Inst. of Cardiovascular Excellence, PLLC v. Fla. Agency for Health Care Admin. (In re Inst. of Cardiovascular Excellence, PLLC)

589 B.R. 204
CourtUnited States Bankruptcy Court, M.D. Florida
DecidedFebruary 9, 2018
DocketCase No. 3:16-bk-1491-JAF; Case No. 3:16-bk-1492-JAF; Case No. 3:16-bk-1493-JAF (JOINTLY ADMINISTERED); Adv. No. 3:17-ap-0200-JAF
StatusPublished

This text of 589 B.R. 204 (Inst. of Cardiovascular Excellence, PLLC v. Fla. Agency for Health Care Admin. (In re Inst. of Cardiovascular Excellence, PLLC)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Inst. of Cardiovascular Excellence, PLLC v. Fla. Agency for Health Care Admin. (In re Inst. of Cardiovascular Excellence, PLLC), 589 B.R. 204 (Fla. 2018).

Opinion

Jerry A. Funk, United States Bankruptcy Judge

This proceeding is before the Court on the amended motion to dismiss filed by *207Defendant FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION ("AHCA") (Doc. 10) and the response in opposition filed by Plaintiff INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC ("Debtor") (Doc. 11). For the reasons stated herein, AHCA's motion is denied as to Count 1, but is granted as to Counts 2 and 3.

BACKGROUND

Debtor filed a voluntary petition under Chapter 11 of the Bankruptcy Code on April 20, 2016. Debtor filed the instant adversary proceeding and complaint on November 8, 2017, naming AHCA as the sole defendant. (Doc. 1). AHCA is Florida's executive-branch agency responsible for, among other things, operating and managing Florida's Medicaid program and disbursement of federal Medicaid funds.1 Debtor is a limited liability company and provider of medical services within the State of Florida.

ALLEGATIONS

The complaint alleges the following facts, which the Court accepts as true for purposes of AHCA's motion to dismiss. In January 2009, Debtor and AHCA entered into a Medicaid Provider Agreement (the "Provider Agreement"), which obligated AHCA to reimburse Debtor for medical services it provided to Medicaid recipients within the terms of the agreement. (Doc. 1 at 2). Pursuant to the Provider Agreement, Debtor performed medical services on Medicaid recipients and AHCA was, in turn, obligated by the Provider Agreement to pay Debtor $294,736.25. Debtor alleges that AHCA has neither paid the claims nor notified Debtor of any denied or contested claim, as required by section 641.3155(3)(b), Florida Statutes.

At some point, Debtor communicated with AHCA in an attempt to collect on the funds due under the Provider Agreement. AHCA responded that the funds are "being held in suspended accounts." (Doc. 1 at 2). At the time, AHCA contended these funds were forfeited or abandoned by virtue of a settlement agreement between Debtor (as well as related entities/individuals) and state and federal government agencies in connection with a Medicaid fraud investigation. AHCA also apparently contended that state and federal law required it to "suspend" the subject accounts and withhold payment in light of the fraud investigation. AHCA has not paid the monies owed to Debtor and has not "notified" Debtor of a "denied or contested claim within 20 days" thereof. AHCA's failure to pay or deny the claim has created an "uncontestable obligation" to pay the claim plus interest, under section 641.3155(3)(b), Florida Statutes. (Doc. 1 at 3, ¶ 11). Based on these allegations, Debtor brings three counts: 1) turnover of property under 11 U.S.C. § 542 ; 2) common law breach of contract; and 3) common law quantum meruit. (Doc. 1 at 3-6).

AHCA's motion to dismiss argues that it retains Eleventh Amendment immunity for these claims, and that the proceeding should be dismissed. (Doc. 10). More specifically, AHCA concedes that the Eleventh Amendment does not immunize it against a "true" turnover claim under § 542, but argues the claims are actually immunized claims for in personam damages masquerading as a non-immunized § 542 turnover claim. (Doc. 10 at 5).

AHCA also asserts two factual arguments going to the merits of Debtor's claims. First, AHCA contends that, in 2015, a medical doctor associated with Debtor came under investigation for Medicaid *208fraud. At the time, AHCA determined it had "reliable evidence" to warrant withholding Medicaid payments to Debtor pursuant to section 409.913(25)(a), Florida Statutes, and 42 C.F.R. § 455.23. Second, AHCA contends that, even if it lifted the suspension of payments, Debtor would be entitled to only $28,441.68. (Doc. 10-1 at 3). AHCA attached an affidavit of a designated representative as well as a letter, dated May 5, 2015, which purports to have informed Debtor that AHCA "is temporarily withholding" provider payments due to Debtor. (Doc. 10-1 at 5). This evidence is outside the four corners of the complaint, and the Court is unable to consider its impact on the merits of Debtor's claims within the present analysis.

ANALYSIS

A motion brought pursuant to Rule 12(b)(1) asks the Court to determine whether a sufficient basis for subject-matter jurisdiction has been pled in the operative complaint. Fed. R. Civ. P. 12(b)(1) ; Fed. R. Bankr. P. 7012(b). In making a determination on subject-matter jurisdiction at the pleadings stage, the Court must "take the allegations in the complaint as true." Cypress v. United States, 646 F. App'x 748, 750 (11th Cir. 2016) ; Douglas v. United States, 814 F.3d 1268, 1275-76 (11th Cir. 2016).

Eleventh Amendment immunity in the bankruptcy context.

"Bankruptcy jurisdiction, as understood today and at the time of the framing [of the U.S. Constitution], is principally in rem jurisdiction." Cent. Virginia Cmty. Coll. v. Katz, 546 U.S. 356, 369, 126 S.Ct. 990, 163 L.Ed.2d 945 (2006). "In ratifying the Bankruptcy Clause,[2 ] the States acquiesced in a subordination of whatever sovereign immunity they might otherwise have asserted in proceedings necessary to effectuate the in rem jurisdiction of the bankruptcy courts." Id. at 378, 126 S.Ct. 990. The Eleventh Circuit has labeled this theory "consent by ratification."3 That is, the "consent by ratification" theory "is predicated on the states' decision when joining the Union to ratify the Bankruptcy Clause, which empowers Congress to establish 'uniform Laws on the subject of Bankruptcies throughout the United States.' " In re Diaz

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Related

Central Virginia Community College v. Katz
546 U.S. 356 (Supreme Court, 2006)
Florida Dept. of Revenue v. Diaz
647 F.3d 1073 (Eleventh Circuit, 2011)
In Re Redman Oil Co., Inc.
95 B.R. 516 (S.D. Ohio, 1988)
Frank Douglas v. United States
814 F.3d 1268 (Eleventh Circuit, 2016)
Billy Cypress v. USA
646 F. App'x 748 (Eleventh Circuit, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
589 B.R. 204, Counsel Stack Legal Research, https://law.counselstack.com/opinion/inst-of-cardiovascular-excellence-pllc-v-fla-agency-for-health-care-flmb-2018.