Angel Cancel v. Alvin Sewell

CourtCourt of Appeals of Georgia
DecidedMarch 29, 2013
DocketA12A1950
StatusPublished

This text of Angel Cancel v. Alvin Sewell (Angel Cancel v. Alvin Sewell) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Angel Cancel v. Alvin Sewell, (Ga. Ct. App. 2013).

Opinion

FIRST DIVISION ELLINGTON, C. J., PHIPPS, P. J., and DILLARD, J.

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed. (Court of Appeals Rule 4 (b) and Rule 37 (b), February 21, 2008) http://www.gaappeals.us/rules/

March 29, 2013

In the Court of Appeals of Georgia A12A1950. CANCEL v. SEWELL et al. A12A1951. SEWELL et al. v. CANCEL. A12A1952. FAULK et al. v. CANCEL.

PHIPPS, Presiding Judge.

After the anesthesiology department of a hospital underwent a restructuring,

four anesthesiologists who had been working there under their practice group were

not selected for continued employment. Alleging that they had been wrongfully

terminated because they had voiced concerns of fraudulent billing practices by fellow

anesthesiologists, the four anesthesiologists – Angel Cancel, M.D., Pravin Jain, M.D.,

Grace Duque-Dizon, M. D., and Monajna Sanjeev, M.D. – filed suit against numerous

individuals and entities. Herein, we review several rulings on various defendants’

motions for summary judgment. For reasons explained below, we affirm the judgment in Case No. A12A1950; we reverse in part the judgment in Case No. A12A1951,

while dismissing that case in part; and we dismiss Case No. A12A1952.

Summary judgment is proper “if the pleadings, depositions, answers to

interrogatories, and admissions on file, together with the affidavits, if any, show that

there is no genuine issue as to any material fact and that the moving party is entitled

to a judgment as a matter of law.”1 “In our de novo review of the grant [or denial] of

a motion for summary judgment, we must view the evidence, and all reasonable

inferences drawn therefrom, in the light most favorable to the nonmovant.”2

Viewed thus in favor of the plaintiffs, the evidence showed the following. The

four anesthesiologists formerly practiced medicine under their group called Central

Georgia Anesthesia Services, P. C. (hereinafter “CGAS”). It was comprised of

approximately 14 anesthesiologists who were all shareholders, members of the board

of directors, and employees of that company. During the years leading up to the

restructuring in 2003, CGAS was under an exclusive contract with The Medical

1 OCGA § 9-11-56 (c). 2 Cowart v. Widener, 287 Ga. 622, 624 (1) (a) (697 SE2d 779) (2010) (citation and punctuation omitted); see Norton v. Budget Rent A Car System, 307 Ga. App. 501 (705 SE2d 305) (2010) (“We review the denial of summary judgment de novo, viewing the evidence and all reasonable inferences therefrom in the light most favorable to the nonmoving party.”) (footnote omitted).

2 Center of Central Georgia, Inc. (hereinafter “The Medical Center”), whereby only

CGAS would provide anesthesiology services, through its physician-employees, to

The Medical Center’s Macon hospital and that hospital’s patients.

Pertinent Terms of the Contract between CGAS and The Medical Center

The contract relevant here provided that its “Term” would run from March 1,

2000 to February 28, 2002, unless terminated earlier pursuant to that contract. Upon

its expiration or termination, the contract required CGAS physicians to resign their

hospital privileges; if any such physician failed to do so, the contract provided that

The Medical Center could terminate that physician’s privileges. The contract did not

terminate in February 2002, as the parties agreed to extend it through mid-January

2004.)

Allegations of Billing Fraud Committed by Certain CGAS Physicians

In April 2001, CGAS physician Cancel (who would become a plaintiff in the

instant action) was named CEO of CGAS. Thereafter, he discovered what he believed

showed that certain of his CGAS physician colleagues were fraudulently billing

Medicare/Medicaid as well as insurance companies, thereby yielding unearned

revenues for both CGAS and The Medical Center. He discussed the billing

irregularities with CGAS members. And later, Cancel met with the Vice President for

3 Medical Affairs for The Medical Center, Louis Goolsby, M.D., and notified him of

the perceived billing problems. Cancel deposed that, within a short period of time,

tension, stress and interpersonal problems arose amongst certain of the CGAS

physicians.

Dissatisfied because of what he saw as continued noncompliant billing

practices, Cancel, with The Medical Center’s approval, contacted the American

Society of Anesthesiologists (hereinafter “ASA”) and requested an independent third-

party investigation. But about a week before the scheduled investigation, during the

first week of December 2002, Goolsby canceled the ASA’s visit and investigation.

Cancel, who already was contemplating quitting his practice at the hospital and

moving to another state, was not informed of the cancellation beforehand. As he

recalled during his deposition, “[B]y then I am frustrated and when [Goolsby] cancels

that without telling me, without consulting with anybody, just unilaterally cancels, I

gave up and I said, that’s it. . . . Emotionally I had probably decided I can no longer

stay here unless this is fixed.”

Investigation Conducted by a Third-Party

Meanwhile, the Chief Executive Officer of The Medical Center, A. Donald

Faulk, engaged a psychological consultant to evaluate the interpersonal dynamics

4 amongst the CGAS physicians. Alvin Sewell, M. D., a shareholder/director/employee

himself of CGAS, encouraged his fellow CGAS physicians to interact with that

consultant. And thereafter, they did so. Cancel revealed during his discussion with the

consultant in January 2003 his concerns of ongoing fraudulent billing irregularities.

In January 2003, Cancel submitted his resignation to be effective March 1,

2003, but within days of so submitting, changed his resignation to a one-year vacation

leave. In February 2003, Cancel began a series of trips to Colorado, during which he

researched housing, hospitals, and medical licensing. In March, he began a medical

practice in Colorado, where he continued to practice until at least his deposition in

the instant case. Hence, after Cancel took vacation leave in February 2003, he never

again practiced medicine as a CGAS employee at the Macon hospital. Cancel

admitted in his deposition that he had essentially abandoned his post as CEO of

CGAS, adding that he had concluded that “the post had no power any more and no

decision-making, I was a captain without a ship.” In June 2003, Cancel resigned from

his employment with CGAS.

While Cancel was on leave, Jain (who would become another plaintiff in the

instant case) had acted as CGAS’s CEO. Having also become concerned about

potential billing non-compliance, Jain reviewed anesthesia records for a period of

5 time through about the middle of April 2003 and discovered therein indications of

billing irregularities by certain CGAS physicians. Jain shared with Goolsby his

findings, as well as his belief that his findings showed that elements of billing

compliance were missing.

Action by The Medical Center

A few days later, Faulk (as President/CEO of The Medical Center) sent a letter

dated April 25, 2003 to Cancel (as CEO of CGAS), advising that, due to the

allegations raised about and by certain CGAS representatives, including behavioral

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