Halikierra Cmty. Servs. LLC v. N.C. Dep’t of Health & Hum. Servs., 2021 NCBC 18. STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE SUPERIOR COURT DIVISION WAKE COUNTY 20 CVS 6058
HALIKIERRA COMMUNITY SERVICES LLC; DWAYLON WHITLEY; and MICHAEL SCALES,
Plaintiffs, ORDER AND OPINION v. ON MOTIONS TO DISMISS
NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, Division of Health Benefits; MEDICAL REVIEW OF NORTH CAROLINA, INC. d/b/a The Carolinas Center for Medical Excellence; KAY COX, in her individual capacity; and PATRICK PIGGOTT, in his individual capacity,
Defendants.
1. This case involves allegations of abuse of authority by the North Carolina
Department of Health and Human Services (“DHHS”) and two of its officials, Kay
Cox and Patrick Piggott. The plaintiff, Halikierra Community Services LLC
(“Halikierra”), was once one of North Carolina’s largest in-home Medicaid healthcare
providers. The company shuttered its business in August 2018 after being audited
and ultimately suspended by DHHS. Halikierra insists that it did nothing wrong and
that it was the target of a malicious campaign by Cox and Piggott with help from a
private auditor, Medical Review of North Carolina, Inc. (“CCME”). Halikierra and
its two principals have sued DHHS, CCME, Cox, and Piggott for violations of state
law and the North Carolina Constitution. 2. The defendants vigorously deny the allegations. All have filed motions to
dismiss. For the following reasons, the Court GRANTS in part and DENIES in
part each motion.
Ralph Bryant Law Firm, by Ralph T. Bryant, Jr., for Plaintiffs Halikierra Community Services LCC, Dwaylon Whitley, and Michael Scales.
Joshua H. Stein, Attorney General of the State of North Carolina, by John H. Schaeffer and Rajeev K. Premakumar, North Carolina Department of Justice, for Defendants North Carolina Department of Health and Human Services, Division of Health Benefits, Kay Cox, and Patrick Piggott.
Smith, Anderson, Blount, Dorsett, Mitchell & Jernigan, L.L.P., by J. Mitchell Armbruster and Grace Anthony Gregson, for Defendant Medical Review of North Carolina, Inc. d/b/a The Carolinas Center for Medical Excellence.
Conrad, Judge.
I. BACKGROUND
3. The following background assumes that the allegations of the complaint are
true.
4. Halikierra was formed by a pair of former college roommates, Dwaylon
Whitley and Michael Scales. (See Compl. ¶ 1, ECF No. 5.) For nearly a decade, it
provided in-home healthcare services to Medicaid beneficiaries under a license issued
by DHHS. (See Compl. ¶¶ 4, 12.) At its peak, the company employed nearly 600
workers. (See Compl. ¶ 14.)
5. The events that led to this case began in June 2018 when DHHS placed
Halikierra on prepayment review. (See Compl. ¶ 23.) Prepayment review—which
often follows an allegation of fraud, for example—entails an audit of selected claims presented by a provider for reimbursement to ensure that they comply with governing
laws. See N.C.G.S. § 108C-7(a). The review is termed “prepayment” because the
provider has no right to receive reimbursement for claims under review until
completion of the audit. (See Compl. ¶ 24.) This is a significant departure from the
usual payment process. Ordinarily, Halikierra received reimbursement within five
business days of billing DHHS. (See Compl. ¶¶ 16–18.) Once placed on prepayment
review, Halikierra’s revenue dried up, even though it continued to render Medicaid-
eligible services. It needed loans to cover expenses and payroll, which exceeded
$700,000 per month. (See Compl. ¶¶ 19, 54–56.)
6. According to Halikierra, DHHS had no lawful basis to place it on
prepayment review. Rather, the decision was orchestrated by Cox and Piggott. (See
Compl. ¶ 22.) Cox is a nurse consultant for the Program Integrity Unit; Piggott is
the associate director for investigations for the Office of Compliance and Program
Integrity. (See Compl. ¶¶ 7, 9.) As alleged, they “personally detested” Halikierra due
to its size and success and set out to destroy it. (Compl. ¶¶ 20, 186.)
7. To carry out their scheme, Cox and Piggott solicited help from CCME, the
company tasked with conducting the audit on DHHS’s behalf. (See Compl. ¶¶ 28, 29.)
At their request, CCME falsely reported to DHHS that Halikierra employed forty-
five convicted felons. (See Compl. ¶¶ 33–35.) Halikierra insists that it had only a
handful of employees with felony records and that it did nothing wrong by hiring
them. (See Compl. ¶¶ 36, 37, 42.) Inflamed by the report, though, DHHS raided
Halikierra’s offices. (See Compl. ¶¶ 43, 44.) 8. In August 2018, shortly after the raid, DHHS claimed to have found credible
allegations of fraud and suspended all payments to Halikierra. (See Compl. ¶¶ 45–
47.) Suspension meant that Halikierra would receive no reimbursements for any
claims, not just those under prepayment review. (See Compl. ¶¶ 54, 57.) It was a
death knell. Unable to meet its financial obligations, Halikierra laid off its employees
and closed its business. (See Compl. ¶ 58.)
9. Meanwhile, the prepayment review continued. In September 2018, CCME
submitted its audit report, which gave Halikierra a passing grade. (See Compl. ¶¶ 64,
65.) A few days later, DHHS’s Medicaid Investigations Division refused to open a
fraud investigation, citing insufficient evidence. (See Compl. ¶ 66.) At that point,
Piggott allegedly urged CCME to redo its report with falsified data. (See Compl.
¶ 67.) Halikierra believes that CCME had a strong incentive to do so because its
compensation from DHHS is based on the number of claims it flunks. (See Compl.
¶ 162.) As a result of Piggott’s urging, CCME fudged the data and produced a new
report, which showed that Halikierra had failed the review by a wide margin. (See
Compl. ¶¶ 68–71.) False report in hand, Piggott went back to the Medicaid
Investigations Division, but it again concluded that there was insufficient evidence
of fraud. (See Compl. ¶ 72.)
10. By this point, an internal review of Halikierra’s suspension was under way.
In proceedings before a DHHS hearing officer, Cox represented that the Program
Integrity Unit had credible allegations of fraud. Neither Cox nor Piggott informed
the hearing officer that the Medicaid Investigations Division had twice declined to open a fraud investigation due to insufficient evidence. (See Compl. ¶¶ 74–78.) The
hearing officer upheld the suspension, and Halikierra was forced to appeal to the
Office of Administrative Hearings (“OAH”). (See Compl. ¶¶ 79, 83.) In January 2019,
while the appeal was pending, DHHS conceded that it had insufficient evidence of
fraud and rescinded the suspension. (See Compl. ¶¶ 83–86.)
11. Alleging that DHHS destroyed its business through targeted and groundless
administrative actions, Halikierra filed this suit. It asserts two claims against DHHS
under the North Carolina Constitution for violations of substantive due process and
equal protection rights. It also asserts a claim for conspiracy in restraint of trade
under N.C.G.S. § 75-1 against Cox and Piggott, in their individual capacities; claims
for fraud and unfair or deceptive trade practices under N.C.G.S. § 75-1.1 against
CCME; and claims for civil conspiracy and punitive damages against Cox, Piggott,
and CCME. Whitley and Scales are named plaintiffs for purposes of the section 75-1.1
claim and the claim for conspiracy in restraint of trade.
12. The defendants deny these allegations. Three motions to dismiss are
pending. CCME has moved to dismiss all claims against it. (ECF No. 15.) DHHS
has moved to dismiss the constitutional claims. (ECF No. 26.) And Cox and Piggott
have moved to dismiss the civil conspiracy and punitive damages claims but not the
claim for conspiracy in restraint of trade. (ECF No. 28.)
13. The motions have been fully briefed, and the Court held a hearing on 18
November 2020. After the hearing, the Court requested and received additional briefing on several issues potentially affecting subject matter jurisdiction. (See ECF
No. 42.) The motions are now ripe for resolution.
II. LEGAL STANDARD
14. Some of the issues presented are jurisdictional in nature. Subject matter
jurisdiction is the “indispensable foundation upon which valid judicial decisions rest,
and in its absence a court has no power to act.” In re T.R.P., 360 N.C. 588, 590 (2006).
Lack of subject matter jurisdiction necessitates dismissal at any stage of litigation.
See N.C. R. Civ. P. 12(b)(1), 12(h)(3); Azure Dolphin, LLC v. Barton, 2017 NCBC
LEXIS 90, at *13 (N.C. Super. Ct. Oct. 2, 2017), aff’d, 371 N.C. 579 (2018). When
assessing its jurisdiction, the Court “may consider matters outside the pleadings.”
Harris v. Matthews, 361 N.C. 265, 271 (2007) (citations omitted).
15. Other issues before the Court are raised under Rule 12(b)(6) for failure to
state a claim. A Rule 12(b)(6) motion “tests the legal sufficiency of the complaint.”
Isenhour v. Hutto, 350 N.C. 601, 604 (1999) (citation and quotation marks omitted).
The motion should be granted only when “(1) the complaint on its face reveals that
no law supports the plaintiff’s claim; (2) the complaint on its face reveals the absence
of facts sufficient to make a good claim; or (3) the complaint discloses some fact that
necessarily defeats the plaintiff’s claim.” Corwin v. Brit. Am. Tobacco PLC, 371 N.C.
605, 615 (2018) (citation and quotation marks omitted).
16. In deciding a Rule 12(b)(6) motion, the Court must treat the well-pleaded
allegations of the complaint as true and view the facts and permissible inferences in
the light most favorable to the nonmoving party. See Sykes v. Health Network Sols., Inc., 372 N.C. 326, 332 (2019); CommScope Credit Union v. Butler & Burke, LLP, 369
N.C. 48, 51 (2016). But the Court need not accept as true any “conclusions of law or
unwarranted deductions of fact.” Wray v. City of Greensboro, 370 N.C. 41, 46 (2017)
(citations and quotation marks omitted). The Court also may consider documents
“attached to and incorporated within [the] complaint” but may not consider matters
outside the complaint. Bucci v. Burns, 2018 NCBC LEXIS 37, at *8 (N.C. Super. Ct.
Apr. 25, 2018) (citation and quotation marks omitted).
III. ANALYSIS
17. At the hearing, the Court inquired whether Whitley and Scales have
standing to pursue the asserted claims. In their supplemental brief, Whitley and
Scales have consented to the dismissal of their claims. (See Pls.’ Suppl. Br. 1, ECF
No. 50.) That leaves Halikierra as the sole plaintiff. The Court begins with its
constitutional claims against DHHS.
A. Constitutional Claims Against DHHS
18. Halikierra asserts that DHHS violated its substantive due process and equal
protection rights under the North Carolina Constitution. Both claims are based on
the allegation that the decision to place Halikierra on prepayment review was
arbitrary. (See Compl. ¶¶ 95, 132, 134.) The complaint, though muddled at times,
alleges two distinct theories. One is that the statute governing prepayment review,
section 108C-7, is vague and therefore facially unconstitutional. (See, e.g., Compl.
¶¶ 98, 100, 101.) The other theory is that DHHS singled out Halikierra, imposing prepayment review without supporting evidence in “a spiteful effort” to punish it.
(Compl. ¶¶ 118, 119, 134, 140.)
19. DHHS has moved to dismiss the claims under Rules 12(b)(1) and 12(b)(6).
Its opening brief centered on the facial challenge to section 108C-7 but said little
about the allegations that DHHS arbitrarily targeted Halikierra. (See, e.g., DHHS
Br. in Supp. 2–4, ECF No. 27.) In response, Halikierra withdrew the facial challenge.
(See Opp’n to DHHS Mot. 1, ECF No. 33.) Then, at the hearing, DHHS raised new
arguments related to the prerequisites for asserting a direct constitutional claim for
damages, prompting the Court to invite supplemental briefing on these and related
issues.
20. The piecemeal briefing, and the withdrawal of the facial challenge to section
108C-7, have produced a confusing jumble of arguments. The Court has endeavored
to fairly construe each side’s arguments and the allegations in the complaint.
1. Proper Defendants for Constitutional Claims
21. DHHS first argues that Halikierra should have asserted its facial challenge
to section 108C-7 against the General Assembly, as the statute’s author, and its
representatives. See N.C.G.S. § 120-32.6(b) (stating that the Speaker of the House of
Representatives and the President Pro Tempore of the Senate are “necessary parties”
in cases involving the “constitutionality of an act of the General Assembly”); see also
N.C. R. Civ. P. 19(d). According to DHHS, it “merely enforces the law” and is
therefore not a proper defendant. (DHHS Reply Br. 1, ECF No. 36.) 22. This argument is moot because Halikierra has dropped its facial challenge.
What remains is the allegation that DHHS acted arbitrarily when it placed
Halikierra on prepayment review. To the extent DHHS argues that Halikierra
should have asserted that theory against a different defendant, it is mistaken. As
the alleged wrongdoer, DHHS is the proper defendant. See, e.g., Craig v. New
Hanover County Bd. of Educ., 363 N.C. 334, 342 (2009) (involving constitutional
claims against a county board of education); Monarch Tax Credits, LLC v. N.C. Dep’t
of Revenue, 2021 NCBC LEXIS 9, at *21–26 (N.C. Super. Ct. Jan. 25, 2021) (involving
constitutional claims against the North Carolina Department of Revenue).
2. Jurisdiction of the Industrial Commission
23. Next, DHHS argues that the Court lacks jurisdiction because these claims
must be brought in the North Carolina Industrial Commission. (See DHHS Br. in
Supp. 6–7.) The Industrial Commission has jurisdiction over negligence claims
against state agencies. See N.C.G.S. § 143-291(a); see also Frazier v. Murray, 135
N.C. App. 43, 47–48 (1999). But Halikierra has not asserted negligence claims. It
has asserted constitutional claims. Binding precedent holds that constitutional
claims for damages—often called Corum claims—belong in the state courts. See
Corum v. Univ. of N.C., 330 N.C. 761, 782 (1992) (“[I]in the absence of an adequate
state remedy, one whose state constitutional rights have been abridged has a direct
claim against the State under our Constitution. . . . Therefore, the common law,
which provides a remedy for every wrong, will furnish the appropriate action for the
adequate redress of a violation of that right.” (citation omitted)); see also Craig, 363 N.C. at 338–39; Taylor v. Wake County, 258 N.C. App. 178, 182 (2018), appeal
dismissed, discretionary review denied, 371 N.C. 569.
24. It appears that DHHS has belatedly acknowledged as much. After
Halikierra pointed to these precedents in its response brief, and after the Court
ordered supplemental briefing, DHHS admitted that “the Industrial Commission
jurisdiction is for claims of negligence, and not for intentional torts or claims of
constitutional rights violations, which the Plaintiffs are asserting here.” (DHHS
Suppl. Br. 7, ECF No. 46.)
3. Sovereign Immunity
25. In its initial briefs, DHHS did not assert sovereign immunity as a defense.
In its supplemental brief, DHHS contends that “this is an intentional tort claim
disguised as a constitutional rights violation” and that DHHS is therefore immune
from suit. (DHHS Suppl. Br. 7.) But “[i]t is well established that sovereign immunity
does not protect the state or its counties against claims brought against them directly
under the North Carolina Constitution.” Peverall v. County of Alamance, 154 N.C.
App. 426, 430 (2002); see also Corum, 330 N.C. at 786 (holding that “when there is a
clash between these constitutional rights and sovereign immunity, the constitutional
rights must prevail”). Sovereign immunity is therefore not a basis to dismiss the
claims.
4. Adequate State Remedy
26. A Corum claim is available only “in the absence of an adequate state
remedy.” Corum, 330 N.C. at 782. The “definition of adequacy is twofold: (1) that the remedy addresses the alleged constitutional injury, and (2) that the remedy provides
the plaintiff an opportunity to enter the courthouse doors.” Taylor, 258 N.C. App. at
185 (cleaned up); see also Rousselo v. Starling, 128 N.C. App. 439, 447–48 (1998).
27. The complaint alleges that Halikierra has no adequate remedy at state law
to redress the arbitrary and unconstitutional imposition of prepayment review. (See
Compl. ¶¶ 124, 137.) DHHS did not dispute these allegations in its opening brief or
reply brief.
28. At the hearing, however, DHHS argued for the first time that Halikierra has
adequate state remedies that preclude its direct constitutional claims for damages.
This issue was the subject of supplemental briefing. DHHS now argues that the
claims against Cox, Piggott, and CCME are adequate state remedies because they
involve the same “alleged harm” and “alleged damages” as the constitutional claims.
(DHHS Suppl. Br. 8–9.) Halikierra objects, calling this an “incomprehensible
position.” (Pls.’ Suppl. Br. 10.)
29. The Court concludes that it would be premature to dismiss the Corum claims
on this basis. In theory, the claims against Cox, Piggott, and CCME could serve as
adequate state remedies. Our appellate courts have held that the “adequacy of a
state law remedy depends upon the injury alleged by a plaintiff, rather than upon the
party from whom a plaintiff seeks recovery.” Taylor, 258 N.C. App. at 188. But that
is only part of the inquiry. To be adequate, an alternative remedy must be available
and accessible to the plaintiff. See, e.g., Taylor, 258 N.C. App. at 183.1 The answer
1 See also, e.g., Craig, 363 N.C. at 342 (holding state law claim was inadequate because it was
“entirely precluded by the application of the doctrine of sovereign immunity”); Midgett v. N.C. to that question, which DHHS does not address, isn’t obvious. The claims against
CCME, for example, are based on its own conduct, not on DHHS’s decision to put
Halikierra on prepayment review. And the claim against Cox and Piggott for
conspiracy in restraint of trade typically involves “an agreement between multiple
market participants intending to illegally hinder trade or commerce.” Preiss v. Wine
& Design Franchies, LLC, 2018 NCBC LEXIS 99, at *28 (N.C. Super. Ct. Sept. 24,
2018) (citing N.C.G.S. § 75-1) (emphasis added). Whether the statute applies to Cox
and Piggott, as government officials, is not yet before the Court.
30. Therefore, the Court cannot conclude at this stage that Halikierra has an
adequate state law remedy so as to bar the Corum claims. This is without prejudice
to DHHS’s right to revisit the issue on a more fully developed record.
5. Exhaustion of Administrative Remedies
31. The availability of an adequate administrative remedy can also bar a Corum
claim. See Taylor, 258 N.C. App. at 185 (citing Copper, 363 N.C. at 789). In general,
“where the legislature has provided by statute an effective administrative remedy,
that remedy is exclusive and its relief must be exhausted before recourse may be had
to the courts.” Presnell v. Pell, 298 N.C. 715, 721 (1979) (citations omitted). But a
plaintiff need not exhaust its administrative remedies if those remedies would be
futile or inadequate. See Abrons Fam. Prac. & Urgent Care, PA v. N.C. Dep’t of Health
State Highway Comm’n, 260 N.C. 241, 249–51 (1963) (holding plaintiffs had no adequate remedy at law because their damages accrued after the time by which they could bring a statutory claim), overruled on other grounds by Lea Co. v. N.C. Bd. of Transp., 308 N.C. 603 (1983); Copper v. Denlinger, 363 N.C. 784, 789 (2010) (holding plaintiffs had an adequate remedy in the form of an administrative appeal). & Hum. Servs., 370 N.C. 443, 451 (2018). A remedy is adequate if “it is calculated to
give relief more or less commensurate with the claim.” Swan Beach Corolla, L.L.C.
v. County of Currituck, 234 N.C. App. 617, 622 (2014) (citation and quotation marks
omitted). The plaintiff bears the burden of establishing futility or inadequacy. See
Abrons, 370 N.C. at 451 (citation omitted).
32. Again, the complaint alleges that Halikierra has exhausted all
administrative remedies. (See Compl. ¶¶ 123, 136.) And again, DHHS did not
dispute these allegations in its opening brief or reply brief.
33. At the hearing, the parties informed the Court that there are two ongoing
proceedings before the OAH involving (i) DHHS’s suspension of Halikierra and
(ii) DHHS’s refusal to pay Halikierra’s clean claims even after the suspension was
rescinded. (See DHHS Suppl. Br. 10; see also ECF Nos. 46.2, 46.3.) By statute,
adverse determinations by DHHS constitute contested cases that must be
adjudicated by the OAH under the Administrative Procedure Act. See N.C.G.S.
§ 108C-12(b).
34. DHHS argues that this is an effective administrative remedy, which has not
yet been exhausted. The Court disagrees. Halikierra’s constitutional claims are
based on the allegedly arbitrary decision to put it on prepayment review in the first
place. (See, e.g., Compl. ¶¶ 20–23, 29, 45, 46, 54; see also Pls.’ Suppl. Br. 3, 14.) That
decision is distinct from the denial of claims and is not reviewable under the
Administrative Procedure Act. See N.C.G.S. § 108C-7(f) (“The decision to place or
maintain a provider on prepayment claims review does not constitute a contested case under Chapter 150B of the General Statutes. A provider may not appeal or
otherwise contest a decision of the Department to place or maintain a provider on
prepayment review.”). Therefore, Halikierra has no adequate administrative remedy
to address the decision to place it on prepayment review. See Monarch Tax Credits,
2021 NCBC LEXIS 9, at *19 (concluding that plaintiff’s Corum claim was “not barred
by [plaintiff’s] failure to exhaust administrative remedies because [plaintiff] as a
practical matter does not have an administrative remedy which might address the
issues its Corum claim raises”).
35. DHHS argues that because section 108C-7(f) makes the decision to place a
provider on prepayment review nonreviewable, Halikierra may not challenge that
decision at all and has suffered no injury from it. (See DHHS Suppl. Br. 9–12.) Not
so. The mere fact that an agency action is nonreviewable under the Administrative
Procedure Act does not shield it from judicial review. See N.C.G.S. § 150B-43
(“Nothing in this Chapter shall prevent any party or person aggrieved from invoking
any judicial remedy available to the party or person aggrieved under the law to test
the validity of any administrative action not made reviewable under this Article.”);
see also Kane v. N.C. Tchrs.’ & State Emps.’ Comprehensive Major Med. Plan, 229
N.C. App. 386, 390 (2013); High Rock Lake Ass’n Inc. v. N.C. Env’t Mgmt. Comm’n,
51 N.C. App. 275, 278 n.* (1981); High Rock Lake Ass’n Inc. v. N.C. Env’t Mgmt.
Comm’n, 39 N.C. App. 699, 707 (1979). Because Halikierra has asserted injuries
relating to DHHS’s placement of Halikierra on prepayment review, (see, e.g., Compl. ¶¶ 21–28, 54–58, 81, 82, 115–20, 124–28, 132–34, 137–44), the exhaustion doctrine
does not preclude the claims.
6. Failure to State a Claim
36. DHHS also argues that Halikierra has failed to adequately plead a
substantive due process or equal protection claim under Rule 12(b)(6).
37. The Law of the Land Clause of the North Carolina Constitution provides
that “[n]o person shall be taken, imprisoned, or disseized of his freehold, liberties, or
privileges, or outlawed, or exiled, or in any manner deprived of his life, liberty, or
property, but by the law of the land.” N.C. Const. art. I, § 19. It is “synonymous with
‘due process of law,’ a phrase appearing in the Federal Constitution and the organic
law of many states.” State v. Ballance, 229 N.C. 764, 769 (1949) (citations omitted);
see also Johnston v. State, 224 N.C. App. 282, 296 (2012).
38. Substantive due process requires that “the law shall not be unreasonable,
arbitrary or capricious, and that the law be substantially related to the valid object
sought to be obtained.” Rhyne v. K-Mart Corp., 358 N.C. 160, 181 (2004) (citation and
quotation marks omitted). If the government action at issue implicates a
fundamental liberty or property interest, then it receives strict scrutiny; otherwise,
“the government action need only have a rational relation to a legitimate
governmental objective to pass constitutional muster.” Toomer v. Garrett, 155 N.C.
App. 462, 469 (2002) (citing Huntington Props., LLC v. Currituck County, 153 N.C.
App. 218, 229–31 (2002)). 39. The Equal Protection Clause of the North Carolina Constitution provides
that “[n]o person shall be denied the equal protection of the laws; nor shall any person
be subjected to discrimination by the State because of race, color, religion, or national
origin.” N.C. Const. art. I, § 19. The clause “require[s] that all persons similarly
situated be treated alike.” State v. Harris, 242 N.C. App. 162, 166 (2015) (quoting
State v. Fowler, 197 N.C. App. 1, 26 (2009)).
40. Typically, equal protection rights arise in the context of “discrimination on
the basis of group classification or interference with the exercise of some fundamental
right.” Toomer, 155 N.C. App. at 476. Halikierra’s theory is different. It contends
that DHHS’s conduct was “a spiteful effort to force . . . Halikierra out of business.”
(Compl. ¶ 140.) An equal protection claim may be brought by a “class of one” if the
plaintiff alleges (1) that the government intentionally treated the plaintiff differently
than other similarly situated persons and (2) that the government’s action was
irrational and wholly arbitrary. See Toomer, 155 N.C. App. at 476–78; see also Village
of Willowbrook v. Olech, 528 U.S. 562, 564 (2000).
41. DHHS’s sole argument for dismissal under Rule 12(b)(6) is that the
complaint does not and cannot allege arbitrary action by the agency. (See DHHS Br.
in Supp. 5–6.) DHHS draws on Halikierra’s allegations that section 108C-7 is vague,
does not provide sufficient guidance, and does not define key terms. (See, e.g., Compl.
¶¶ 98, 100, 101.) If true, DHHS’s argument goes, then it could not have acted
arbitrarily because it “was handed . . . a deeply flawed statute.” (DHHS Br. in Supp.
5.) 42. This argument, like many of the other arguments asserted by DHHS,
appears to be based on the facial challenge to section 108C-7, which Halikierra has
withdrawn. DHHS contends that the allegations of vagueness remain in the
complaint and therefore must be taken as true. That’s not correct. The Court need
not accept “conclusions of law” as true for purposes of a Rule 12(b)(6) motion. Wray,
370 N.C. at 46 (citations and quotation marks omitted).
43. Moreover, the complaint includes allegations of wrongdoing that are distinct
from those based on statutory vagueness. These include allegations that DHHS
targeted Halikierra out of spite, placed it on prepayment review without any
supporting evidence, and held it to a different standard than other providers. (See,
e.g., Compl. ¶¶ 109–20, 131, 133, 134, 139, 140.) “[I]t is clear that ‘government actors
cannot single out a particular individual or entity for disparate treatment based on
illegitimate, political or personal motives.’ ” Town of Beech Mountain v. Genesis
Wildlife Sanctuary, Inc., 247 N.C. App. 444, 461 (2016) (quoting Browning-Ferris
Indus. of S. Atl., Inc. v. Wake County, 905 F. Supp. 312, 321 (E.D.N.C. 1995)).
44. In its supplemental brief, DHHS suggests for the first time that the
complaint is also deficient because Halikierra has not pleaded a case of respondeat
superior so as to attribute the actions of Cox and Piggott to DHHS. (See DHHS Suppl.
Br. 7.) This was not one of the issues on which the Court invited supplemental
briefing, so DHHS’s argument is not properly before the Court. See In re
Southeastern Eye Center-Pending Matters, 2019 NCBC LEXIS 29, at *149 (N.C.
Super. Ct. May 7, 2019) (declining to consider arguments in supplemental brief that were outside the scope of the allowed supplemental briefing); State v. Maready, 205
N.C. App. 1, 14 n.4 (2010) (same).
* * *
45. Because Halikierra has withdrawn the facial challenge to section 108C-7,
the Court dismisses it. In all other respects, the Court denies DHHS’s motion to
dismiss.
B. Claims Against CCME, Cox, and Piggott
46. CCME has moved under Rule 12(b)(6) to dismiss all claims against it. Cox
and Piggott join CCME’s challenges to the claims for civil conspiracy and punitive
damages but have not advanced any arguments of their own. (See ECF No. 29.) For
simplicity, the Court refers only to CCME when addressing the briefs and
arguments.2
1. Fraud
47. CCME contends that the fraud claim is deficient because, as alleged, it made
no misrepresentations to Halikierra. (See CCME Br. in Supp. 3–5, ECF No. 16.) In
2 Although CCME is not a party to the OAH matters, it contends that those proceedings
address issues that overlap with this case such that the OAH’s decisions are “likely to extinguish or resolve many of the factual allegations in the Complaint which concern CCME.” (CCME Suppl. Br. 6, ECF No. 49.) But nothing in Chapter 108C or the Administrative Procedure Act enables Halikierra to seek recovery against CCME for the injuries CCME has allegedly caused. What’s more, Halikierra has alleged wrongdoing by CCME separate and apart from DHHS’s actions at issue in the OAH matters. For example, CCME is accused of falsifying records and audit results it sent to DHHS and deceiving Halikierra about the purpose of various requests for information. (See, e.g., Compl. ¶¶ 28, 33–36, 44, 64, 65, 67– 71, 162–65, 167–71.) Given that the OAH matters do not encompass these issues, the exhaustion requirement does not apply to Halikierra’s claims against CCME. response, Halikierra has conceded the point and agreed to withdraw the claim. (See
Opp’n to CCME Mot. 22, ECF No. 21.) The Court therefore dismisses the fraud claim.
2. Section 75-1.1
48. The elements of a claim under section 75-1.1 are that “(1) [the] defendant
committed an unfair or deceptive act or practice, (2) the action in question was in or
affecting commerce, and (3) the act proximately caused injury to the plaintiff.” Dalton
v. Camp, 353 N.C. 647, 656 (2001) (citation omitted). “A practice is unfair if it is
unethical or unscrupulous, and it is deceptive if it has a tendency to deceive.” Id.
(citation omitted).
49. According to CCME, the only acts that it allegedly took were to perform the
prepayment review and to inform DHHS of criminal background checks received from
Halikierra. These acts, CCME contends, were legal and therefore not unfair or
deceptive. See N.C.G.S. § 108C-7(a) (“In order to ensure that claims presented by a
provider for payment by the Department meet the requirements of federal and State
laws and regulations and medical necessity criteria, a provider may be required to
undergo prepayment claims review by the Department.”); N.C.G.S. § 131E-265(a)
(addressing the use and disclosure of “criminal history record check” results).3 On
that basis, CCME seeks to dismiss the claim. (See CCME Br. in Supp. 5–8.)
3 Section 131E-265(a) provides, in relevant part:
An offer of employment by a home care agency licensed under this Chapter to an applicant to fill a position that requires entering the patient’s home is conditioned on consent to a criminal history record check of the applicant. . . . [T]he Department of Public Safety shall return the results of national criminal history record checks for employment positions . . . to the Department of Health and Human Services, Criminal Records Check Unit[, which] . . . shall notify the nursing home or home 50. This is a misreading of the claim and supporting allegations. Although not
always as clear as it could be, the complaint alleges unfair or deceptive acts that go
beyond the purportedly lawful acts identified by CCME. Liberally construed, the
complaint alleges that CCME colluded with Cox and Piggott, intentionally inflated
the number of convicted felons employed by Halikierra, and falsified data while
performing the prepayment review, all with an aim toward disqualifying Halikierra
as a Medicaid provider. (See, e.g., Compl. ¶¶ 28, 29, 33–37, 66–71, 161–71.) The
complaint also alleges that CCME had a financial motive for doing so because its
compensation is tied to the denial of claims under review. (See, e.g., Compl. ¶¶ 161–
63.) Taking these allegations as true, Halikierra has sufficiently alleged that CCME
committed unfair or deceptive acts.
51. With its supplemental brief, CCME submitted evidence to disprove these
allegations and show that it did not falsify data. (See CCME Suppl. Br. 7–10; ECF
No. 49.3.) But the Court is confined to the pleadings on a Rule 12(b)(6) motion.
CCME’s evidence is better suited for summary judgment.
52. The Court denies CCME’s motion to dismiss the section 75-1.1 claim.
3. Civil Conspiracy
53. To state a claim for civil conspiracy, a plaintiff must allege “(1) a conspiracy;
(2) wrongful actions taken by at least one of the conspirators in furtherance of that
care agency as to whether the information received may affect the employability of the applicant. In no case shall the results of the national criminal history record check be shared with the nursing home or home care agency. . . . All criminal history information received by the home or agency is confidential and may not be disclosed, except to the applicant as provided in subsection (b) of this section. conspiracy; and (3) injury to the plaintiff as a result.” Lunsford v. ViaOne Servs.,
LLC, 2020 NCBC LEXIS 111, at *17 (N.C. Super. Ct. Sept. 28, 2020) (citing Krawiec
v. Manly, 370 N.C. 602, 614 (2018)). Conspiracy “requires an agreement between at
least two persons to take an unlawful action or to take a lawful action in an unlawful
manner.” Id. (citations omitted).
54. CCME argues that Halikierra has not alleged the existence or terms of any
conspiracy. (See CCME Br. in Supp. 9.) But it has. The complaint alleges that Cox
and Piggott “solicited and obtained the help of” CCME in a “scheme to destroy
[Halikierra’s] business,” that CCME falsely reported the number of convicted felons
employed by Halikierra, and that CCME falsified its audit findings at Piggott’s
request. (Compl. ¶¶ 29, 67, 68, 153.) The complaint also identifies the CCME
employee who communicated with and assisted Cox and Piggott in this scheme. (See
Compl. ¶ 30.) And it provides the timeframe during which this all occurred. (See,
e.g., Compl. ¶¶ 64–70.) Taking these allegations as true, Halikierra has set forth “not
only that [CCME, Cox, and Piggott] entered into an agreement but also . . . when the
agreement happened, how it arose, and its purpose.” Lunsford, 2020 NCBC LEXIS
111, at *17–18 (denying motion to dismiss); see also Glob. Textile All., Inc. v. TDI
Worldwide, LLC, 2018 NCBC LEXIS 159, at *27–29 (N.C. Super. Ct. Nov. 29, 2018)
(same); S. Fastening Sys., Inc. v. Grabber Constr. Prods., Inc., 2015 NCBC LEXIS 42,
at *19–21 (N.C. Super. Ct. Apr. 28, 2015) (same).
55. CCME also argues that the civil conspiracy claim must be dismissed if the
underlying substantive claims are dismissed. (See CCME Br. in Supp. 10.) But the Court has denied the motion to dismiss the section 75-1.1 claim, and no party has
challenged the underlying claim for conspiracy in restraint of trade.
56. The Court denies the motions of CCME, Cox, and Piggott to dismiss the
claim for civil conspiracy.
4. Punitive Damages
57. CCME argues that punitive damages are a remedy rather than a standalone
cause of action. (See CCME Br. in Supp. 10.) This is true. See, e.g., Azure Dolphin,
2017 NCBC LEXIS 90, at *29. Accordingly, the Court dismisses the purported claim
for punitive damages without prejudice to Halikierra’s right to seek punitive damages
as a remedy for its surviving claims, if allowed by law. See Aldridge v. Metro. Life
Ins. Co., 2019 NCBC LEXIS 116, at *146 (N.C. Super. Ct. Dec. 31, 2019).
IV. CONCLUSION
58. For all these reasons, the Court ORDERS as follows:
a. The Court DISMISSES Whitley and Scales as parties to this action,
without prejudice, under Rule 21.
b. DHHS’s motion to dismiss is GRANTED in part and DENIED in
part. The facial challenge to the constitutionality of section 108C-7 is
DISMISSED without prejudice. In all other respects, the motion is
DENIED.
c. CCME’s motion to dismiss is GRANTED in part and DENIED in
part. The claim for fraud is DISMISSED without prejudice. The claim
for punitive damages is DISMISSED without prejudice to Halikierra’s right to seek punitive damages as a remedy for its surviving claims, if
allowed by law. In all other respects, the motion is DENIED.
d. Cox and Piggott’s motion to dismiss is GRANTED in part and
DENIED in part. The claim for punitive damages is DISMISSED
without prejudice to Halikierra’s right to seek punitive damages as a
remedy for its surviving claims, if allowed by law. In all other respects,
the motion is DENIED.
SO ORDERED, this the 25th day of March, 2021.
/s/ Adam M. Conrad Adam M. Conrad Special Superior Court Judge for Complex Business Cases