Core Finance Team Affiliates, LLC v. Maine Medical Center

2024 ME 78
CourtSupreme Judicial Court of Maine
DecidedNovember 26, 2024
DocketBCD-23-440
StatusPublished

This text of 2024 ME 78 (Core Finance Team Affiliates, LLC v. Maine Medical Center) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Core Finance Team Affiliates, LLC v. Maine Medical Center, 2024 ME 78 (Me. 2024).

Opinion

MAINE SUPREME JUDICIAL COURT Reporter of Decisions Decision: 2024 ME 78 Docket: BCD-23-440 Argued: September 10, 2024 Decided: November 26, 2024 Revised: December 26, 2024

Panel: STANFILL, C.J., and MEAD, HORTON, LAWRENCE, and DOUGLAS, JJ.

CORE FINANCE TEAM AFFILIATES, LLC

v.

MAINE MEDICAL CENTER et al.

HORTON, J.

[¶1] Three Maine hospitals1 (the Hospitals) appeal from a judgment of

the Business and Consumer Docket (Duddy, J.) awarding restitution for unjust

enrichment to a healthcare consulting firm that provided services to the

Hospitals. The court held a bench trial on the unjust enrichment claim after a

jury trial resulted in a verdict for the Hospitals on the firm’s breach of contract

claim. The Hospitals contend that the judgment should be set aside for several

reasons, including that the consulting firm was not entitled to assert an unjust

enrichment claim in lieu of a quantum meruit claim for the reasonable value of

1 The hospitals are Maine Medical Center, Southern Maine Health Care, and Franklin Memorial Hospital. 2

its services. We agree that the court erred, vacate the judgment, and remand

for judgment to be entered in favor of the Hospitals.

I. BACKGROUND

A. Facts

[¶2] The following factual summary is based on the evidence presented

at the jury trial, viewed in the light most favorable to the jury’s verdict.

See Kezer v. Cent. Me. Med. Ctr., 2012 ME 54, ¶ 2, 40 A.3d 955.

[¶3] Core Finance Team Affiliates, LLC (Core) provides consulting and

data services to hospitals. One of Core’s services is to provide hospitals with

data that they need to support their claims for reimbursement by the federal

government for services to Medicare-eligible patients. The two types of data

relevant to this case are “annual hourly wage” data for a range of health care

occupations (such as registered nurse, nurse aide, and medical assistant) in a

hospital’s geographic service area, and “occupational mix survey” (OMS) data

that is used to adjust the annual hourly wage data to reflect the hospital’s mix

of health care occupations in its provision of patient services.

[¶4] In June 2014, the Maine Hospital Association, Inc. (the Association),

an association of Maine hospitals, entered into a contract for Core to provide

data services to the Hospitals. Core’s services involved making adjustments 3

and revisions to the Hospitals’ internal data to be incorporated in the Hospitals’

reimbursement submittals to the federal government.

[¶5] The contract called for Core to provide its services related to annual

hourly wage data at stated fixed costs. Regarding OMS data, an attachment to

the contract, titled Exhibit E, stated: “[The Association] will provide a listing of

the providers who elect to participate in the Occupational Mix Survey review.

[Core] will be responsible for confirming the provider(s’) participation and

directly bill the provider for those services.” Unlike the fixed costs for Core’s

annual hourly wage services, the stated cost for Core’s OMS services was

contingent—a fee of 12.5% of the increase in federal Medicaid and Medicare

reimbursement to the Hospitals attributable to the OMS services. The Hospital

finance representatives with overall responsibility for the Core contract

considered Core’s proposed contingent fee for OMS data to be unacceptable for

various reasons, and the Hospitals did not become contractually bound to pay

Core the contingent fee for OMS services. However, the Hospitals nevertheless

provided Core with the information that it needed to perform its OMS services,

leading Core to believe that the Hospitals had in fact agreed to receive—and

pay the contingent fee for—the OMS data. Core provided adjusted annual 4

hourly wage data and adjusted OMS data to the Hospitals, and the Hospitals

used the data to obtain reimbursement for their services to Medicare patients.

[¶6] When Core demanded payment of the 12.5% contingent fee for OMS

services called for in the contract, the Hospitals refused to pay.

B. Procedure

[¶7] On November 20, 2018, Core filed a complaint in the Superior Court

(Cumberland County) against the Association and the Hospitals, alleging that

Core was entitled to compensation for the OMS services. In its complaint, Core

pleaded two theories of liability, “Breach of Contract” (Count 1) and “Unjust

Enrichment” (Count 2), and attached a copy of the June 2014 contract between

the Association and Core. The Hospitals answered and denied Core’s

allegations on December 21, 2018. On the same day, the matter was transferred

to the Business and Consumer Docket.

[¶8] On January 4, 2019, the Association answered, denying Core’s

allegations, and moved to compel arbitration under the provisions of the

contract between the Association and Core. The Hospitals took no position on

the Association’s motion but denied contracting with Core for OMS services. On

March 6, 2019, the Business and Consumer Court (Duddy, J.) entered an order 5

compelling arbitration only between the Association and Core.2 The Hospitals

filed a demand for a jury trial on all issues triable to a jury. See M.R. Civ. P. 38(b).

On June 28, 2021, the court denied the parties’ cross-motions for summary

judgment on the issue of whether the Hospitals were liable to Core for OMS

services under the contract between Core and the Association.

[¶9] On April 10, 2023, Core filed a motion in limine seeking to exclude

from the jury trial any reference to the unjust enrichment claim. It argued: “If

the jury concludes there was a contract in this case, then the unjust enrichment

claim is moot. However, if the jury finds there was no contract, then the unjust

enrichment claim is ripe [for] consideration by the Court.” The Hospitals

opposed the motion, arguing that “Core’s claim styled as ‘unjust enrichment’

should be tried to the jury” because Core “actually pled a quantum meruit

claim” triable to a jury. The Hospitals alternatively argued that if the court were

to find that a jury trial right did not attach to Core’s unjust enrichment claim,

the court should nonetheless use the jury in an advisory capacity to decide

issues of fact relevant to the claim. See M.R. Civ. P. 39(d).

[¶10] On April 26, 2023, the court ordered that any reference to the

unjust enrichment claim be excluded from the trial. It explained:

2 The claim between Core and the Association is not at issue in this appeal. 6

As noted by [the Hospitals], the language used in [Core’s] Count II Unjust Enrichment claim is susceptible to interpretation as a claim for quantum meruit. However, [Core] assures us all that it has pled a claim for unjust enrichment, and the Court will respect [Core’s] interpretation of its own Complaint. However, the only relief available to [Core] on Count II, if any, will be relief appropriate to the equitable claim of unjust enrichment, not damages as would be appropriate to quantum meruit.

The court ultimately decided that the claim for unjust enrichment would be

decided by the court at a bench trial. At the pre-trial conference, the Hospitals

raised the issue again, contending that Core had pleaded a quantum meruit

claim, not an unjust enrichment claim, and that the Hospitals were entitled to a

jury trial on that claim. The court again responded that, despite some ambiguity

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2024 ME 78, Counsel Stack Legal Research, https://law.counselstack.com/opinion/core-finance-team-affiliates-llc-v-maine-medical-center-me-2024.