Greg Swafford,M.D. v. Memphis Individual Practive Association, Southern Health Plan, Inc., The Apple Plan

Court of Appeals of Tennessee·Decided June 2, 1998·No. 02A01-9612-CV-00311·Published

Opinion

IN THE COURT OF APPEALS OF TENNESSEE WESTERN SECTION AT JACKSON

FILED

GREG SWAFFORD, M.D., )

)

Plaintiff/Appellant, ) Shelby Law No. 54167 )

vs. )

) Appeal No. 02A01-9612-CV-00311 2, 1998 June

MEMPHIS INDIVIDUAL PRACTICE ) ASSOCIATION, SOUTHERN HEALTH ) PLAN, INC., THE APPLE PLAN, a ) Product of the Southern Health Plan, ) Cecil Crowson, Jr. Inc., a Federally Qualified Health ) Maintenance Organization, BLUE ) Appellate C ourt Clerk

CROSS AND BLUE SHIELD OF ) TENNESSEE, INC., THCC, INC., a ) Tennessee Non-Profit Corporation, )

)

Defendants/Appellees. )

APPEAL FROM THE CIRCUIT COURT OF SHELBY COUNTY AT MEMPHIS, TENNESSEE

THE HONORABLE ROBERT L. CHILDERS, JUDGE

For the Plaintiff/Appellant: For the Defendants/Appellees Memphis Individual Practice Association and Southern Health Plan, Inc.:

William J. Simmons John I. Houseal, Jr. Memphis, Tennessee William L. Bomar Leo Bearman, Jr.

Sean M. Haynes

Gary K. Smith

Steven S. Heinrichs

Memphis, Tennessee

REVERSED IN PART,

AFFIRMED IN PART

AND REMANDED

HOLLY KIRBY LILLARD, J.

CONCUR:

W. FRANK CRAWFORD, P.J., W.S.

DAVID R. FARMER, J.

OPINION

This is a libel suit brought by a physician against a health maintenance organization and related health insurance entities. The trial court granted summary judgment in favor of the defendants based on the statute of limitations. The lawsuit involves allegedly false information reported to the National Practitioner Data Bank. In an issue of first impression, we hold that each dissemination of the allegedly defamatory information by the Data Bank gives rise to a separate cause of action. The grant of summary judgment is affirmed in part and reversed in part, and the cause is remanded.

Plaintiff/Appellant Greg Swafford, M.D. (“Dr. Swafford”) is a licensed physician practicing family medicine in Shelby County. Defendant/Appellee Southern Health Plan, Inc. (“Southern”) is a federally qualified health maintenance organization operating in Tennessee. Southern hired Defendant/Appellee Memphis Individual Practice Association (“MIPA”) to promote, sell, and manage an insurance product known as “The Apple Plan.” MIPA is responsible for supervising physicians who treat Apple Plan policyholders in Tennessee.1 Southern and MIPA may collectively be referred to as “the Defendants.”

In February 1990, the parties entered into a contract entitled “MIPA Participating Primary Care Physician Agreement” (“Agreement”). The Agreement required MIPA to refer a specified number of Apple Plan patients to Dr. Swafford and required Dr. Swafford to treat the patients referred to him. The Agreement stated that either party could withdraw from the Agreement upon ninety days’ notice.

In early 1991, Dr. Swafford was notified that the Defendants intended to sanction him for substandard care. On April 17, 1991, Dr. Swafford received a notice of termination due to alleged violations of quality of care standards.2 Dr. Swafford believed that the assertion of substandard care was false, but did not object to his termination.

On August 22, 1991, the Defendants reported Dr. Swafford’s termination to the National Practitioner Data Bank (“Data Bank”). The Data Bank operates pursuant to 42 U.S.C.A. §§ 11131, et. seq. (1995), and maintains a data base of information concerning health care providers. Among

1 Dr. Swafford also sued Blue Cross Blue Shield of Tennessee and THCC, Inc.; these parties were voluntarily dismissed without prejudice and are not involved in this appeal.

2 Defendants assert that this April 17, 1997, notification gave Dr. Swafford notice that he would be terminated 90 days thereafter. Dr. Swafford maintains that he was terminated effective on April 17, 1997, without advance notice.

other requirements, the Act imposes a mandate that all health care entities report adverse professional review actions to the Data Bank. Id. § 11133. Information in the Data Bank is confidential and can be accessed only by health care entities. Id. § 11137(b).

Dr. Swafford alleged that, at the time that the Defendants reported his termination to the Data Bank, he was unaware of the report’s existence. In January 1992, Dr. Swafford was notified by the Data Bank that the Defendants had reported that his clinical privileges had been revoked due to violations of quality of care standards. Dr. Swafford was uncertain about the specific number of instances in which health care entities accessed his information from the Data Bank; however, at least three entities have retrieved information from the Data Bank: Baptist Hospital, St. Francis Hospital, and the Tennessee Board of Medical Examiners. None denied clinical privileges to Dr. Swafford. Nevertheless, Dr. Swafford maintains that the existence of the Data Bank report forced him to defend his record to these entities by demonstrating that the charge of substandard care was false. The record does not clearly indicate when each of these health care entities retrieved information from the Data Bank or when Dr. Swafford became aware that the information had been retrieved.3 Dr. Swafford filed a lawsuit against the Defendants on June 1, 1993. The case was removed to federal court and the parties engaged in considerable discovery. On April 28, 1995, Dr. Swafford filed an amended complaint that appears to allege several causes of action, including defamation, injury to personal property, intentional infliction of emotional distress, outrageous conduct, tortious interference with business relations, and civil conspiracy. The federal court remanded the case to state court. Both parties filed cross-motions for summary judgment. In their motion, the Defendants argued that the gravamen of Dr. Swafford’s Complaint is libel and is barred by a one-year statute of limitations. The Defendants also maintained that Dr. Swafford failed to satisfy the elements of certain other claims.

On June 6, 1996, the trial court entered a succinct order granting the Defendants’ motion for summary judgment, without elaborating on its reasoning. From this order, Dr. Swafford now appeals.

3 Dr. Swafford filed an affidavit stating that he learned of the retrieval of the allegedly defamatory information by St. Francis Hospital on March 6, 1995. Dr. Swafford’s brief claims that Baptist Hospital accessed the information in July of 1992, but this assertion is not clearly supported by the record.

On appeal, Dr. Swafford asserts that the trial court erred by granting summary judgment to the Defendants. Dr. Swafford argues that the trial court misapplied the one year statute of limitations for injury to person as opposed to the three year statute for injury to property. Dr. Swafford also contends that the trial court improperly utilized the “single publication rule” for the alleged defamation, as opposed to the “multiple publication rule.” Finally, Dr. Swafford argues that the trial court erred by not applying a three year statute of limitations to the civil conspiracy charge, and that his claim for tortious interference with business relations should not have been dismissed.

In addition to responding to Dr. Swafford’s contentions, the Defendants assert that his appeal should be dismissed due to Dr. Swafford’s “fatal procedural errors.” The Defendants allege that Dr. Swafford failed to comply with Rules 4(a), 24(a), and 24(d) of the Tennessee Rules of Appellate Procedure. We will first address the procedural issues.

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Greg Swafford,M.D. v. Memphis Individual Practive Association, Southern Health Plan, Inc., The Apple Plan, (Tenn. Ct. App. 1998).

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