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Therapy Resources Management LLC, et al. v. Whittier Health Network, Inc., et al. (Lawyers Weekly No. 12-120-17)

COMMONWEALTH OF MASSACHUSETTS SUFFOLK, ss. SUPERIOR COURT CIVIL ACTION No. 1784CV0942 BLS 1 THERAPY RESOURCES MANAGEMENT LLC, et al vs. WHITTIER HEALTH NETWORK, INC., et al ORDER ON CROSS-MOTIONS FOR PARTIAL SUMMARY JUDGMENT Count IV of the Amended Complaint seeks a declaratory judgment to the effect that defendants (referred to collectively as “Whittier”) are barred from seeking indemnity from plaintiffs (referred to collectively as “Therapy”). Whittier has not yet answered the amended complaint or asserted a counterclaim, but the record is clear that Whittier believes it has the right to be indemnified by Therapy for litigation costs and a settlement payment incurred by Whittier in connection with an investigation and lawsuit under the False Claims Act (“FCA”), 31 U.S.C. §3729.1 There is an actual controversy between the parties regarding whether, as a matter of law, Whittier can obtain indemnification under its contracts with Therapy which state that “[Therapy] shall indemnify and hold [Whittier] harmless from and against all claims, demands, costs, expenses, liabilities and losses (including reasonable attorney’s fees) which may result against [Whittier] as a consequence of any malfeasance, negligence . . . caused . . . by [Therapy] . . . .” 1 Whittier has effectively obtained some indemnification by refusing to pay invoices for services rendered by Therapy. Thus, Therapy is the plaintiff in this action seeking recovery for non-payment of invoices. The claim for indemnification by Whittier is anticipated because such claim is the stated basis for Whittier’s refusal to pay the invoices. 1 Therapy’s argument for summary judgment on Count IV is based on the following undisputed facts. The losses that Whittier wants indemnification for arise from the fact that Whittier was sued, along with Therapy, for fraud under the FCA. The suit was brought by a former employee of Therapy. There was also another suit by a different former employee of Therapy against Therapy alone. The filing of the suits triggered an investigation by federal officials. The gist of the FCA claims was that Whittier and Therapy knowingly presented false claims for Medicare reimbursement. Both Whittier and Therapy denied the allegations. At some point, the claims against Therapy were dismissed. It is unclear from the record whether the dismissal was a result of a settlement or whether it was a dismissal without prejudice. Sometime later, Whittier entered into a settlement with the FCA plaintiffs, including the government, requiring, among other things, payment by Whittier of $ 2.5 million. Therapy was not a party to the settlement. FCA claims against Therapy were not released in the Whittier settlement. The settlement agreement alleges that Whittier failed “to take sufficient steps to prevent [Therapy] from engaging in a pattern and practice of fraudulently inflating the reported amounts […]

Whittier IPA, Inc. v. Steward Health Care Network, Inc. (Lawyers Weekly No. 12-005-17)

ΔCOMMONWEALTH OF MASSACHUSETTS SUFFOLK, ss. SUPERIOR COURT. 1484CV03029-BLS2 ____________________ WHITTIER IPA, INC. v. STEWARD HEALTH CARE NETWORK, INC. ____________________ MEMORANDUM AND ORDER DENYING DEFENDANT’S MOTION FOR LEAVE TO ASSERT COUNTERCLAIMS AGAINST WHITTIER IPA, INC., AND THIRD-PARTY CLAIMS AGAINST ANNA JACQUES HOSPITAL Steward Health Care Network, Inc., (“SHCN”) is a physician network. It negotiates and implements contracts with insurers and other entities that pay for SHCN’s participating doctors to provide medical care to the payors’ insureds or members. Whittier IPA, Inc., is an association of independent physicians. It joined the SHCN network in January 2012, but began exploring other options in 2013. After SHCN learned that Whittier had agreed to join a competing physician network run by the Beth Israel Deaconess Care Organization (“BIDCO”), SHCN terminated its agreements with Whittier effective August 31, 2014. Whittier claims that is still owed substantial sums by SHCN under the parties’ contracts. The court (Kaplan, J.) granted partial summary judgment in Whittier’s favor in June 2015, declaring that if SHCN received incentive payments from health insurers and other payors for periods during which Whittier was an SHCN member, then “SHCN breached its contract with Whittier by failing to pay Whittier its pro rata share of those payments.” The amount that SHCN must pay Whittier is still in dispute. The current case schedule, which was jointly requested by both parties, requires the litigants to complete all fact discovery by February 10, 2017, and to complete the exchange of any expert reports by March 24, 2017. SHCN seeks leave to assert counterclaims against Whittier and third-party claims against Anna Jacques Hospital. The Court will DENY this motion. It would be futile to allow SHCN to assert its proposed counterclaims against Whittier for breach of contract because they could not survive a motion to dismiss. The proposed claims against Anna Jacques for intentional interference and allegedly violating G.L. c. 93A would also be futile. In any case, it would be unfairly prejudicial to – 2 – Whittier and to Anna Jacques to allow permissive joinder of a new defendant-in-counterclaim under Mass. R. Civ. P. 20 just weeks before the completion of discovery in this case. SHCN has no right to join Anna Jacques as a defendant-in-counterclaim under Rule 19 and does not seek to assert third-party claims for indemnification or contribution as allowed under Rule 14. 1. Proposed Counterclaims Against Whittier. SHCN seeks leave to assert counterclaims against Whittier for allegedly breaching parts of its written contracts with SHCN. The Court will deny leave to assert these counterclaims because doing so would be futile, in that these counterclaims could not survive a motion under Mass. R. Civ. P. 12(b)(6) to dismiss for failure to state a claim upon […]