Dpmlgsprla, LLC Versus Doctor's Advantage, Inc.

CourtLouisiana Court of Appeal
DecidedFebruary 20, 2025
Docket25-C-34
StatusUnknown

This text of Dpmlgsprla, LLC Versus Doctor's Advantage, Inc. (Dpmlgsprla, LLC Versus Doctor's Advantage, Inc.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dpmlgsprla, LLC Versus Doctor's Advantage, Inc., (La. Ct. App. 2025).

Opinion

DPMLGSPRLA, LLC NO. 25-C-34

VERSUS FIFTH CIRCUIT

DOCTOR'S ADVANTAGE, INC. COURT OF APPEAL

STATE OF LOUISIANA

February 20, 2025

Morgan Naquin Deputy Clerk

IN RE DPMLGSPRLA, LLC

APPLYING FOR SUPERVISORY WRIT FROM THE TWENTY-FOURTH JUDICIAL DISTRICT COURT, PARISH OF JEFFERSON, STATE OF LOUISIANA, DIRECTED TO THE HONORABLE E. ADRIAN ADAMS, DIVISION "G", NUMBER 831-258

Panel composed of Judges Susan M. Chehardy, Stephen J. Windhorst, and Scott U. Schlegel

WRIT DENIED

On August 1, 2016, plaintiff-relator, DPMLGSPRLA, LLC, a medical

practice specializing in podiatry, and defendant-respondent, Doctor’s Advantage,

Inc. (“DA”), executed a contract for medical coding/billing services. Plaintiff

alleges that after initially performing satisfactorily, DA “negligently and

fraudulently mismanaged numerous duties and obligations it was required to

perform” under the contract. More specifically, plaintiff alleged that DA “failed to

input and/or correct a multitude of medical claim and billing codes and failed to

use the correct systems, which allegedly deprived Plaintiff of substantial payment

and caus[ed] loss of income.”

During discovery, DA asked plaintiff for: “Any document which you

contend supports your claim for the damages you are seeking in this matter” in its

Request for Production of Documents No. 1. Plaintiff’s response to DA’s request

stated: “Please see the produced boxes, tax returns, spreadsheets, and emails.”

25-C-34 According to DA, plaintiff produced almost 21,000 loose pages of documents,

many of which reference data collected and maintained in plaintiff’s TRAKnet

and/or Trizetto systems, but that plaintiff refused to produce the requested

TRAKnet and Trizetto data itself, as confirmed by plaintiff’s counsel in September

2024.1

DA filed a motion to compel discovery responses, arguing that plaintiff’s

complete billing data is not only relevant but also crucial to its defense, and the

information cannot be obtained without access to plaintiff’s TRAKnet/Trizetto

systems. In support of its motion to compel, DA cited Moss v. State, 05-1963 (La.

4/4/06), 925 So.2d 1185, a case in which the Supreme Court determined that La.

R.S. 13:3715.1 authorizes a court to compel the disclosure of privileged medical

information after a contradictory hearing, if disclosure is necessary to promote the

interests of justice, even in the absence of one of the statutory exceptions

enumerated in La. C.E. art. 510 (B)(2).2

In opposition, plaintiff argued that DA had access to all of the necessary

documents through those already produced in response to the discovery requests.

Further, plaintiff contended that DA had access to both the TRAKnet and Trizetto

systems when it was working for plaintiff, and that DA maintained a backup

system during that time. Plaintiff also contended that neither system has a date-set

administrative lock to limit DA’s access exclusively to the term of the contract

between the parties. Further, plaintiff argued that all of the error reports,

explanations of benefits, and documentation of rejections were already submitted.

Finally, plaintiff argued that the data sought is private information that belongs to

1 According to plaintiff, the Trizetto system managed the medical coding claims and identified claim errors in order to correct the errors before submitting a claim for processing. TRAKnet managed the billing for reimbursement of medical treatment claims from insurers and other payors. 2 La. C.E. art. 510 (B)(2) provides a number of exceptions to the general rule that a patient has a privilege to refuse to disclose, and to prevent another person from disclosing, a confidential communication made for the purpose of receiving health care. 2 its patients, not to plaintiff. Plaintiff claimed that DA “never asked or informed any

of the nonparty patients” that it was seeking their information, nor did it acquire

waivers for production of that information. Therefore, plaintiff argued, the trial

court could not order production of the information.

The trial court granted DA’s motion to compel, ordering plaintiff to produce

the documents but imposing certain restrictions and protections. Specifically, the

court’s judgment ordered plaintiff to “fully produce documents responsive to

Request for Production of Documents No. 1,” but that the documents “shall be

limited to medical coding, claims, and billing information contained in the

TRAKnet and Trizetto systems during the 2016-2020 term of the Contract” (all

emphasis in original). The trial court’s judgment stated that plaintiff “shall not be

required to disclose any documents and/or information to [DA] regarding

individuals that became patients after the termination of the Contract between the

parties, or after October 2020” (emphasis in original). Finally, the trial court’s

judgment indicated that the documents “shall be produced according to a

Protective Order,” and that they “shall be organized and labeled.” (Emphasis in

original).

Plaintiff now seeks review of that ruling, arguing that there are adverse

public policy implications if the trial court’s judgment—requiring disclosure of

certain patient information “without any showing of defendant’s efforts to inform”

the patients; in violation of the doctor-patient privilege; and without DA having to

show that it attempted to gain this information from its own sources—is allowed to

stand.

We disagree with plaintiff’s argument. First, the trial court ordered the

information to be produced subject to a protective order, and prohibits any

unnecessary disclosure of non-party patients’ records. Second, the trial court’s

judgment and reasons for judgment reveal that after conducting a contradictory

3 hearing, its ruling was sufficiently tailored to produce the information requested.

The Louisiana Supreme Court stated:

[T]he legislature has entrusted the courts with the duty of determining, in the context of a contradictory hearing, on a case by case basis, according to the unique facts presented, whether disclosure of a non-party’s otherwise privileged medical information is “proper” in a particular case in the absence of consent or a waiver. This determination is not … confined solely to ascertaining whether a statutory exception to the privilege exists.

Moss, 925 So.2d at 1199-1200. Here, DA requested applicable billing and coding

information to address a contractual dispute between the parties, not to scrutinize a

particular individual’s medical records. After a contradictory hearing, the trial

court was evidently satisfied that DA met its burden of showing relevance and

need.

Third, on the showing made, we are unable to determine whether the

documents that plaintiff already produced satisfied Request for Production No. 1,

as plaintiff argues.

For all of these reasons, and because a trial court is accorded vast discretion

in matters of discovery, on the showing made, we cannot say the trial court abused

its discretion. Accordingly, plaintiff’s writ application is denied.

Gretna, Louisiana, this 20th day of February, 2025.

SMC SJW SUS

4 SUSAN M. CHEHARDY CURTIS B. PURSELL

CHIEF JUDGE CLERK OF COURT

SUSAN S. BUCHHOLZ FREDERICKA H. WICKER CHIEF DEPUTY CLERK JUDE G. GRAVOIS MARC E. JOHNSON STEPHEN J. WINDHORST LINDA M. WISEMAN JOHN J. MOLAISON, JR. FIRST DEPUTY CLERK SCOTT U. SCHLEGEL TIMOTHY S. MARCEL FIFTH CIRCUIT MELISSA C.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Moss v. State
925 So. 2d 1185 (Supreme Court of Louisiana, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
Dpmlgsprla, LLC Versus Doctor's Advantage, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/dpmlgsprla-llc-versus-doctors-advantage-inc-lactapp-2025.