New legal fight in the Mission Hospital case

HCA Healthcare is challenging whether the North Carolina attorney general has the authority to enforce provisions of the agreement that governed its acquisition of Mission Health in 2019.

The argument appears in an October 15 motion asking a court to dismiss a lawsuit over hospital services, a case filed by the state in December 2023.

The lawsuit accuses HCA and Mission Hospital of violating obligations involving emergency and oncology care. Those accusations have not been resolved at trial.

Why the state filed suit

When HCA bought the nonprofit Mission system, the sale agreement included commitments to maintain certain hospital services and to keep rural satellite hospitals operating for a defined period.

The agreement provided for independent oversight and gave the attorney general a role in enforcing its provisions.

The state argues Mission did not meet requirements concerning the provision of emergency and oncology services in 2023.

HCA's position

In its new filing, HCA's attorneys contend that an agreement between private parties cannot, by itself, grant the attorney general governmental authority to bring this type of lawsuit.

They are asking the court to dismiss the case for lack of jurisdiction, even though the purchase agreement itself contained language allowing the attorney general to enforce provisions.

HCA also requested that the trial be divided into stages and asked the court to reconsider an earlier interpretation of the agreement's requirement not to discontinue services.

The motions are legal arguments, not court findings that HCA complied with the agreement.

What has happened in court

A July ruling resolved several disputed interpretations in the state's favor and allowed major parts of the litigation to proceed.

The latest motions mean the court must now consider additional legal objections. A decision on those filings has not been announced in the reporting reviewed for this article.

Why it matters to Western North Carolina

Mission Hospital serves Asheville and a broad region of mountain communities, making questions about access to emergency and cancer services consequential for patients and families.

The lawsuit also tests how commitments made during a major nonprofit hospital sale can be enforced years later.

For readers, the key distinction is that the state has made allegations, HCA is contesting the legal basis and interpretation of the claims, and the courts have not delivered a final outcome.

828 Daily will follow the rulings and explain their practical implications as the case continues.