Gorshow v. eQHealth Solutions

CourtDistrict Court, D. Colorado
DecidedAugust 2, 2022
Docket1:20-cv-03687
StatusUnknown

This text of Gorshow v. eQHealth Solutions (Gorshow v. eQHealth Solutions) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gorshow v. eQHealth Solutions, (D. Colo. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO Judge William J. Martínez

Civil Action No. 20-cv-3687-WJM-KLM

STEPHEN GORSHOW,

Plaintiff,

v.

EQHEALTH SOLUTIONS, INDIVIDUAL DEFENDANT GLEN J. GOLEMI, INDIVIDUAL DEFENDANT DR. RON RITCHEY, INDIVIDUAL DEFENDANT HEATHER WICKER, INDIVIDUAL DEFENDANT CHRISTINE GATLIN, INDIVIDUAL DEFENDANT KATHERINE DENNEY, INDIVIDUAL DEFENDANT KATRINA FEYINTOLA, and INDIVIDUAL DEFENDANT JANE DOE,

Defendants.

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT

This matter is before the Court on eQHealth Solutions (“EQHS”), Dr. Ron Ritchey, Heather Wicker, Christine Gatlin, and Glen Golemi’s (collectively, “EQHS Defendants”) Motion for Summary Judgment (“Motion”), in which they request that the Court enter judgment in their favor on all claims asserted against them. (ECF No. 59.) Plaintiff Stephen Gorshow brings five claims against the EQHS Defendants: (1) disability discrimination in violation of the Americans with Disabilities Act (“ADA”), 42 U.S.C. §§ 12101, et seq. against EQHS; (2) wrongful termination in violation of Colorado public policy against the EQHS Defendants; (3) promissory estoppel against EQHS; and (4) conspiracy against EQHS Defendants. (ECF No. 28 at 15–21.) For the reasons set forth below, the Motion is granted in part and denied in part. I. BACKGROUND1 A. Plaintiff’s Employment and Disability This action arises out of Plaintiff’s employment with EQHS, “a population health management company.” (ECF No. 59 ¶ 1.) EQHS has a contract with the Colorado

Department of Health Care Policy and Financing (“HCPF”), which administers Colorado’s Medicaid program. (Id. ¶¶ 2–3.) The contract requires EQHS to perform utilization reviews for Medicaid beneficiaries. (Id.) On March 6, 2017, Plaintiff began his employment with EQHS as a Senior Medical Director. (Id. ¶ 11.) In that role, Plaintiff performed Medicaid utilization reviews, which involved testifying on behalf of HCPF at Medicaid appeal hearings. (Id. ¶ 67.) Plaintiff was employed by EQHS, not HCPF; however, EQHS required the approval of HCPF before it hired any Senior Medical Director. (Id. ¶ 12.) Plaintiff has had a hearing impairment since 2002 and has worn a cochlear

implant since 2014. (Id. ¶ 82.) Plaintiff’s hearing impairment was well-known to employees of EQHS and HCPF because they observed his cochlear implant or because Plaintiff had disclosed his impairment to them. (Id. ¶ 84.) EQHS knew about Plaintiff’s disability at the time he was hired. (Id.) Individuals at EQHS and HCPF made efforts, whenever Plaintiff requested, to assist him by repeating, clarifying, or explaining items Plaintiff believed he missed

1 The following factual summary is based on the parties’ briefs on the Motion and documents submitted in support thereof. These facts are undisputed unless attributed to a party or source. All citations to docketed materials are to the page number in the CM/ECF header, which sometimes differs from a document’s internal pagination. because of his hearing impairment.2 (Id. ¶ 87.) Plaintiff admits there were times when he had performance deficits because of symptoms related to his hearing, but when those occurred, he did not notify the individuals at HCPF or EQHS that these deficits were in any way related to his hearing because he did not want to “make a fuss.” (Id. ¶

90.) B. Events Leading to Adverse Employment Action On December 6, 2018, HCPF officials directed Plaintiff to testify at a hearing that a certain medical device, a Continuous Glucose Monitor, was not medically necessary for adults. (ECF No. 61-2 at 6; ECF No. 59 ¶ 103.) Plaintiff refused HCPF’s demand because, according to him, this assertion was untrue. (ECF No. 61-2 at 5.) Plaintiff alleges that as a result his refusal to testify, HCPF began an “unlawful quest to discredit the Plaintiff’s performance and professional competence.” (ECF No. 28 ¶ 32.) In July 2019, Katherine Denney, an employee of HCPF, raised concerns to Wicker regarding Plaintiff’s job performance as observed by her and another HCPF

employee, Katrina Feyintola. (ECF No. 59 ¶¶ 21, 24–26.) Specifically, Denney told Wicker that on appeals calls Plaintiff was forgetful, disorganized, and that he sometimes mixed-up cases. (Id. ¶ 26.) Additionally, EQHS staff members informed Wicker of concerns about Plaintiff’s performance citing his history of “mis-documentation in client records, which constituted a potential HIPAA violation.” (Id. ¶ 27.) Wicker notified her supervisor, Vicky Ducworth, who then notified Dr. Ritchey and requested that he participate in investigating the complaints about Plaintiff’s

2 Plaintiff made these requests at appeals hearings but not at appeals meetings. (ECF No. 59 ¶ 88.) Plaintiff felt embarrassed about making these requests at meetings and did not feel safe doing so; however, he never spoke to anyone at EQHS about these feelings. (Id.) performance. (Id. ¶¶ 28, 30.) Wicker also notified Gatlin, who requested she provide specific examples of Plaintiff’s unsatisfactory performance. (Id. ¶¶ 31–32.) On August 3, 2019, Wicker provided to Ducworth, Gatlin, and Dr. Ritchey the following examples: Cross charting in member files resulting in incorrect information being sent on denial letters[;] Frequent forgetfulness on how to handle processes in PURS [software program] including special handling line items at recons, capabilities available at unlock (items he was previously able to perform)[;] Push back on UM Manager and Supervisor for cases that were previously hand[led] administratively, but direction has been given from the Department that a medical necessity review is needed[;] Review completion post submission to MES [company which engages contract physicians for various specialties] for review—recently completed a review and did not remember requesting that it be sent to MES[;] Cross review submission to MES, resulting in 1st PR review going to MES[;] HCPF (State of Colorado) has mentioned issues with lack of organization during appeal meetings as well as confusing cases being reviewed with other cases[.] (Id. ¶ 33.) On August 19, 2019, Gatlin, Dr. Ritchey, Wicker, and Ducworth had a meeting to discuss Plaintiff’s performance issues. (Id. ¶ 34.) At the conclusion of the August 19, 2019, meeting, Dr. Ritchey requested that Wicker set up a call between himself and the appropriate representative of HCPF, and he asked Wicker to send him the names of the HCPF personnel and EQHS personnel who had complained of issues with Plaintiff’s performance. (Id. ¶ 39.) Dr. Ritchey considered Plaintiff’s alleged errors to be “serious errors,” especially cross-charting (putting data from one patient into the incorrect patient’s chart). (Id. ¶ 41.) He was especially concerned because Plaintiff had “a very senior, very high position in the [HCPF] contract that is highly visible to the client,” and Plaintiff’s “responsibilities include making critical medical clinical decisions that can impact Medicaid beneficiaries in Colorado and potentially result in harm.” (Id.)

Per EQHS’s request for documentation of HCPF’s specific concerns with Plaintiff’s performance, Denney requested the staff at HCPF compile a list of specific concerns. (Id.

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

Related

United Mine Workers of America v. Gibbs
383 U.S. 715 (Supreme Court, 1966)
McDonnell Douglas Corp. v. Green
411 U.S. 792 (Supreme Court, 1973)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
Carnegie-Mellon University v. Cohill
484 U.S. 343 (Supreme Court, 1988)
Scott v. Harris
550 U.S. 372 (Supreme Court, 2007)
Brooks v. Gaenzle
614 F.3d 1213 (Tenth Circuit, 2010)
Adler v. Wal-Mart Stores, Inc.
144 F.3d 664 (Tenth Circuit, 1998)
Stone v. Autoliv ASP, Inc.
210 F.3d 1132 (Tenth Circuit, 2000)
Davidson v. America Online, Inc.
337 F.3d 1179 (Tenth Circuit, 2003)
Rivera v. City & County of Denver
365 F.3d 912 (Tenth Circuit, 2004)
Plotke v. White
405 F.3d 1092 (Tenth Circuit, 2005)
Argo v. Blue Cross & Blue Shield of Kansas, Inc.
452 F.3d 1193 (Tenth Circuit, 2006)
McWilliams v. Jefferson County
463 F.3d 1113 (Tenth Circuit, 2006)
Timmerman v. U.S. Bank, N.A.
483 F.3d 1106 (Tenth Circuit, 2007)
Proctor v. United Parcel Service
502 F.3d 1200 (Tenth Circuit, 2007)
Orr v. City of Albuquerque
531 F.3d 1210 (Tenth Circuit, 2008)
Thatcher Enterprises v. Cache County Corporation
902 F.2d 1472 (Tenth Circuit, 1990)

Cite This Page — Counsel Stack

Bluebook (online)
Gorshow v. eQHealth Solutions, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gorshow-v-eqhealth-solutions-cod-2022.