Glenn v. HEALTHLINK HMO, INC.

360 S.W.3d 866, 2012 WL 9675, 2012 Mo. App. LEXIS 2
CourtMissouri Court of Appeals
DecidedJanuary 3, 2012
DocketED 96233
StatusPublished
Cited by38 cases

This text of 360 S.W.3d 866 (Glenn v. HEALTHLINK HMO, INC.) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Glenn v. HEALTHLINK HMO, INC., 360 S.W.3d 866, 2012 WL 9675, 2012 Mo. App. LEXIS 2 (Mo. Ct. App. 2012).

Opinion

KURT S. ODENWALD, Chief Judge.

Introduction

Dr. Byron Glenn (Glenn) appeals from the trial court’s order granting summary judgment for HealthLink HMO and HealthLink PPO (collectively “Health-Link”). Glenn brought separate claims for breach of contract alleging HealthLink breached the HMO Agreement and PPO Agreement it had with Glenn. The petition avers various breaches of these agreements. The trial court concluded that no genuine issues of material fact existed to support Glenn’s claims, and held that HealthLink was entitled to judgment as a matter of law. Because the record supports a finding that a genuine issue of material fact exists with regard to two of Glenn’s claims for breach of contract, we reverse the trial court’s entry of summary judgment with regard to these two claims and remand those claims to the trial court. We affirm the remainder of the trial court’s entry of summary judgment.

Factual and Procedural History

In 2001, Glenn executed HMO and PPO agreements to become a network provider for HealthLink. Each agreement contained an automatic renewal provision and procedures for the termination or non-renewal of the agreements. On June 28, 2007, 1 after receiving complaints regarding the services Glenn provided to employees of one of its clients, HealthLink mailed Glenn two certified letters informing him *870 of its intention to terminate the HMO and PPO Agreements. The letters informed Glenn that the HMO Agreement would terminate after 90 days, and the PPO Agreement would terminate in 120 days. The letters further informed Glenn that he had the right to request a hearing prior to the termination of either agreement. Glenn requested hearings regarding the termination of both agreements.

On October 30, 2007, HealthLink mailed Glenn a third letter. This letter stated that HealthLink believed its earlier communication terminating the HMO Agreement was deficient because it failed to provide a reason for the termination. As such, HealthLink rescinded its June 28, 2007 notice that it was terminating the HMO Agreement. However, the letter continued that HealthLink was again giving notice that it intended to terminate the HMO Agreement “due to quality of care issues,” and offered Glenn the opportunity for a hearing to contest the termination of the HMO Agreement. The letter also reaffirmed HealthLink’s earlier notice that it was terminating the PPO Agreement, but stated that its earlier offer to provide a hearing regarding the termination of the PPO Agreement was “an administrative error,” and no hearing would be provided.

On November 30, 2007, Glenn filed a petition seeking a temporary restraining order preventing a hearing regarding the termination of the HMO Agreement. Although the circuit court denied the request, HealthLink canceled the hearing and, for a second time, withdrew its notice to terminate the HMO Agreement. Six months later, in a letter dated May 8, 2008, HealthLink informed Glenn of its intention to non-renew the HMO Agreement. The current contract term was set to end on July 14, 2008. The letter provided Glenn notice of HealthLink’s intent to non-renew in excess of the 60 day contract requirement. In its letter, HealthLink offered Glenn an opportunity for a hearing, but Glenn declined. On May 29, 2008, Glenn’s name was removed from two of Health-Link’s online provider directories although Glenn’s HMO Agreement continued until July 14, 2008. HealthLink extended Glenn’s continuation of care period until December 2008. In late December, 2008, HealthLink discontinued listing Glenn in the remainder of its online provider directories.

In February 2010, Glenn filed his Second Amended Petition against HealthLink seeking damages for breach of contract. After an opportunity for discovery, Health-Link moved for summary judgment and the trial court granted the motion. Glenn now appeals.

Points on Appeal

Glenn raises four issues on appeal, all of which he alleges apply to both the HMO and PPO Agreements. First, Glenn argues that the trial court erred in granting summary judgment because genuine issues of material fact exist as to whether Health-Link breached the HMO and PPO Agreements by failing to provide marketing assistance as required under the terms of both contracts. Second, Glenn contends that the trial court erred in granting summary judgment because the record contains a question of fact as to whether HealthLink failed to properly pay Glenn in-network reimbursement rates. Third, Glenn asserts that the trial court erred in granting summary judgment because Glenn was entitled to a hearing prior to the non-renewal of the HMO Agreement and the termination of the PPO Agreement. In his final point on appeal, Glenn argues that the trial court erred in granting summary judgment because Health-Link did not end the HMO and PPO agreements in good faith.

*871 Standard of Review

We review the entry of summary judgment de novo. Rice v. Shelter Mut. Ins. Co., 301 S.W.3d 43, 46 (Mo. banc 2009). We review the record in the light most favorable to the party against whom judgment was entered. ITT Commercial Finance Corp. v. Mid-America Marine Supply Corp., 854 S.W.2d 371, 376 (Mo. banc 1993). We will affirm where the pleadings, depositions, affidavits, answers to interrogatories, exhibits, and admissions establish that no genuine issue of material fact exists, and the moving party is entitled to judgment as a matter of law. Beyerbach v. Girardeau Contractors, Inc., 868 S.W.2d 163, 165 (Mo.App. E.D.1994).

Discussion

I. The trial court erred in part by granting summary judgment to HealthLink on Glenn’s marketing claims.

Glenn argues that the trial court erred in granting summary judgment in favor of HealthLink on his claims that HealthLink breached its obligations to provide marketing assistance under the HMO and PPO Agreements. Section 2.10(a)(vi) of the HMO Agreement states that HealthLink HMO will provide “marketing of Health-Link HMO Providers.” Section 2.8(a)(f) of the PPO Agreement contains an identical provision. Glenn first argues that there is a genuine issue of material fact as to what level of performance was required to satisfy HealthLink’s marketing obligations under these provisions. Glenn contends that merely listing Glenn as a provider in HealthLink’s online directories does not satisfy HealthLink’s marketing obligations under the HMO and PPO Agreements. As a separate basis for breach of contract, Glenn asserts that HealthLink breached the HMO and PPO Agreements when it removed his name from two of the online provider directories prior to the expiration of the agreements.

A. Performance of HealthLink’s marketing obligations.

We hold Glenn’s claim that a genuine issue of material fact exists as to the level of performance required to satisfy HealthLink’s obligation under the marketing assistance provisions to be without merit.

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Cite This Page — Counsel Stack

Bluebook (online)
360 S.W.3d 866, 2012 WL 9675, 2012 Mo. App. LEXIS 2, Counsel Stack Legal Research, https://law.counselstack.com/opinion/glenn-v-healthlink-hmo-inc-moctapp-2012.