Cheruvu v. HealthNow New York Inc.

CourtDistrict Court, W.D. New York
DecidedAugust 12, 2022
Docket1:20-cv-00808
StatusUnknown

This text of Cheruvu v. HealthNow New York Inc. (Cheruvu v. HealthNow New York Inc.) is published on Counsel Stack Legal Research, covering District Court, W.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cheruvu v. HealthNow New York Inc., (W.D.N.Y. 2022).

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK

SREEKRISHNA CHERUVU,

Plaintiff,

v. 20-CV-808-LJV-LGF DECISION & ORDER HEALTHNOW NEW YORK INC., et al.,

Defendants.

On May 27, 2020, the plaintiff, Sreekrishna Cheruvu, commenced this action in New York State Supreme Court, Erie County, alleging violations of his civil rights under 42 U.S.C. §§ 1981, 1982, 1983, and 1985. Docket Item 1-1. He also brings claims for malicious prosecution, common law fraud, intentional infliction of emotional distress, and negligent infliction of emotional distress under New York law. Id. Cheruvu’s claims stem from his criminal prosecution and the associated investigation for his alleged use of incorrect billing codes. See id. He has sued HealthNow New York, Inc., doing business as Blue Cross and Blue Shield of Western New York (“BCBS”); Independent Health Association, Inc. (“IHA”); Individual Practice Association of Western New York, Inc. (“IPA”), an affiliate of IHA; Excellus Health Plan, Inc., doing business as Univera Healthcare (“Univera”); and a BCBS employee, Susan Schultz, who is also known as Susan Nason (“Schultz”). Id. On June 29, 2020, the defendants removed the case to this Court based on federal question jurisdiction, Docket Item 1, and about a month later, the defendants moved to dismiss, Docket Items 11 (BCBS’s and Schultz’s motion); 13 (IHA’s and IPA’s motion); 14 (Univera’s motion). The next day, this Court referred the case to United States Magistrate Judge Leslie G. Foschio for all proceedings under 28 U.S.C. § 636(b)(1)(A) and (B). Docket Item 15. On September 9, 2020, Cheruvu responded to the motions to dismiss, Docket Items 23, 24, 25; and about three weeks later, the

defendants replied, Docket Items 30 (IHA’s and IPA’s reply); 31 (Univera’s reply); 32 (BCBS’s and Schultz’s reply). On March 23, 2022, Judge Foschio issued a Report and Recommendation (“R&R”) finding that the defendants’ motions should be granted. Docket Item 33. On April 20, 2022, Cheruvu objected to the R&R. Docket Item 36. On July 15, 2022, the defendants responded to the objections. Docket Items 39 (BCBS’s and Schultz’s response); 40 (Univera’s response); 41 (IHA’s and IPA’s response). And two weeks later, Cheruvu replied. Docket Item 42. A district court may accept, reject, or modify the findings or recommendations of a magistrate judge. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b)(3). The court must

review de novo those portions of a magistrate judge’s recommendation to which a party objects. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b)(3). This Court has carefully and thoroughly reviewed the R&R; the record in this case; the objection, response, and reply; and the materials submitted to Judge Foschio. Based on that de novo review, the Court accepts and adopts Judge Foschio’s recommendation to grant the defendants’ motion to dismiss the federal claims. But for the reasons that follow, the Court declines to exercise supplemental jurisdiction over Cheruvu’s state-law claims and remands those claims to state court. FACTUAL BACKGROUND1

In 1985, Cheruvu “obtained his New York medical license.” Docket Item 1-1 at ¶ 23. In the years that followed, BCBS, IHA, IPA, and Univera all granted Cheruvu credentials as a participating physician and approved him as an in-network provider. See id. at ¶¶ 7-11, 14. But in early 2013, Cheruvu resigned as a BCBS participating provider, id. at ¶ 12. And in 2014, BCBS terminated Cheruvu in his capacity as a non- participating provider, id. at ¶ 15; Univera suspended Cheruvu as provider, id. at ¶ 14; and IHA terminated Cheruvu as a participating provider, id. at ¶ 13. From 2009 until 2014, Cheruvu focused his practice on addiction medicine. Id. at ¶ 29. To treat patients with opioid addictions, Cheruvu sometimes prescribed

Suboxone. See id. at ¶¶ 36-37. In addition to closely monitoring patients’ Suboxone treatment, Cheruvu ensured that his patients received substance abuse counseling, sometimes including group counseling. Id. Cheruvu’s treatment protocol followed the recommendation of several medical organizations, including the Substance Abuse and Mental Health Services Administration; the American Society of Addiction Medicine; and the New York Department of Health Office of Alcoholism and Substance Abuse. Id. at ¶ 37.

1 On a motion to dismiss, the Court “accept[s] all factual allegations as true and draw[s] all reasonable inferences in favor of the plaintiff.” Trs. of Upstate N.Y. Eng’rs Pension Fund v. Ivy Asset Mgmt., 843 F.3d 561, 566 (2d Cir. 2016). The Court assumes the reader’s familiarity with the facts alleged in the complaint, see Docket Item 1-1, and limits its discussion of the factual background to the facts relating to Cheruvu’s objections. For a full recitation of the facts, the Court refers the reader to Judge Foschio’s R&R, see Docket Item 33 at 4-14. As part of his practice in addiction medicine, Cheruvu employed Barry Herman, M.D., and Bidappa G. Maneyapanda, M.D., to provide backup coverage when Cheruvu was away or otherwise unable to see patients. Id. at ¶ 55. In addition, Cheruvu employed several licensed counselors and therapists. Id.

Two disputes arose about Cheruvu’s billing practices, and those disputes ultimately led to both a criminal prosecution for insurance fraud and civil forfeiture proceedings. See id. at ¶¶ 35, 55, 58, 59. The first dispute centered on the billing codes Cheruvu used when patients were seen in group counseling. See id. at ¶ 36. The second concerned whether Cheruvu improperly billed for services provided by Dr. Herman and Dr. Maneyapanda when Cheruvu was traveling outside the country. See id. at ¶ 55. Both the Federal Bureau Investigation (“FBI”) and the Western New York Health Care Joint Task Force Work Group (the “Task Force”) investigated the billing disputes. See id. at ¶¶ 35, 36, 43, 53. The Task Force works with federal and state law

enforcement officials to investigate allegations of insurance fraud, and BCBS, IHA, and Univera are on the Task Force. Id. at ¶ 53. Schultz was BCBS’s representative on the Task Force. Id. at ¶ 6. BCBS, IHA, and Univera also had internal Special Investigation Units (“SIU”) that investigated allegations of insurance fraud,2 see, e.g., id. at ¶¶ 44, 61, 70, 71, and Schultz was a BCBS SIU investigator as well, see id. at ¶¶ 44, 64. On November 11, 2011, Schultz and another BCBS SIU investigator, Janette Siuta, “arrived unannounced” at Cheruvu’s office to discuss Cheruvu’s billing code

2 New York law requires insurance companies that conduct business in New York to maintain internal Special Investigation Units for the purpose of investigating suspected fraudulent activities. See N.Y. Ins. Law § 409. practices. Id. at ¶ 38.

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