Cancel v. Sewell

740 S.E.2d 870, 321 Ga. App. 523, 2013 Fulton County D. Rep. 1277, 2013 WL 1277751, 2013 Ga. App. LEXIS 320
CourtCourt of Appeals of Georgia
DecidedMarch 29, 2013
DocketA12A1950, A12A1951; A12A1952
StatusPublished
Cited by5 cases

This text of 740 S.E.2d 870 (Cancel v. 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
Cancel v. Sewell, 740 S.E.2d 870, 321 Ga. App. 523, 2013 Fulton County D. Rep. 1277, 2013 WL 1277751, 2013 Ga. App. LEXIS 320 (Ga. Ct. App. 2013).

Opinion

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

[524]*524Viewed 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 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 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.

[525]*525Dissatisfied 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 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 or 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 noncompliance, Jain reviewed anesthesia records for a period of 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, [526]*526as 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 issues and fraudulent billing practices, The Medical Center was intending to cancel its contract with CGAS, effective May 31, 2003, pursuant to the contract’s “with cause” clause, unless CGAS demonstrated by that date that it was in substantial compliance with the contract. The April 25 letter demanded that CGAS promptly retain a qualified independent consulting firm, subject to The Medical Center’s approval of both the firm and its audit protocol, to conduct an audit of CGAS’s billing practices and report the findings thereof to CGAS and to The Medical Center.

Additionally, the April 25 letter announced The Medical Center’s intent to restructure its anesthesiology department effective February 29, 2004, even if CGAS demonstrated its compliance with their contract on or before May 31, 2003.

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Related

Cancel v. Med. Ctr. of Cent. Ga., Inc.
812 S.E.2d 592 (Court of Appeals of Georgia, 2018)
Alvin Sewell v. Angel Cancel
771 S.E.2d 388 (Court of Appeals of Georgia, 2015)
Sewell v. Cancel
759 S.E.2d 485 (Supreme Court of Georgia, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
740 S.E.2d 870, 321 Ga. App. 523, 2013 Fulton County D. Rep. 1277, 2013 WL 1277751, 2013 Ga. App. LEXIS 320, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cancel-v-sewell-gactapp-2013.