MICHAEL E. MURRAY, Appellant,
STATE OF WASHINGTON, DEPARTMENT OF LABOR & INDUSTRIES, Respondent.
E. Murray appeals the superior court's order granting the
Department of Labor & Industries' (Department) motion
for summary judgment affirming the Board of Industrial
Insurance Appeals' (Board) decision to deny payment for
his hip surgery. The Department's decision was based on
the Health Technology Clinical Committee's (HTCC)
decision concluding that Murray's proposed hip surgery
was not a covered procedure under state health care law.
Therefore, Murray was not entitled to an individualized
inquiry as to whether the surgery was proper and necessary
medical treatment. Murray argues that the delegation of
authority to the HTCC is unconstitutional, thus, an HTCC
decision cannot preclude review of an individualized inquiry
into whether a specific medical treatment is proper and
necessary. We hold that because there are appropriate
procedural safeguards to control arbitrary action and prevent
the abuse of discretionary power, the legislature's
delegation of authority to the HTCC is constitutional.
also argues that we should overrule our holding in Joy v.
Department of Labor and Industries. He also argues
that his procedural and substantive due process rights were
violated because he was denied a review of the HTCC decision.
We decline to overrule our holding in Joy. And, we
hold that Murray has no vested right protected by due
process, therefore, his due process claim fails. Accordingly,
we affirm the Board's order denying Murray's claim
for hip surgery.
2009, Murray injured his right hip at work. The Department
allowed his claim. In 2013, Murray sought authorization for
surgical treatment of Femoral Acetabular Impingement (FAI)
resulting from a labral tear in his right hip. The Department
denied Murray's claim because, in 2011, the HTCC
determined that the surgical treatment was not a covered
appealed the Department's decision to the Board. The
Department moved for summary judgment. The Board concluded
that the HTCC's decision could not be overruled by the
Board and affirmed the Department's decision. Murray
appealed the Board's decision to the superior court.
Department moved for summary judgment before the superior
court. Murray filed a cross motion for summary judgment. The
superior court denied Murray's motion for summary
judgment and granted the Department's motion for summary
judgment. Murray appeals.
51.52.110 and RCW 51.52.115 govern judicial review of matters
arising under the Industrial Insurance Act." Stelter
v. Dep't. of Labor & Indus., 147 Wn.2d 702, 707,
57 P.3d 248 (2002). "When a party appeals from a board
decision, and the superior court grants summary judgment
affirming that decision, the appellate court's inquiry is
the same as that of the superior court."
Stelter, 147 Wn.2d at 707. A summary judgment motion
will be granted only if after viewing all the pleadings,
affidavits, depositions, admissions and all reasonable
inferences drawn therefrom in favor of the nonmoving party,
it can be said that (1) there is no genuine issue of material
fact, (2) all reasonable persons could reach but one
conclusion, and (3) the moving party is entitled to judgment
as a matter of law. Walston v. Boeing Co., 181 Wn.2d
391, 395, 334 P.3d 519(2014).
the Industrial Insurance Act (IIA), a worker is entitled to
medical treatment for work related injuries. RCW 51.36.010.
Once a worker establishes that he or she is entitled to
compensation, "he or she shall receive proper and
necessary medical and surgical services." RCW
2006, the legislature created the HTCC. RCW 70.14.090. The
HTCC is comprised of eleven members appointed by the Health
Care Authority (HCA) administrator. RCW 70.14.090. The eleven
members of the HTCC are practicing physicians and licensed
health professionals who use health technology in their scope
of practice. RCW 70.14.090. The HTCC reviews health
technology to determine:
(a) The conditions, if any, under which the health technology
will be included as a covered benefit in health care programs
of participating agencies; and (b) if covered, the criteria
which the participating agency administering the program must
use to decide whether the technology is medically necessary,
or proper and necessary treatment.
RCW 70.14.110(1). The HTCC is required to make its
determinations "in an open and transparent process"
considering "evidence regarding the safety, efficacy,
and cost-effectiveness of the technology." RCW
70.14.110(2)(a). The HTCC is also required to provide an
opportunity for public comment. RCW 70.14.110(2)(b); RCW
70.14.130. And although the HTCC is not an agency subject to
the Administrative Procedure Act (APA), chapter 34.05 RCW, it
is subject to the Open Public Meetings Act of 1971, chapter
42.30 RCW. RCW 70.14.090(4), (5).
participating agencies under the HCA, including the
Department, are required to comply with the HTCC s
determinations. RCW 70.14.120. "A health technology not
included as a covered benefit. . . shall not be subject to a
determination in the case of an individual patient as to
whether it is medically necessary, or proper and necessary
treatment." RCW 70.14.120(3). However, RCW 70.14.120(4)
Nothing in [this chapter] diminishes an individual's
right under existing law to appeal an action or decision of a
participating agency regarding a ...