Fraser v. Team Health Holdings, Inc.

CourtDistrict Court, N.D. California
DecidedMarch 31, 2022
Docket4:20-cv-04600
StatusUnknown

This text of Fraser v. Team Health Holdings, Inc. (Fraser v. Team Health Holdings, Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fraser v. Team Health Holdings, Inc., (N.D. Cal. 2022).

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 SIA FRASER, et al., Case No. 20-cv-04600-JSW

8 Plaintiffs, ORDER GRANTING MOTION TO 9 v. DISMISS

10 TEAM HEALTH HOLDINGS, INC., et al., Re: Dkt. No. 51 Defendants. 11

12 13 This matter comes before the Court upon consideration of Defendants’ motion to dismiss 14 Plaintiffs’ First Amended Class Action Complaint (“FAC”), and the parties’ responses to an Order 15 to Show Cause issued on April 19, 2021, directing the parties to show cause why this case should 16 not be transferred pursuant to 28 U.S.C. section 1404(a). The Court has considered the parties’ 17 papers, the responses to the Order to Show Cause, relevant legal authority, and the record in this 18 case, and it HEREBY retains this case and GRANTS Defendants’ motion to dismiss with leave to 19 amend.1 20 BACKGROUND 21 Plaintiffs Sia Fraser, Tricia Bakonyi, Gabrielle DiBella, and Katja Fiume (collectively, 22 “Plaintiffs”) bring this action alleging that Team Health Holdings, Inc. (“Holdings”), AmeriTeam 23 Services, LLC (“AmeriTeam”), TeamHealth, Inc. n/k/a Team Health LLC (“TeamHealth”), and 24 HCFS Health Care Financial Services, LLC (“HCFS”) (collectively, “Defendants”) violated the 25 Racketeering Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. sections 1961, et 26

27 1 Defendants submitted a request for judicial notice in connection with the motion to dismiss. 1 seq. 2 According to Plaintiffs, Defendants, together with other entities not named as defendants, 3 are part of an alleged RICO enterprise, which acts to “maximize corporate profits while avoiding 4 state bans on the corporate practice of medicine.” (Id. ¶ 4.) Plaintiffs allege that the TeamHealth 5 organization is structured as a pyramid with each entity performing a role in the enterprise. 6 Holdings engages in “strategic planning and goals, implementation of overall vision, values, 7 mission and direction of TeamHealth organization.” (Id. ¶ 43.) AmeriTeam is the primary 8 operating subsidiary of the TeamHealth organization and performs duties such as payroll, 9 procuring professional liability insurance, information technology, finance, tax, compliance, 10 accounts payable, human resources, and negotiations with health insurance plans. (Id. ¶ 44.) 11 TeamHealth performed a role substantially similar to the role of AmeriTeam prior to January 1, 12 2015. (Id. ¶ 45.) HCFS performs billing services for companies associated with the TeamHealth 13 organization. (Id. ¶ 46.) Defendants contract with hospitals to staff and manage various hospital 14 departments. (Id. ¶ 55.) When a patient receives care from a TeamHealth medical professional, 15 TeamHealth bills the patient for the hospital services. (Id. ¶¶ 56-58.) 16 Hospitals and healthcare providers that operate within hospitals, like Defendants, use 17 Current Procedural Terminology (“CPT”) codes for the services they provide and assign prices to 18 CPT codes. (Id. ¶ 62.) These prices are known as the “list price” or “chargemaster” rates. (Id. ¶ 19 62.) Plaintiffs allege that Defendants control the rates its physicians and practice groups charge 20 patients. (Id. ¶ 4.) Specifically, HCFS sets the chargemaster prices that are charged by the 21 provider groups at the hospitals with which the providers contract to provide services. (Id. ¶ 139.) 22 Plaintiffs allege that TeamHealth does not have a contract with the patients, and so is only legally 23 entitled to recover the reasonable or market rate price for services provided under the common law 24 doctrine of quantum meruit. (Id. ¶¶ 70-71.) Plaintiffs allege, however, that Defendants charge 25 uninsured and out-of-network patients inflated chargemaster rates that exceed the rates hospitals 26 normally charge for the same services. (Id. ¶¶ 68, 78.) 27 Plaintiffs were billed for emergency, radiology, anesthesiology, and other care provided by 1 a TeamHealth-owned physician group in Oceanside, California in September 2019. (Id. ¶ 19.) 2 Fraser received bills from TeamHealth for $1,082. (Id. ¶ 21.) She is paying the bill under a 3 payment plan. (Id. ¶ 22.) 4 Plaintiff Bakonyi visited the emergency department at a facility in Austin, Texas on 5 September 30, 2019, while experiencing discomfort in her abdomen. (Id. ¶ 24.) Bakonyi’s insurer 6 informed her that TeamHealth had not justified the level of service billed and instructed 7 TeamHealth to resubmit the claim under the correct code. (Id. ¶ 26.) Instead, TeamHealth billed 8 Bakonyi for $1,370. (Id. ¶ 27.) Bakonyi continued to communicate with TeamHealth and her 9 insurer regarding her bill. (Id.) She has not yet made payments on the bill and is concerned that 10 her credit will be adversely impacted by the outstanding debt. (Id. ¶ 30.) 11 Plaintiff DiBella visited the emergency department in Syracuse, New York after being 12 exposed to a bat to determine if she required a rabies shot. (Id. ¶ 31.) DiBella did not receive a 13 rabies shot or any other test at the facility. (Id. ¶ 33.) DiBella received a bill for $554.00 from 14 TeamHealth for her emergency department visit. (Id. ¶ 35.) She has not yet made payments on 15 her TeamHealth bill, and she is concerned that the outstanding debt will adversely impact her 16 credit. (Id. ¶ 36.) 17 Plaintiff Fiume visited the emergency department in La Mesa, California on June 13, 2020, 18 because she was experiencing discomfort in her chest and lungs. (Id. ¶ 37.) Fiume had her vital 19 signs checked and after they appeared normal, she declined further treatments. (Id. ¶ 38.) One 20 month later, Fiume received a bill from TeamHealth for $715.00 for “high severity” emergency 21 department visits. (Id. ¶ 39.) Fiume has not yet made payments on her TeamHealth bill, and she 22 is concerned that the outstanding debt will adversely impact her credit. (Id. ¶ 40.) 23 Plaintiffs bring causes of action for violations of: (1) the Racketeer Influenced and Corrupt 24 Organizations Act (“RICO”), 18 U.S.C. section 1961, et seq.; (2) California’s Unfair Competition 25 Law (“UCL”), Cal. Bus. & Prof. Code section 17200, et seq.; (3) California’s Consumer Legal 26 Remedies Act (“CLRA”), Cal. Civ. Code section 1750, et seq.; (4) Texas Deceptive Trade 27 Practices Act (“TDTPA”), Tex. Bus. & Com. Code section 17.41, et seq.; (5) New York General 1 restitution, punitive damages, and an injunction. 2 ANALYSIS 3 A. The Court Will Not Transfer the Case. 4 Plaintiffs allege venue in this District is proper pursuant to 28 U.S.C. sections 1391(b) and 5 (c) and pursuant to 18 U.S.C. section 1965(a). None of the Plaintiffs and none of the Defendants 6 reside in this District. Plaintiffs’ choice of venue rests on their allegations that one of the 7 members of the alleged RICO enterprise, non-party TeamHealth West is located in Pleasanton, 8 California. Plaintiffs allege that Plaintiff Sia Fraser’s bills directed that payments be sent to 9 TeamHealth West’s address and that TeamHealth West owns the provider group that provided Ms. 10 Fraser’s medical care. (FAC ¶¶ 23, 48.) While those allegations would be sufficient show venue 11 is proper in this District, they do not necessarily demonstrate this District is the most convenient 12 forum. Hence, the Court’s order to show cause. 13 Pursuant to 28 U.S.C. section 1404

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Fraser v. Team Health Holdings, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/fraser-v-team-health-holdings-inc-cand-2022.