Advanced Benefit Concepts, Inc. v. Blue Cross and Blue Shield of Alabama, Access Health, Inc. & Preferred Care Services, Inc.

CourtLouisiana Court of Appeal
DecidedFebruary 27, 2025
Docket2022CA1193
StatusUnknown

This text of Advanced Benefit Concepts, Inc. v. Blue Cross and Blue Shield of Alabama, Access Health, Inc. & Preferred Care Services, Inc. (Advanced Benefit Concepts, Inc. v. Blue Cross and Blue Shield of Alabama, Access Health, Inc. & Preferred Care Services, Inc.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Advanced Benefit Concepts, Inc. v. Blue Cross and Blue Shield of Alabama, Access Health, Inc. & Preferred Care Services, Inc., (La. Ct. App. 2025).

Opinion

STATE OF LOUISIANA

COURT OF APPEAL

FIRST CIRCUIT

2022 CA 1193- R

Cr' ADVANCED BENEFIT CONCEPTS, INC.

VERSUS

BLUE CROSS AND BLUE SHIELD OF ALABAMA, ACCESS HEALTH, INC., & PREFERRED CARE SERVICES, INC.

Judgment Rendered:

On Appeal from the 19th Judicial District Court In and for the Parish of East Baton Rouge State of Louisiana Suit No. C709719, Section 27

Honorable Trudy White, Judge Presiding

Timothy S. Babcock Attorneys for Plaintiff A - ppellant, Baton Rouge, LA Advanced Benefit Concepts, Inc.

A. Edward Cangelosi, Jr. New Orleans, LA

Andree M. Cullens Attorneys for Defendants -Appellees, Joseph E. Cullens, Jr. Blue Cross and Blue Shield of Renee C. Crasto Alabama, Access Health, Inc., & S. Layne Lee Preferred Care Services, Inc. Baton Rouge, LA

Carl S. Burkhalter Harold W. Bloom Matthew J. Bowness Birmingham, AL

BEFORE: THERIOT, RESTER, AND EDWARDS, JJ., HESTER, J.

This matter is before us on remand from the Supreme Court of Louisiana with

instructions to consider the merits of the exception raising the objection of

prescription filed by plaintiff-appellant, Advanced Benefit Concepts, Inc. (" ABC"),

and the motion for summary judgment filed by defendants -appellees, Access Health,

Inc., Preferred Care Services, Inc., and Blue Cross and Blue Shield of Alabama

collectively, " Access Health").'

FACTS AND PROCEDURAL, HISTORY

The pertinent facts and procedural history in Advanced Benefit Concepts,

Inc. v. Blue Cross & Blue Shield of Alabama, 2023- 01291 ( La. 9/ 6/ 24), 392 So. 3d

308, 310- 13, reh' g denied, 2023- 01291 ( La. 10/ 24/ 24), 395 So. 3d 255 ( hereinafter,

referred to as " ABC 11"), is applicable and provides as follows:

ABC entered into an agreement with Access Health. ABC helped Access Health identify, establish, and enter into relationships with employer groups, which Access Health could contract with to provide healthcare benefits. 3 Among the groups identified by ABC was the State of Louisiana' s Office of Group Benefits (" OGB"). The contract between Access Health and OGB provided that Access Health would provide a primary healthcare network and services to OGB plan participants. The agreement between ABC and Access Health provided for Access Health to pay ABC a fee of $ 1. 25 per month for each employee covered under the OGB contract.4

3 The agreement provided in part: " Whereas, ABC has and may continue to provide efforts and expend resources for the purpose of assisting [ Access Health] in identifying and establishing business relationships with various [ Employer groups]."

4 The term of the OG 13- contract was from July 1, 2019 to June 30, 2022, with two one- year options to extend the term to June 30, 2024.

In December of 2020, OGB sent Access Health a demand letter claiming Access Health owed it money for failure to meet the return on investment benchmarks mandated in the OGB contract. In February of 2021, OGB began withholding payments to Access Health. Later that

1 Access Health, Blue Cross and Blue Shield of Alabama, and Preferred Care Services, Inc. operated as a single business enterprise. Advanced Benefit Concepts, Inc. v. Blue Cross & Blue Shield of Alabama, 2023- 01291 ( La. 9/ 6/ 24), 392 So. 3d 308, 310, n.2, rehg denied, 2023- 01291 La. 10/ 24/ 24), 395 So. 3d 255.

K1 year, OGB and Access Health reached a settlement and amended the OGB contract.

Beginning in December of 2020, Access Health stopped paying ABC' s monthly fee under the agreement. ABC claims it is owed 6,930, 000. ABC filed a petition for damages asserting breach of contract against Access Health.

Access Health answered ABC' s lawsuit with a general denial and asserted a reconventional demand followed by a supplemental and amended reconventional demand. Pertinent to this case, Access Health asserted as separate affirmative defenses in its answer that the agreement was " an absolute nullity and void ab initio" and that "the Fee Agreement is void." In the first supplemental and amended answer and reconventional demand, it asserted as separate affirmative defenses that the agreement was " an absolute nullity and void ab initio" and that " the Fee Agreement ( and any alleged preexisting oral agreement) is void ... pursuant to [ La. R.S.] 49: 78. 1."

In Count I of its reconventional demand, Access Health alleged ABC represented [ Access Health] as a lobbyist[,]" and "[ d] uring its representation of [Access Health], ABC, through its principal, Charles Calvi, directly communicated with the chief executive officer of the OGB ... for the purpose of influencing the OGB to award the OGB Agreement to [ Access Health]." Access Health asserted that OGB was an executive branch agency of the state, and, as such, ABC and Mr. Calvi were required to register as lobbyists in the State of Louisiana pursuant to La. R.S. 49: 78. 1. Access Health alleged that because neither ABC nor Mr. Calvi were registered as lobbyists with the State of Louisiana when they entered into the agreement, ABC and Mr. Calvi engaged in a misrepresentation that rendered the agreement void pursuant to La. R.S. 49: 78. 1. Access Health asserted that because the agreement was void, ABC was not entitled to any of the payments established by the agreement, and ABC was unjustly enriched. Access Health prayed for a judgment declaring the agreement void and awarding as damages payments that Access Health had tendered to ABC under the agreement.

In response to the reconventional demand, ABC filed a declinatory exception of lack of subject matter jurisdiction, arguing that the district court did not have jurisdiction over enforcement provisions of the Code of Ethics. Rather, the legislature had provided the enforcement provisions of the [ Executive Branch Lobbying Act] to be within the exclusive purview of the Board [ of Ethics], absent a

challenge to the constitutionality of a provision of the Code of Ethics. As a result, the district court lacked subject matter jurisdiction to hear Access Health' s reconventional demand claim, and the claim should be dismissed with prejudice. In the alternative, ABC argued that the time for the Board to take action to void the contract had prescribed. See La. R.S. 49: 78( A) and ( B).

Access Health moved for summary judgment seeking dismissal of ABC' s cause of action for breach of contract on the ground that the agreement was an " absolute nullity and void ab initio due to [ ABC' s]

93 failure to register that contract with the State or ... to register as a lobbyist." Access Health requested the district court take judicial notice that ABC and Mr. Calvi were not registered as lobbyists via a " lobbying portal" located at HTTSP:Ilethics.la.gov/LobbyistData.s Access Health

also argued it was entitled to summary judgment for unjust enrichment to recover the amounts paid to ABC pursuant to the null agreement.

5 In its list of undisputed facts in support of the motion for summary judgment, Access Health, in a footnote, stated that "[ a] search of the Lobbying Portal on March 25, 2022[,] returned no entries for [ABC] ... no entries for `Charles Calvi,' ` Charles Calvi Jr.,' or `Calvi. "'

ABC filed an opposition to the motion for summary judgment, disputing that the agreement was a contract for ABC to provide lobbying services on behalf of Access Health and that ABC and Mr. Calvi met the requirements of being executive branch lobbyists under Louisiana law. In addition to arguing that the agreement was not a lobbying contract and that it and Mr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Union Planters Bank v. CCHC
907 So. 2d 129 (Louisiana Court of Appeal, 2005)
State v. Galazz
2 So. 3d 1083 (District Court of Appeal of Florida, 2009)
Smith v. Cannon
2 So. 3d 1227 (Louisiana Court of Appeal, 2009)
River Birch, Inc. v. ROBIN & ASSOC., INC.
906 So. 2d 729 (Louisiana Court of Appeal, 2005)
Bovie v. St. John the Baptist Parish, Dept. of Streets & Roads
125 So. 3d 1158 (Louisiana Court of Appeal, 2013)
Mendoza v. Mendoza
249 So. 3d 67 (Louisiana Court of Appeal, 2018)

Cite This Page — Counsel Stack

Bluebook (online)
Advanced Benefit Concepts, Inc. v. Blue Cross and Blue Shield of Alabama, Access Health, Inc. & Preferred Care Services, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/advanced-benefit-concepts-inc-v-blue-cross-and-blue-shield-of-alabama-lactapp-2025.