Epic Medical Management, LLC v. Paquette

244 Cal. App. 4th 504
CourtCalifornia Court of Appeal
DecidedJanuary 28, 2016
DocketB261541
StatusPublished
Cited by16 cases

This text of 244 Cal. App. 4th 504 (Epic Medical Management, LLC v. Paquette) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Epic Medical Management, LLC v. Paquette, 244 Cal. App. 4th 504 (Cal. Ct. App. 2016).

Opinion

Opinion

RUBIN, J.

This case involves a dispute between a doctor, appellant Justin Dominic Paquette, M.D., and a medical management company, Epic Medical Management, LLC (management company), with which he had contracted to supply non-medical management services to his practice. The doctor and the management company had a falling out and agreed to terminate their contract. The management company believed it was due additional fees under the *508 agreement; the doctor believed the management company had underperformed its duties under the contract and owed him money. The matter proceeded to arbitration, and the arbitrator ruled in favor of the management company. On cross-petitions to confirm and vacate the award, the trial court ruled in favor of the management company and confirmed the award. The doctor appeals, arguing that the arbitration award cannot stand because the contract, as interpreted by the arbitrator, is illegal. We conclude that the issue is not reviewable, and, if it were, the contract is not illegal as a matter of law. We therefore affirm.

FACTUAL AND PROCEDURAL BACKGROUND

On November 1, 2008, the doctor and the management company entered into a “Management Services Agreement.” Pursuant to the agreement, the doctor engaged the management company “to provide management services as are reasonably necessary and appropriate for the management of the non-medical aspects of [the doctor’s] medical practice.” Among other things, the management company was required to lease office space to the doctor, lease to him all equipment he deemed reasonably necessary and appropriate, provide support services, provide non-physician personnel, establish and implement a marketing plan, conduct billing and collections, and perform accounting services. The doctor was responsible for providing medical services. 1

As to compensation, the contract stated the parties agreed that “it will be impracticable to ascertain and segregate all of the exact costs and expenses that will be incurred by [the management company] in performance of the [nfjanagement [s]ervices. However, it is the intent of the parties that the compensation paid to [the management company] provides a reasonable return, considering the investment and risk taken by [the management company] and the value of the [p]remises, [l]eased [ejquipment and other [m]anagement [s]ervices provided by [the management company] hereunder.” The agreement then provided, “For each month that [the management company] provides the [m]anagement [s]ervices . . . , [the doctor] shall pay to [the management company] a management fee equal to one hundred twenty percent (120%) of the aggregate costs [the management company] incurs in providing the [ management [s]ervices ... in that month but not to exceed fifty percent (50%) of the Collected Professional Revenues plus twenty five percent (25%) of the Collected Surgical Revenues . ...” A subsequent provision defined “Collected Revenues” to mean the total received by the practice, less any refunds paid and bad-debt write-offs.

*509 The contract also included an arbitration clause and a prevailing party attorney’s fee clause.

The parties performed under the agreement for three and a half years until the doctor terminated it at the end of March 2012. However, the management company never charged, and the doctor never paid, a fee based on 120 percent of the management company’s costs. Instead, the management company charged, and the doctor paid, a fee calculated as 50 percent of office medical services, 25 percent of surgical services, and 75 percent of pharmaceutical expenses. (We call this the “50-25-75” method.) 2

As any patient knows, delays occur between the time a physician performs services for a patient and the time the physician receives payment for those services from the patient’s insurance company. The main issue of dispute, from the management company’s point of view, was whether it was entitled to its share, under the 50-25-75 method, of the revenues collected after the agreement was terminated, traceable to services provided by the doctor to his patients before termination. 3 The main issue, from the doctor’s point of view, was whether the management company breached its obligations under the agreement.

Cross-complaints were filed. Pursuant to the arbitration clause in the agreement, the parties agreed to stay the pending action and resolve their claims by arbitration.

The matter proceeded to arbitration. After a hearing, the arbitrator issued a written award, concluding that the management company did not materially breach the agreement, but the doctor did. As to the management fees, the arbitrator found that, by the parties’ practice, they had modified the agreement so that the management company was entitled to fees on a 50-25-75 basis. The arbitrator also concluded that the doctor had a continuing obligation to pay management fees accrued during the term of the agreement. At the arbitration hearing, the doctor had argued that because some of the fees were paid for the management company’s marketing services, the payments constituted an illegal kickback scheme for referred patients. There is no dispute that some physician members of the management company did, in fact, refer *510 patients to the doctor. The doctor took the position that paying the management company a percentage of the revenues generated by those patients constituted illegal kickbacks, barred by Business and Professions Code section 650 (section 650). 4 The arbitrator did not entirely disagree with this characterization, but concluded that any such violation was “technical” and did not impact the award.

The arbitrator awarded the management company a total of $286,776.95 in unpaid management fees. Pre-award interest, costs, and prevailing party attorney’s fees were also awarded.

The management company petitioned to confirm the award; the doctor moved to vacate it. The doctor’s purported grounds for vacation, also pursued on appeal, were that (1) the arbitrator exceeded her powers by creating a new agreement between the parties; (2) the agreement created by the arbitrator violated the statutory prohibition on the payment of referral fees and the law against the corporate practice of medicine; and (3) the arbitrator prejudicially erred by not allowing the doctor sufficient time to testify.

The doctor supported his request to vacate with a declaration of his counsel, setting forth counsel’s recollection of the arbitration; some of the exhibits submitted to the arbitrator; and a declaration of his expert witness, Carol Lucas. Lucas had testified at the arbitration to show that the management company improperly engaged in the practice of medicine due to its referrals of patients to the doctor.

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Cite This Page — Counsel Stack

Bluebook (online)
244 Cal. App. 4th 504, Counsel Stack Legal Research, https://law.counselstack.com/opinion/epic-medical-management-llc-v-paquette-calctapp-2016.