Abira Medical Laboratories, LLC d/b/a Genesis Diagnostics v. HEALTH PLANS INC.

CourtDistrict Court, E.D. Pennsylvania
DecidedSeptember 12, 2024
Docket2:24-cv-00158
StatusUnknown

This text of Abira Medical Laboratories, LLC d/b/a Genesis Diagnostics v. HEALTH PLANS INC. (Abira Medical Laboratories, LLC d/b/a Genesis Diagnostics v. HEALTH PLANS INC.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Abira Medical Laboratories, LLC d/b/a Genesis Diagnostics v. HEALTH PLANS INC., (E.D. Pa. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

ABRIA MEDICAL LABORATORIES, CIVIL ACTION NO. 24-158 LLC d/b/a GENESIS DIAGNOSTICS

v.

HARVARD PILGRIM HEALTH CARE, INC., AND HEALTH PLANS, INC.

MEMORANDUM RE: MOTION TO DISMISS

Baylson, J. September 12, 2024

This action was brought by Plaintiff Abira Medical Laboratories, doing business as Genesis Diagnostics (“Plaintiff”), against Defendants Harvard Pilgrim Health Care, Inc. (“HPHC”) and Health Plans, Inc. (“HPI”) (collectively “Defendants”) to recover unpaid and underpaid claims for laboratory testing services performed for patients insured by Defendants. Plaintiff alleges it received requisitions for laboratory testing containing an assignment of benefits, transferring the patients’ rights to payment and to sue in the event of nonpayment to Plaintiff. Plaintiff brings claims for breach of contract (Count I), breach of the implied covenant of good faith and fair dealing (Count II), violation of the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act (Count III), and, in the alternative, for quantum meruit/unjust enrichment (Count IV). Presently before this Court is Defendants’ Motion to Dismiss all counts of the Second Amended Complaint (“SAC”) for lack of personal jurisdiction under Federal Rule of Civil Procedure 12(b)(2) and for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6). ECF 30. For the reasons stated below, Defendants’ Motion to Dismiss is GRANTED as to HPHC for lack of personal jurisdiction.1 As to HPI, Defendants’ Motion to Dismiss is GRANTED as to the claims for breach of the implied covenant of good faith and fair dealing and violation of the FFCRA and CARES Act, and is DENIED as to the breach of contract claim and as to the alternative claim of quantum meruit/unjust enrichment.2

I. RELEVANT FACTUAL ALLEGATIONS The events giving rise to this case, as alleged by Plaintiff, are as follows.3 Plaintiff is a New Jersey limited liability company and operates a medical testing laboratory in Langhorne, Pennsylvania. SAC (ECF 20) at ¶¶ 6, 13. HPHC is a Massachusetts health insurer and HPI is a third-party administrator of health insurance plans with its place of business in Massachusetts. Id. at ¶¶ 7–8. Between 2016 and 2021, medical service providers submitted requisitions to Plaintiff for laboratory testing services on behalf of patients insured by Defendants. Id. ¶ 13. Each of these requisitions contained an assignment of benefits which assigned the patients’ right to payment from the insurer and right to sue for that payment to Plaintiff. Id. at ¶¶ 14, 21. Plaintiff performed

laboratory testing on those specimens and thereafter submitted claims for payment to Defendants. Id. at ¶ 22. Defendants either did not respond at all to these claims or refused to pay or underpaid

1 Defendants contend there is no personal jurisdiction over only one of the two Defendants, HPHC, and that the Complaint fails to state a claim against both Defendants. ECF 30. Because the Court finds that there is no personal jurisdiction over HPHC, the Court does not address arguments under Federal Rule 12(b)(6) as to HPHC.

2 Defendants also filed a Motion to Stay Discovery pending the resolution of Defendants’ Motion to Dismiss. ECF 31. Because the Court now addresses Defendants’ Motion to Dismiss, the Court will deny Defendants’ Motion to Stay Discovery as moot.

3 This Court also considered Plaintiff’s exhibit attached to the Second Amended Complaint. See Buck v. Hampton Twp. Sch. Dist., 452 F.3d 256, 260 (3d Cir. 2006) (courts may consider documents attached to or submitted with the complaint in evaluating a motion to dismiss). In evaluating the claims under Federal Rule 12(b)(2), the Court additionally considered the affidavit of Jonathan Bove attached to Defendants’ Motion to Dismiss, ECF 30-2, and the affidavit of Abraham Miller and related exhibits attached to Plaintiff’s Response to Defendants’ Motion to Dismiss. ECF 32-2. See Metcalfe v. Renaissance Marine, Inc., 566 F.3d 324, 330 (3d Cir. 2009) (requiring that the plaintiff submit affidavits or other evidence to support jurisdiction). for those claims without any reason. Id. at ¶¶ 19, 24. In sum, Plaintiff alleges Defendants owe it no less than $224,439.00 for laboratory testing services it performed. Id. at ¶ 26; Ex. 1. II. PROCEDURAL HISTORY Plaintiff commenced this action in the Pennsylvania Court of Common Pleas, Bucks

County on November 29, 2023. ECF 1-1. On January 12, 2024, Plaintiff removed the case to this Court pursuant to 28 U.S.C. §§ 1441 and § 1446 on the grounds that this Court exercises diversity jurisdiction under 28 U.S.C. § 1332, federal question jurisdiction under 28 U.S.C. § 1331, and supplemental jurisdiction to hear the related State law claims under 28 U.S.C. § 1367. ECF 1 at ¶¶ 8–20. On April 18, 2024, Plaintiff filed a First Amended Complaint. ECF 18. Defendants moved to dismiss the First Amended Complaint on May 9, 2024, for lack of personal jurisdiction over HPHC and for failure to state a claim upon which relief can be granted as to both Defendants. ECF 19. On May 22, 2024, Plaintiff filed a Second Amended Complaint, bringing four claims: (1) Breach of Contract;

(2) Breach of Implied Covenant of Good Faith and Fair Dealing; (3) Violation of the FFCRA and CARES Act; and (4) Unjust Enrichment. ECF 20. On June 28, 2024, Defendants filed a Motion to Dismiss Plaintiff’s Second Amended Complaint for lack of personal jurisdiction over HPHC and for failure to state a claim upon which relief can be granted as to both Defendants. ECF 30. On July 12, 2024, Plaintiff filed a Response in Opposition. ECF 32. On July 19, 2024, Defendants filed a Reply. ECF 33. III. PARTIES’ CONTENTIONS A. Defendants’ Motion to Dismiss Defendants first argue that this Court has no personal jurisdiction over HPHC, either generally or specifically, because HPHC is a Massachusetts company, is not registered to do

business in Pennsylvania, and does not conduct any business in Pennsylvania. ECF 30-1 at 7–9; ECF 30-2 at ¶ 4. Defendants attached an affidavit to their Motion stating that HPHC does not have a physical office in Pennsylvania; is not registered to do business in Pennsylvania; is not licensed to engage in the business of insurance in Pennsylvania; does not solicit clients in Pennsylvania; does not direct advertisements to Pennsylvania; does not have any bank accounts in Pennsylvania; does not maintain any licenses or certifications from Pennsylvania, does not offer or underwrite insured plans for groups based or headquartered in Pennsylvania; and does not offer products in Pennsylvania or contract with a network of providers in Pennsylvania. ECF 30-2 at ¶¶ 5–14. Defendants also argue that most of Plaintiff’s claims against HPHC are barred by Pennsylvania’s four-year statute of limitations for contractual claims, which began to run at the

time payment was due. ECF 30-1 at 20–21.

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Abira Medical Laboratories, LLC d/b/a Genesis Diagnostics v. HEALTH PLANS INC., Counsel Stack Legal Research, https://law.counselstack.com/opinion/abira-medical-laboratories-llc-dba-genesis-diagnostics-v-health-plans-paed-2024.