Christine Pitcher v. Centene Corporation

Missouri Court of Appeals·Decided March 3, 2020·No. WD82564·Published

Opinion

In the

Missouri Court of Appeals Western District

CHRISTINE PITCHER,   WD82564

Respondent,  OPINION FILED:

v.   MARCH 3, 2020

CENTENE CORPORATION, ET AL.,  

Appellants.  

Appeal from the Circuit Court of Jackson County, Missouri The Honorable Jack Richard Grate, Judge

Before Division One: Thomas N. Chapman, Presiding Judge, Mark D. Pfeiffer, Judge, Anthony Rex Gabbert, Judge

Centene Corporation (“Centene”) and AcariaHealth Pharmacy, Inc. (“Acaria”)

(“Appellants” collectively) appeal the circuit court’s judgment entered on a jury verdict finding in favor of Christine Pitcher on her common-law retaliatory discharge claim against Appellants. Appellants assert eight points on appeal, contending that the circuit court, 1) erred in overruling Acaria’s motion to dismiss, arguing the trial court had no jurisdiction over Acaria; 2) erred in overruling Centene’s motion for judgment notwithstanding the verdict, arguing Centene was not Pitcher’s employer; 3) erred in overruling Appellants’ motion for judgment notwithstanding the verdict, arguing Pitcher failed to make a submissible claim of retaliatory discharge; 4) erred in

admitting evidence of a separation agreement offered Pitcher; 5) erred in excluding evidence of an ADT report; 6) erred in awarding front pay, arguing Pitcher did not plead a request for front pay; 7) erred in awarding front pay, arguing front pay was inappropriate under the circumstances, and; 8) erred in awarding front pay to retirement age. We affirm.

Factual and Procedural Background Pitcher, a licensed pharmacist and Missouri resident, was hired in May 2014 by Acaria as the director of a pharmacy located in Lenexa, Kansas (also called “PC20”). Acaria is a corporation incorporated in California with corporate headquarters in Orlando, Florida. Centene is Acaria’s parent company. Centene is a Delaware corporation with its principal place of business in St. Louis, Missouri.

In July 2016, Pitcher raised concerns about the legality of a transaction involving a Kansas Medicaid recipient. A Kansas Medicaid beneficiary who had an HIV infection and was immunocompromised required refill of an anti-parasitic medication called Daraprim. The cost of a one-month supply of Daraprim is $54,000. Pitcher sent an email to Acaria’s Houston, Texas pharmacy (also called “PC11”) requesting a transfer of Daraprim to the Lenexa Pharmacy. In response, she received an email from Adnan Raza, an intern specialist, stating: “We’re not supposed to transfer Daraprim. Daraprim is to be filled only at PC11. Please send it back once you receive immediately.”

On July 22, 2016, Alexis Baez, an account executive with Acaria, sent an email to Maurice Bundage, the inventory manager in Houston, with a copy to a number of other coworkers, reading: “… Sunflower must be shipped out of PC20. Right now we have an order that a patient needs tomorrow, and that the health plan is concerned with the implications if we process the claim out

of PC11, considering that PC20 should be the only pharmacy processing for Sunflower 1 patients ….”

Jonalan Smith, Vice-President of Sunflower’s Pharmacy Division and liaison with the Kansas Medical Assistance Program (KMAP), emailed to Baez and others, including Pitcher: “… the Houston pharmacy should never fill for Kansas members. Only the Lenexa pharmacy should fill for Kansas members.” Later that day, Jason Ng wrote to Pitcher’s supervisor, Steve Cobb: “Steve, due to billing issues can do a virtual transfer for Daraprim, No. 28 for PC20. We did not transfer meds earlier per Adnan. Only PC11 can fill Daraprim orders. Please let us know.”

A “virtual transfer” occurs when a pharmacy provides a service at one location, and bills for that service as if it was provided at a different location. Based on the above email exchange, Pitcher became concerned that the virtual transfer involving shipping Daraprim from the Houston pharmacy to the patient, but billing for it as if it was shipped from Kansas, was prohibited by Kansas regulations on Medicaid reimbursements as fraudulent and could result in her losing her license.

That same day, Cobb emailed to approve the virtual transfer. In response, Pitcher emailed Cobb and others:

I apologize for the inconvenience that this may cause but because Sunflower stated that this could not be shipped from another location, I ethically bond [sic] and unable to complete this transfer. Please complete this transfer by those who did receive the authorization from Sunflower to perform the virtual transfer. The correspondence that I am included on did not authorize this from Sunflower. If there is authorization that I missed, please forward this and I am more than happy to complete the transfer.

1 Sunflower health plan, also a subsidiary of Centene, handles Kansas Medicaid reimbursements.

On July 26, 2016, Bundage emailed: “Transfer has been created. PC 20 please received into your stock.” That same day, Pitcher forwarded the email string related to Daraprim to John Vandervoot, Centene’s Compliance Officer, with this accompanying explanation, testifying at trial that she sent the email because she was feeling harassed for doing the right thing:

… There was a shipment made from Houston on Friday for a Kansas Medicaid patient. I realize that Kansas law typically does not allow for Medicaid to be shipped from out of state which is confirmed by Jonalan.

Ethically, I believe that I need to be within Kansas law and have this medication be shipped from Houston PC11. I do not know the politics surrounding the transfer of this medication to PC20 in Kansas but honestly I am reluctant to sign for a transfer that Sunflower did not approve or provide an exception for.

Pitcher received no response from Vandervoot.

That same day, Pitcher emailed Baez, Cobb, and others:

… Unfortunately, the VP of Sunflower stated that all shipments should come out of Lenexa. Until Compliance/legal weighs in on this, we are unable to complete this transfer since it is not in compliance with Kansas Law. Additionally, if Jonalan would authorize this exception, then there is no problem.

After Pitcher raised concerns about the legality of the virtual transfer of Daraprim, Appellants engaged in a pattern of conduct Pitcher believed was retaliatory for Pitcher having raised concerns. Although Cobb had reviewed Pitcher’s performance on July 25, 2016, indicating Pitcher’s performance exceeded expectations, on August 18, 2016, Cobb issued a “Last Chance Agreement” to Pitcher stating that her conduct was unprofessional and unacceptable. Prior to this agreement, Pitcher had received no verbal or written discipline or counseling.

On November 29, 2016, Mr. Jackson emailed Richard Giles, with a copy to Cobb and Kenyata Virgil, “… We will be officially terminating Christine Pitcher’s employment on Thursday morning November 30 …. Her manager, Steven Cobb and HR Manager Kenyata Virgil, will communicate this decision via phone while Christine is at her home location ….” On December

1, 2016, Cobb and Virgil called Pitcher at her home in Missouri to terminate Pitcher’s employment. The claimed reason for Pitcher’s termination was that she had left the pharmacy unattended on November 18, 2016; Pitcher testified that she never left the pharmacy unattended and never admitted to leaving the pharmacy unattended. Contemporaneous with Pitcher’s termination, Appellants offered Pitcher a Separation Agreement.

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Christine Pitcher v. Centene Corporation, (Mo. Ct. App. 2020).

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