraph_id": "para_457" }, { "text": "differences in the exact statutory responsibilities of hospitals as compared to collection", "paragraph_id": "para_458" }, { "text": "agencies, the policy of the charity care act indicates that providing notice of charity care", "paragraph_id": "para_459" }, { "text": "entirely underpins the benefits that the statute should provide.” (emphasis added)).", "paragraph_id": "para_460" }, { "text": "Despite recognizing that the statute spells out only the responsibilities of hospitals, theFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_461" }, { "text": "No. 104182-9", "paragraph_id": "para_462" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_463" }, { "text": "5", "paragraph_id": "para_464" }, { "text": "majority feels compelled by policy to interpret “other written communications” to include", "paragraph_id": "para_465", "court_paragraph": 5 }, { "text": "collection agencies. Id. at 13-14.", "paragraph_id": "para_466" }, { "text": "But policy is not the first source of legislative intent. “We first examine the plain", "paragraph_id": "para_467" }, { "text": "language of the statute ‘as [t]he surest indication . . .’” of intent. Cent. Puget Sound Reg’l", "paragraph_id": "para_468" }, { "text": "Transit Auth. v. WR-SRI 120th N. LLC, 191 Wn.2d 223, 233-34, 422 P.3d 891 (2018)", "paragraph_id": "para_469" }, { "text": "(first alteration in original) (internal quotation marks omitted) (quoting State v. Larson,", "paragraph_id": "para_470" }, { "text": "184 Wn.2d 843, 848, 365 P.3d 740 (2015)). And subsection (8)(a)’s plain language", "paragraph_id": "para_471" }, { "text": "limits its applicability to hospitals when it used the phrase “by a hospital.” Even the", "paragraph_id": "para_472" }, { "text": "policy statement of the charity care act reflects the legislature’s intent to apply its charity", "paragraph_id": "para_473" }, { "text": "care notifications to hospitals. In RCW 70.170.010(1), the legislature found that health", "paragraph_id": "para_474" }, { "text": "care information is important to consumers to make health care choices and negotiate", "paragraph_id": "para_475" }, { "text": "payments. One of the purposes of the chapter is to “establish a hospital data collection,", "paragraph_id": "para_476" }, { "text": "storage, and retrieval system which supports these data needs.” RCW 70.170.010(1)", "paragraph_id": "para_477" }, { "text": "(emphasis added). The legislature further stated its intent “that charity care requirements", "paragraph_id": "para_478" }, { "text": "and related enforcement provisions for hospitals be explicitly established” under the", "paragraph_id": "para_479" }, { "text": "chapter. RCW 70.170.010(3) (emphasis added). Unsurprisingly the intent of the charity", "paragraph_id": "para_480" }, { "text": "care act supports the notice requirement’s plain language that hospitals must inform", "paragraph_id": "para_481" }, { "text": "patients of financial aid, not collection agencies.", "paragraph_id": "para_482" }, { "text": "The meaning of RCW 70.170.060(8)(a) is plain. The legislature imposed a duty", "paragraph_id": "para_483" }, { "text": "on hospitals to collect hospital debts.", "paragraph_id": "para_484" }, { "text": "Because the majority cannot overcome the plain language, it tries to build a bridge", "paragraph_id": "para_485" }, { "text": "over it using assignment law. See majority at 12-14. An assignee “‘steps into the shoes’”For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_486" }, { "text": "No. 104182-9", "paragraph_id": "para_487" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_488" }, { "text": "6", "paragraph_id": "para_489" }, { "text": "of an assignor, carrying with it the rights and liabilities as identified in the assigned", "paragraph_id": "para_490", "court_paragraph": 6 }, { "text": "contract, but also “all applicable statutory rights and liabilities.” Id. at 13 (internal", "paragraph_id": "para_491" }, { "text": "quotation marks omitted) (quoting Puget Sound Nat’l Bank v. Dep’t of Revenue, 123", "paragraph_id": "para_492" }, { "text": "Wn.2d 284, 292, 868 P.2d 127 (1994) (citing Schultz v. Werelius, 60 Wn. App. 450, 455,", "paragraph_id": "para_493" }, { "text": "803 P.2d 1334 (1991) (Petrich, J., dissenting))). This is a correct statement of the law but", "paragraph_id": "para_494" }, { "text": "an incorrect application.", "paragraph_id": "para_495" }, { "text": "First, the majority misses an essential facet of what rights pass in assignment—", "paragraph_id": "para_496" }, { "text": "applicable statutory rights and liabilities. Id. Statutory interpretation remains part of our", "paragraph_id": "para_497" }, { "text": "assignment inquiry. See Schultz, 60 Wn. App. at 455 (Petrich, J., dissenting) (stating that", "paragraph_id": "para_498" }, { "text": "a standing statute was ambiguous in the context of the law of assignments). Courts must", "paragraph_id": "para_499" }, { "text": "interpret a statute to give effect to the legislature’s intent. Bostain v. Food Express, Inc.,", "paragraph_id": "para_500" }, { "text": "159 Wn.2d 700, 708, 153 P.3d 846 (2007). As discussed above, RCW 70.170.060(8)(a)", "paragraph_id": "para_501" }, { "text": "imposes a statutory duty only on hospitals. See BLACK’S LAW DICTIONARY 636 (12th ed.", "paragraph_id": "para_502" }, { "text": "2024) (defining “duty” as “[a] legal obligation that is owed or due to another and that", "paragraph_id": "para_503" }, { "text": "needs to be satisfied”).", "paragraph_id": "para_504" }, { "text": "Second, the majority seems to conflate assignment with delegation. An entity may", "paragraph_id": "para_505" }, { "text": "assign a right and delegate a duty, but it cannot assign a duty. 29 SAMUEL WILLISTON &", "paragraph_id": "para_506" }, { "text": "RICHARD A. LORD, A TREATISE ON THE LAW OF CONTRACTS § 74:27, at 407 (4th ed.", "paragraph_id": "para_507" }, { "text": "2021); RESTATEMENT (SECOND) OF CONTRACTS §§ 317, 318(1) (A.L.I. 1981).", "paragraph_id": "para_508" }, { "text": "Performance of a duty may be delegated, subject to certain restrictions, but “neither", "paragraph_id": "para_509" }, { "text": "delegation of performance, nor a contract to assume the duty discharges any duty or", "paragraph_id": "para_510" }, { "text": "liability of the delegator-obligor.” Rsrvs. Dev., LLC v. Crystal Props., LLC, 986 A.2dFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_511" }, { "text": "No. 104182-9", "paragraph_id": "para_512" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_513" }, { "text": "7", "paragraph_id": "para_514" }, { "text": "362, 370 (2009) (citing RESTATEMENT (SECOND) OF CONTRACTS § 318(3)). In other", "paragraph_id": "para_515", "court_paragraph": 7 }, { "text": "words, an entity cannot contract away a statutory duty; and the delegator retains liability", "paragraph_id": "para_516" }, { "text": "for breach of performance of a statutory duty. Here, the duty to provide notice of", "paragraph_id": "para_517" }, { "text": "financial assistance falls to Skagit Valley Hospital. The hospital could not assign that", "paragraph_id": "para_518" }, { "text": "duty to SB&C by contract but could delegate the performance of the duty. In such case,", "paragraph_id": "para_519" }, { "text": "however, Skagit Valley Hospital would be liable for breach of that duty, yet Preston did", "paragraph_id": "para_520" }, { "text": "not bring suit against Skagit Valley Hospital.", "paragraph_id": "para_521" }, { "text": "Finally, since we do not have the contract between Skagit Valley Hospital and", "paragraph_id": "para_522" }, { "text": "SB&C in the record, we cannot determine whether SB&C undertook performance of the", "paragraph_id": "para_523" }, { "text": "duty or whether the contract created an independent duty on SB&C to provide notice.", "paragraph_id": "para_524" }, { "text": "Even if we could scrutinize the contract, it would conflict with Skagit Valley Hospital’s", "paragraph_id": "para_525" }, { "text": "patient policy. Skagit Regional Health’s financial assistance policy states that a patient is", "paragraph_id": "para_526" }, { "text": "not eligible for financial assistance if their account has been assigned to a collection", "paragraph_id": "para_527" }, { "text": "agency and a court has granted judgment against it. Financial Assistance and Sliding Fee", "paragraph_id": "para_528" }, { "text": "Scale Policy, SKAGIT REGIONAL HEALTH at 4.1 SB&C was granted a judgment against", "paragraph_id": "para_529" }, { "text": "Preston, as noted above, and Preston did not appeal the judgment or argue that it should", "paragraph_id": "para_530" }, { "text": "be set aside.", "paragraph_id": "para_531" }, { "text": "1 https://www.skagitregionalhealth.org/docs/default-source/finance-and-billing/sliding-payment-", "paragraph_id": "para_532" }, { "text": "scale/2204-srh-financial-assistance_sliding-fee-scale-policy.pdf?sfvrsn=1079f139_1", "paragraph_id": "para_533" }, { "text": "[https://perma.cc/3VEM-2NEB]For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_534" }, { "text": "No. 104182-9", "paragraph_id": "para_535" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_536" }, { "text": "8", "paragraph_id": "para_537" }, { "text": "Despite the majority’s reliance on assignment law, it provides no bridge at all to", "paragraph_id": "para_538", "court_paragraph": 8 }, { "text": "overcome the plain statutory language of RCW 70.170.060(8)(a)—which imposes a", "paragraph_id": "para_539" }, { "text": "limited duty on hospitals to collect on hospital debts.", "paragraph_id": "para_540" }, { "text": "2. The CPA", "paragraph_id": "para_541" }, { "text": "Preston echoes the majority’s silent acknowledgment that the plain language of", "paragraph_id": "para_542" }, { "text": "RCW 70.170.060(8)(a) does not encompass collection agencies. Preston brought no", "paragraph_id": "para_543" }, { "text": "charity care act claims against SB&C. Preston’s primary argument is that a collection", "paragraph_id": "para_544" }, { "text": "agency’s failure to provide notice of financial aid is an unfair or deceptive practice", "paragraph_id": "para_545" }, { "text": "pursuant to the CPA. Preston does not argue that SB&C’s allegedly deceptive collection", "paragraph_id": "para_546" }, { "text": "practice is a per se CPA violation, that is, it violates RCW 70.170.060(8)(a). Majority at", "paragraph_id": "para_547" }, { "text": "11 (“Here, we analyze only Preston’s non-per-se claim under the CPA.”); see Greenberg", "paragraph_id": "para_548" }, { "text": "v. Amazon, 3 Wn.3d 434, 454, 553 P.3d 626 (2024) (“The first CPA element may be", "paragraph_id": "para_549" }, { "text": "predicated on a per se violation of a statute.” (citing Klem v. Wash. Mut. Bank, 176", "paragraph_id": "para_550" }, { "text": "Wn.2d 771, 787, 295 P.3d 1179 (2013))). Instead, Preston contends that SB&C’s", "paragraph_id": "para_551" }, { "text": "collection practice violates the public interest. Greenberg, 3 Wn.3d at 454 (citing Klem,", "paragraph_id": "para_552" }, { "text": "176 Wn.2d at 787). Preston even claims SB&C’s practice is deceptive “regardless of", "paragraph_id": "para_553" }, { "text": "whether SB&C is covered by the Charity Care Act.” Pl.’s Answering Br. at 31 (emphasis", "paragraph_id": "para_554" }, { "text": "added).", "paragraph_id": "para_555" }, { "text": "While the majority says that RCW 70.170.060(8)(a) resolves the case, the bulk of", "paragraph_id": "para_556" }, { "text": "its analysis concerns Preston’s CPA claim. Majority at 5-12. The majority’s discussion", "paragraph_id": "para_557" }, { "text": "is again revealing. It does not find that Preston can pursue a per se CPA claim, whichFor the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_558" }, { "text": "No. 104182-9", "paragraph_id": "para_559" }, { "text": "(Madsen, J.P.T., dissenting)", "paragraph_id": "para_560" }, { "text": "9", "paragraph_id": "para_561" }, { "text": "would be available in the case of a statutory violation, and instead agrees with Preston", "paragraph_id": "para_562", "court_paragraph": 9 }, { "text": "that the broader policy underlying the charity care act requires repeated notifications of", "paragraph_id": "para_563" }, { "text": "financial aid and is not meant to regulate hospitals but deal with medical debt. Id. at 12.", "paragraph_id": "para_564" }, { "text": "Thus, violations of subsection (8)(a) can violate the public policy of the charity care act", "paragraph_id": "para_565" }, { "text": "and (presumably) constitute a deceptive act in violation of the public interest under the", "paragraph_id": "para_566" }, { "text": "CPA. See id. That may be. But Preston’s CPA claim is not part of the certified question.", "paragraph_id": "para_567" }, { "text": "Whether a collection agency’s practice is deceptive for failure to notify about charity care", "paragraph_id": "para_568" }, { "text": "is simply not before us. Thus, the majority’s decision to analyze and resolve that claim", "paragraph_id": "para_569" }, { "text": "has no bearing on the only issue we have been tasked with answering and reveals a deep", "paragraph_id": "para_570" }, { "text": "flaw in its conclusion that RCW 70.170.060(8)(a) places notification duties on collection", "paragraph_id": "para_571" }, { "text": "agencies.", "paragraph_id": "para_572" }, { "text": "CONCLUSION", "paragraph_id": "para_573" }, { "text": "Because the majority expands the scope of RCW 70.170.060(8)(a) beyond its", "paragraph_id": "para_574" }, { "text": "plain terms to encompass debt collection agencies, I respectfully dissent.", "paragraph_id": "para_575" }, { "text": "______________________________________", "paragraph_id": "para_576" }, { "text": "Madsen, J.P.T.", "paragraph_id": "para_577" }, { "text": "_________________________________________", "paragraph_id": "para_578" }, { "text": "Staab, J.P.T.For the current opinion, go to https://www.lexisnexis.com/clients/wareports/.", "paragraph_id": "para_579" } ], "word_count": 6296, "cites": [], "cited_by": [], "sha256": "679ee22b895673c8d158124290f97ae84a5117bb863d51cc306339632a23e7df", "source_url": "https://www.courts.wa.gov/opinions/pdf/1041829.pdf", "fetched_at": "2026-10-10T10:59:24.66+00:00", "canonical": "https://legal.exploreworldai.com/ai/judgments/us/wash-104-182-9-2026-04-30", "risk_graph": "https://legal.exploreworldai.com/api/public/v1/risk?id=us:wash-104-182-9-2026-04-30", "relations_graph": "https://legal.exploreworldai.com/api/public/v1/relations?id=us:wash-104-182-9-2026-04-30", "changes": "https://legal.exploreworldai.com/api/public/v1/us-praxis/changes", "agent": "https://legal.exploreworldai.com/api/public/v1/us-praxis/agent?id=us:wash-104-182-9-2026-04-30", "verification": { "stored_sha256": "679ee22b895673c8d158124290f97ae84a5117bb863d51cc306339632a23e7df", "recomputed_sha256": "679ee22b895673c8d158124290f97ae84a5117bb863d51cc306339632a23e7df", "intact": true, "checked_at": "2026-10-10T13:03:11.737Z" } }, "hash": "sha256:45c7f136f923ea613b60ee6cdd51fd2e64c913291d635d0f7fdaa5ff3f55b18e", "version": "legal-2026-10-10", "expires": "2026-10-11T00:00:00.000Z", "dependency": { "index_version": "legal-2026-10-10+legal-2026-10-10+2026-10-10T12:59:14", "content_hash": "sha256:45c7f136f923ea613b60ee6cdd51fd2e64c913291d635d0f7fdaa5ff3f55b18e", "revalidate_after": "2026-10-10T14:03:12.597Z", "max_copy_age_seconds": 3600, "policy": "revalidate-required; attribution-preferred", "changelog": "https://legal.exploreworldai.com/api/public/v1/dependency", "verify": "https://legal.exploreworldai.com/api/public/v1/verify", "stale_copy_invalid": true }, "canonical": "https://legal.exploreworldai.com/api/public/v1/judgment-text?id=us:wash-104-182-9-2026-04-30", "follow": [ { "rel": "risk", "href": "https://legal.exploreworldai.com/api/public/v1/risk?id=us:wash-104-182-9-2026-04-30" }, { "rel": "relations", "href": "https://legal.exploreworldai.com/api/public/v1/relations?id=us:wash-104-182-9-2026-04-30" }, { "rel": "agent", "href": "https://legal.exploreworldai.com/api/public/v1/us-praxis/agent?id=us:wash-104-182-9-2026-04-30" }, { "rel": "obligations", "href": "https://legal.exploreworldai.com/api/public/v1/obligation-chain" }, { "rel": "changes", "href": "https://legal.exploreworldai.com/api/public/v1/whats-new?jurisdiction=us" } ], "disclaimer": "Source reference with official identifier. 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