Family Health Physical Medicine, LLC v. Pulse8, LLC

105 F.4th 567
Court of Appeals for the Fourth Circuit·Decided June 21, 2024·No. 22-1393·Published·Cited by 1 cases

Opinion

PUBLISHED

UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

No. 22-1393

FAMILY HEALTH PHYSICAL MEDICINE, LLC, an Ohio limited liability company, individually and as the representative of a class of similarly-situated persons,

Plaintiff – Appellant,

v.

PULSE8, LLC, a Maryland limited liability company; PULSE8, INC., a Maryland corporation,

Defendants – Appellees.

Appeal from the United States District Court for the District of Maryland, at Baltimore. Stephanie A. Gallagher, District Judge. (1:21-cv-02095-SAG)

Argued: May 10, 2024 Decided: June 21, 2024

Before KING, AGEE, and HEYTENS, Circuit Judges.

Reversed and remanded by published opinion. Judge Heytens wrote the opinion, which Judge King joined. Judge Agee wrote an opinion concurring in part and dissenting in part.

ARGUED: Glenn Lorne Hara, ANDERSON & WANCA, Rolling Meadows, Illinois, for Appellant. Amy R. Upshaw, KING & SPALDING LLP, Chicago, Illinois, for Appellees. ON BRIEF: Stephen H. Ring, LAW OFFICES OF STEPHEN H. RING, P.C., Rockville, Maryland, for Appellant. Livia M. Kiser, Chicago, Illinois, Marisa C. Maleck, KING & SPALDING LLP, Washington, D.C., for Appellees.

TOBY HEYTENS, Circuit Judge:

With some exceptions not applicable here, a federal statute forbids using “any . . .

device to send, to a telephone facsimile machine, an unsolicited advertisement.” 47 U.S.C. § 227(b)(1)(C). The question before us is whether a complaint plausibly alleged that a fax which was sent by a company that sells a product containing medical coding technology and invited recipients to attend a free webinar where that sort of coding would be promoted was a covered advertisement. Concluding the answer is yes, we reverse and remand for further proceedings.

I.

Pulse8, LLC is a “Healthcare Analytics and Technology Company.” JA 9. 1 The company sells a “platform” to “health-plans and at-risk providers” that Pulse8 says will help those providers “achieve the greatest financial impact in the ACA Commercial, Medicare Advantage, and Medicaid markets.” Id. The “[p]latform includes,” among other things, “Coding Technology.” Id.

In 2020, Pulse8 sent Family Health Physical Medicine LLC a fax inviting it to attend a free webinar. The fax encouraged recipients to “Open your Mind to Behavioral Health Coding” and “Expand your knowledge by learning how to successfully document and code conditions that are due to substance abuse, major depression, schizophrenia, bipolar, and other mental health disorders.” JA 20. The fax included a link to register at

1

The complaint also names as a defendant another entity we are told “no longer exists.” Pulse8 Br. i n.1. Because the complaint alleges that both defendants were independently responsible for sending the relevant fax, any difference between the two is immaterial to this appeal.

“https://pulse8.zoom.us” and directed questions to “providerengagement@pulse8.com.” Id. It also offered recipients “a chance to win a $25 Amazon gift card” by “[c]omplet[ing] the webinar survey.” Id.

Just over a year later, Family Health filed this suit. As relevant here, the complaint alleged the fax was an unsolicited advertisement and thus violated the federal Telephone Consumer Protection Act (TCPA). Pulse8 moved to dismiss for failure to state a claim, arguing the fax did not qualify as an advertisement under the TCPA because the webinar was free. The district court granted the motion.

We placed Family Health’s appeal in abeyance pending this Court’s resolution of a different appeal that also involved the proper interpretation of “unsolicited advertisement” in the TCPA. See Carlton & Harris Chiropractic, Inc. v. PDR Network, LLC (PDR), 80 F.4th 466, 470 (4th Cir. 2023). After that case was decided, this one was returned to the argument calendar.

II.

Family Health’s complaint pressed four theories for why Pulse8’s fax satisfied the statutory definition of “unsolicited advertisement”—specifically, why the fax constituted “material advertising the commercial availability or quality of any property, goods, or services.” 47 U.S.C. § 227(a)(5). The district court concluded each set of allegations failed as a matter of law. We review that decision “de novo, applying the same standards as the district court.” Pendleton v. Jividen, 96 F.4th 652, 656 (4th Cir. 2024).

A.

As Family Health conceded at oral argument, PDR forecloses the complaint’s first

theory of liability. PDR holds that the TCPA’s definition of “unsolicited advertisement” “does not include offers or solicitations with no commercial component or purpose” and that, as a result, merely “promot[ing] the quality of a free good or service” is not enough to make something an advertisement. 80 F.4th at 474–75 (quotation marks removed). For that reason, that the fax “ma[de] known” and “call[ed] public attention” to the free webinar did not, standing alone, make it an advertisement. Family Health Br. 8–9 (quotation marks removed).

B.

We reach a different conclusion about the complaint’s second theory. The complaint also alleged that the fax was an advertisement because it promoted a webinar that “relate[d] to [Pulse8’s] for-profit business”—selling software containing medical coding technology. JA 10; see also JA 7, 9. In other words, the complaint alleged that the webinar was being used to market Pulse8’s product. See E.I. du Pont de Nemours & Co. v. Kolon Indus., Inc., 637 F.3d 435, 448 (4th Cir. 2011) (“In deciding whether a complaint survives a motion to dismiss, a court evaluates the complaint in its entirety[.]”). We conclude Family Health has plausibly alleged the fax was an advertisement under this theory. 2 PDR makes clear that a fax need not “propose a specific commercial transaction on its face” to be covered by the TCPA. 80 F.4th at 476 (quotation marks removed). Instead,

2

We disagree with Pulse8’s suggestion that Family Health forfeited this argument by failing to develop it in its opening brief. Family Health argued that the “subject of the webinar . . . relate[d] to Pulse8’s commercially available Coding Technology” and spent pages explaining why that relationship meant the fax should “be presumed to at least plausibly be an advertisement at the pleading stage.” Family Health Br. 6, 21 (quotation marks removed). That is enough to preserve the issue for our review.

the most natural “understanding of the term advertise” means transmitting “information with a commercial nexus to the sender’s business.” 80 F.4th at 472–73 (quotation marks removed). To qualify as an “advertisement” under the TCPA, then, “there must be a commercial component” to the fax “or a commercial nexus” between the fax and “the sender’s business—its property, products, or services.” Id. at 474 (quotation marks removed).

Family Health plausibly alleged such a connection here. PDR explained that “[a]cceptance of a free good or service” can be “leveraged into an opportunity for a sales pitch,” thereby giving the offer of a free good or service the requisite “commercial component.” 80 F.4th at 474 (third quote), 478–79 (first and second quotes). Pulse8 thus misreads PDR as holding that a fax which offers something for free is commercial only if “there is a ‘direct mechanism by which the sender will profit if the offer is accepted.’” Pulse8 Suppl. Br. 1. To the contrary, PDR identified “the fax at issue in” Physicians Healthsource, Inc. v. Boehringer Ingelheim Pharmaceuticals, Inc., 847 F.3d 92 (2d Cir. 2017)—one that invited recipients to “a free dinner meeting” (id. at 93)—as the “prototypical . . . example” of one kind of covered advertisement. PDR, 80 F.4th at 478.

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Family Health Physical Medicine, LLC v. Pulse8, LLC, 105 F.4th 567 (4th Cir. 2024).

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