The state Supreme Court has ruled against Avera Health in a pay dispute case against Sully County.
The issue orbits emergency care for a person on a seasonal visa.
Under the court’s unanimous opinion issued Thursday, the county is not required to pay for the medical care offered to a non-permanent resident of the area.
The case centers around a man known to the courts as “J.R.,” a Mexican national living temporarily on visa in Sully County in 2014 who needed an emergency appendectomy. A friend took J.R. to an Avera facility in nearby Hughes County for treatment.
After the procedure, J.R. returned to Mexico without paying roughly $75,000 in fees.
Avera sought payment from Sully County under South Dakota poor-relief laws, a statute that places the onus on counties to reimburse medical facilities for the relief of impoverished patients.
Avera’s care to the patient was not voluntary and was instead required under federal law to provide care to a high-risk case.
In turn, the county cited a century old state Supreme Court decision, Roane V. Hutchinson County, as their basis for refusing to pay in this situation.
In Roane, multiple emergency surgeries were performed on nonresidents, and ultimately concluded there was no statute in state law for emergency cases.
The court writes in this circumstance, the county was unaware of the illness prior to treatment and had no opportunity to investigate if J.R. was “lying sick” and “in distress.”
Additionally, the opinion reads when temporary relief has already been administered, Sully County has no statutory obligations to repay the medical network for these services.
