Integranet Physician Resource v. Texas Independent

945 F.3d 232
CourtCourt of Appeals for the Fifth Circuit
DecidedDecember 11, 2019
Docket18-20659
StatusPublished
Cited by11 cases

This text of 945 F.3d 232 (Integranet Physician Resource v. Texas Independent) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Integranet Physician Resource v. Texas Independent, 945 F.3d 232 (5th Cir. 2019).

Opinion

Case: 18-20659 Document: 00515231867 Page: 1 Date Filed: 12/11/2019

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals Fifth Circuit

FILED December 11, 2019 No. 18-20659 Lyle W. Cayce Clerk INTEGRANET PHYSICIAN RESOURCE, INCORPORATED, doing business as IntegraNet Health,

Plaintiff–Appellant

v.

TEXAS INDEPENDENT PROVIDERS, L.L.C.; ROBERT VINCENT ROTH; CARLOS J. PALACIOS, Medical Doctor,

Defendants–Appellees

******************************************************** INTEGRANET PHYSICIAN RESOURCE, INCORPORATED,

ROBERT VINCENT ROTH,

Defendant–Appellee

Appeal from the United States District Court for the Southern District of Texas

Before SOUTHWICK, WILLETT, and OLDHAM, Circuit Judges. DON R. WILLETT, Circuit Judge: IntegraNet sued a competitor and its two owners (one of whom was a former IntegraNet employee) in state court. They removed to federal court. Then IntegraNet sued the former-employee owner in state court for another Case: 18-20659 Document: 00515231867 Page: 2 Date Filed: 12/11/2019

No. 18-20659 claim. And the owner again removed. The district court consolidated the cases. The so-called consolidation order sua sponte barred IntegraNet from filing another case against Appellees without the judge’s permission. On appeal, IntegraNet argues that the district court lacked jurisdiction and that consolidation was improper, as was the sua sponte pre-filing injunction. We agree with IntegraNet. We reverse the consolidation order, vacate the injunction, and remand both claims with instructions to the district court to remand the Texas state law claims to the Texas state court from which the cases were removed.

I. BACKGROUND IntegraNet is a Texas independent physician association (IPA), a network of independent physicians who’ve banded together to reduce overhead costs and negotiate contracts with payers. IntegraNet employed Robert Vincent Roth as Vice President of Contracting and Director of Financial Analytics. A big part of Roth’s job was to collect money owed to IntegraNet from insurers. Roth allegedly dropped the ball. In 2014 he sought recovery of only $337,784 of roughly $4.3 million owed to IntegraNet by an insurer. IntegraNet asserts that Roth knew about the underreporting prior to the claim deadline and failed to correct it. Roth quit IntegraNet that same year. About three years later, IntegraNet supposedly caught the mistake, but managed to collect only around $550,000 of the roughly $4.3 million. So IntegraNet is coming after Roth for the rest. After Roth quit IntegraNet in 2014, he started a competitor IPA called Texas Independent Providers (TIP). TIP serves patients through Medicare Advantage plans. Roth and his partner, Dr. Carlos Palacios, are the principal owners. IntegraNet says that Roth, Palacios, and TIP conspired to harm IntegraNet’s business, improperly prying physicians and insurers away from IntegraNet. For example, IntegraNet points to the insurer WellCare (a now- 2 Case: 18-20659 Document: 00515231867 Page: 3 Date Filed: 12/11/2019

No. 18-20659 dismissed defendant). WellCare was an IntegraNet insurer, but withdrew in 2018. 1 WellCare notified its members of the termination with IntegraNet. The parties agree that federal regulations and the contract between IntegraNet and WellCare required IntegraNet to abstain from interfering with patient enrollment upon WellCare’s termination of the contract. 2 Put differently, IntegraNet was not supposed to pressure WellCare enrollees to switch insurance plans. IntegraNet insists it didn’t. But in April 2018, WellCare sent cease-and-desist letters to IntegraNet and some of its providers. The letters state that WellCare received “a complaint relating to unsolicited contacts with one or more of [the doctors’] patients who are Medicare-eligible beneficiaries.” IntegraNet says these letters were “thinly-veiled threats” to its doctor-members motivated by the desire for them to leave IntegraNet for another IPA—like TIP—or to contract directly with WellCare. IntegraNet also alleges that, around the same time, many of its doctor-members received marketing materials from TIP touting the benefits of their membership. These materials supposedly contain mischaracterizations about IntegraNet “that only Roth would have the knowledge to make.” Appellees Roth and Palacios co-own TIP. Palacios is also a Medical Director at WellCare. IntegraNet believes that WellCare acted in concert with TIP, Roth, and Palacios.

1 In this situation, if IntegraNet-affiliated doctors wanted the continued opportunity to treat their patients with WellCare insurance, they could (1) terminate their relationship with IntegraNet and join a different IPA that contracts with WellCare, or (2) contract directly with WellCare without the negotiating advantages of an IPA. 2 See 42 C.F.R. §§ 422.2268(e), (j), and (k), 423.2268(e), (j), and (k). These regulations were updated effective June 15, 2018, but these citations refer to the previous version that was in effect during the time period at issue in this case. See also CTR. FOR MEDICARE & MEDICAID SERVS., MEDICARE MKTG. GUIDELINES § 70.5.1 (2017), available at https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/CY-2018- Medicare-Marketing-Guidelines_Final072017.pdf (citing the previously listed federal regulations). 3 Case: 18-20659 Document: 00515231867 Page: 4 Date Filed: 12/11/2019

No. 18-20659 IntegraNet filed two suits in state court. Suit #1 was against TIP, Roth, Palacios, and WellCare for interfering with IntegraNet’s business (TIP lawsuit). Suit #2 was against Roth alone for breach of fiduciary duty and negligence (Roth lawsuit). But WellCare and Roth removed to federal court. Here’s the timeline: April 18, 2018—IntegraNet files TIP lawsuit in state court. IntegraNet petitions for, and is granted, a temporary restraining order against defendants.

April 29, 2018—WellCare removes TIP lawsuit to federal court under 28 U.S.C. §§ 1441 (removal), 1442 (federal officer), and 1446.

May 10, 2018—After WellCare had been dismissed from the TIP lawsuit, IntegraNet moves for remand.

June 18, 2018—IntegraNet files Roth lawsuit in state court.

August 30, 2018—Roth removes the Roth lawsuit to federal court based on supplemental jurisdiction and 28 U.S.C. § 1446(b)(3), and he moves to consolidate with the TIP lawsuit.

September 17, 2018—IntegraNet moves for remand of the Roth lawsuit.

September 18, 2018—The district court consolidates the TIP and Roth lawsuits. The consolidation order forbids IntegraNet from “fil[ing] another case against the defendants on the facts in this action without [the district] court’s permission.”

September 24, 2018—IntegraNet appeals the consolidation order under 28 U.S.C. § 1292.

June 5, 2019—The district court denies remand of the Roth lawsuit.

In this appeal, we review the interlocutory order consolidating the two cases and the denial of the motions to remand.

II. JURISDICTION AND STANDARD OF REVIEW 4 Case: 18-20659 Document: 00515231867 Page: 5 Date Filed: 12/11/2019

No. 18-20659 A. Statement of Jurisdiction The preliminary issue is whether we have jurisdiction to hear the appeal of this interlocutory order consolidating the two cases. Appellees argue that we lack jurisdiction. They are mistaken. Under 28 U.S.C. § 1292

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945 F.3d 232, Counsel Stack Legal Research, https://law.counselstack.com/opinion/integranet-physician-resource-v-texas-independent-ca5-2019.