In Re Medical Care Management Co.

361 B.R. 863, 2003 Bankr. LEXIS 2266, 2003 WL 25481931
CourtUnited States Bankruptcy Court, M.D. Tennessee
DecidedJanuary 2, 2003
Docket301-44089, 301-14090
StatusPublished
Cited by6 cases

This text of 361 B.R. 863 (In Re Medical Care Management Co.) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Medical Care Management Co., 361 B.R. 863, 2003 Bankr. LEXIS 2266, 2003 WL 25481931 (Tenn. 2003).

Opinion

*866 MEMORANDUM OPINION

MANIAN F. HARRISON, Bankruptcy Judge.

This case is before the Court upon the Motion for Mandatory Abstention Pursuant to 28 U.S.C. § 1334(c)(2), or in the Alternative for Permissive Abstention Pursuant to 28 U.S.C. § 1334(c)(1) and the Motion for Relief from the Automatic Stay of 11 U.S.C. § 362 as Necessary to Proceed in State Court Action, both filed by Anne P. Pope, Commissioner of the Tennessee Department of Commerce and Insurance (hereinafter “Commissioner”). The debtors, Medical Care Management Company (hereinafter “MCMC”) and Access Health Systems, Inc. (hereinafter “AHS”), and the unsecured creditors committees of the debtors oppose the motions. Also before the Court is the debtors’ motion asking the Court to take judicial notice that its files contain a proof of claim and a request for administrative expenses from the Tennessee Department of Labor and Workforce Development, which claim and request were subsequently withdrawn.

Based on the testimony, the pleadings, and the arguments of counsel, the Court finds as follows: (1) the Commissioner’s motion for abstention is premature and should be denied; (2) the motion for relief from the stay for cause pursuant to 11 U.S.C. § 362(d)(1) should be granted to the extent set forth herein; and (3) the debtors’ motion asking the Court to take judicial notice of the claim and request filed and withdrawn by the unrelated state agency should be granted. The following represents the Court’s findings of fact and conclusions of law pursuant to Rule 7052, Federal Rules of Bankruptcy Procedure.

I. BACKGROUND

The Commissioner heads the Department of Commerce and Insurance of the state of Tennessee and is charged under Title 56 of the Tennessee Code with the regulation and oversight of insurance companies operating in Tennessee. These statutory responsibilities extend to the regulation and operation of health maintenance organizations (hereinafter “HMOs”) operating in Tennessee pursuant to T.C.A. § 56-32-202, et seq.

Tennessee Consolidated Case Network (hereinafter “TCCN”) is a non-profit public benefit Corporation, incorporated in the state of Tennessee and holding a certificate of authority from the Commissioner to operate as a Tennessee domestic HMO. TCCN previously contracted with the state’s TennCare Bureau which operates TennCare, the state’s alternative to the Medicaid system, under the direction of the Department of Finance and Administration. Under the Contractor Risk Agreement with TennCare, TCCN was to provide medical services to indigent and other uninsurable enrollees as an HMO. Pursuant to its contract, the state was to pay TCCN an amount each month (capitation rate) for each individual enrolled by TCCN, and TCCN was to provide the necessary medical care to its enrollees.

TCCN had only one employee, its president. MCMC and AHS were closely aligned with TCCN and essentially operated the HMO, according to the Chancery Court’s “Final Order Appointing Commissioner for Purposes of Liquidation .... ” Specifically, pursuant to the Agreement for Management Services between MCMC and TCCN, MCMC managed TCCN’s operations and supplied or arranged for all of the personnel, physical space, and equipment that was required to administer and carry out TCCN’s functions as an HMO. MCMC also provided the accounting, legal, and general administrative services that were required by TCCN pursuant to the management agreement. In addition, *867 MCMC maintained records related to TCCN’s business. Debtor AHS, which is the parent company of MCMC, managed the affairs of MCMC.

As a result of varied state concerns over the financial viability of TCCN, Courtney Pearre was appointed Supervisor for TCCN under the Insurers Rehabilitation and Liquidation Act, T.C.A. § 56-9-101, et seq., pursuant to the Commissioner’s Notice of Administrative Supervision (hereinafter “Supervision Notice”), dated May 10, 2000, and T.C.A. § 56-9-503. The Supervision Notice was extended by agreement on September 20, 2000, and again on June 19, 2001, and Mr. Pearre served as Supervisor of TCCN from May 10, 2000, until approximately October 18, 2001. As Supervisor, Mr. Pearre was charged with the responsibility of reviewing and approving all requests for disbursements. Specifically, the Supervision Notice prohibited TCCN from making any disbursements, withdrawing any of its bank accounts, and, in general, transferring any of its property or assets, “without the prior written approval of the Commissioner or the Commissioner’s appointed Supervisor.” In addition, the Supervision Notice provided for a safety net — the state guaranteed all payments to providers from May 10, 2000, to February 1, 2001, and afterwards extended its risk band to guarantee half of the payments owed by TCCN to providers. These guarantees were instituted to ensure that providers would not abandon the plan threatening the loss of health care to enrollees. According to the Commissioner’s witnesses, the estimated amounts owed by the state under the risk band totaled approximately $16 million and the state’s obligations under the safety net are approximately $7 million.

On September 19, 2001, Deputy Commissioner of Finance and Administration, Mark Reynolds, gave written notice to TCCN of the state’s intent to terminate TCCN’s contract absent proof of immediate contractual compliance. Following an exchange of information, on October 16, 2001, Deputy Commissioner Reynolds gave written confirmation to TCCN that its contract would end October 31, 2001. On October 16, 2001, the Commissioner alleges a request was made to AmSouth Bank to transfer $5.7 million from TCCN to debtor MCMC. Neither Mr. Pearre nor the Commissioner, whose consent was required for any transfer of funds, were aware of this request, transfer, or “attempted transfer” (the Commissioner’s terminology), until after the fact, despite the language of the Supervision Notice.

On October 17, 2001, the Commissioner applied to the Chancery Court of Davidson County for an order of seizure of TCCN. That same date, the Chancery Court entered a temporary restraining order and mandatory injunction stopping disbursement of the funds by AmSouth Bank. Thereafter, on October 18, 2001, the Chancery Court entered an order granting the Commissioner’s Application for an Order of Seizure of TCCN. On November 2, 2001, the Chancery Court entered the Final Order Appointing Commissioner for Purposes of Liquidation of Respondent Tennessee Coordinated Care Network and Permanent Injunction and a separate Order Continuing Injunctive Relief regarding the $5.7 million, which Order was approved for entry by counsel for the debtor, MCMC. Mr.

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361 B.R. 863, 2003 Bankr. LEXIS 2266, 2003 WL 25481931, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-medical-care-management-co-tnmb-2003.