INTERNAL MEDICINE NEPHROLOGY, INCORPORATED v. FRESENIUS BIO-MEDICAL APPLICATIONS OF INDIANA, INC.

CourtDistrict Court, S.D. Indiana
DecidedSeptember 26, 2019
Docket2:18-cv-00506
StatusUnknown

This text of INTERNAL MEDICINE NEPHROLOGY, INCORPORATED v. FRESENIUS BIO-MEDICAL APPLICATIONS OF INDIANA, INC. (INTERNAL MEDICINE NEPHROLOGY, INCORPORATED v. FRESENIUS BIO-MEDICAL APPLICATIONS OF INDIANA, INC.) is published on Counsel Stack Legal Research, covering District Court, S.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
INTERNAL MEDICINE NEPHROLOGY, INCORPORATED v. FRESENIUS BIO-MEDICAL APPLICATIONS OF INDIANA, INC., (S.D. Ind. 2019).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF INDIANA TERRE HAUTE DIVISION

INTERNAL MEDICINE NEPHROLOGY, ) INCORPORATED, ) ) Plaintiff, ) ) v. ) No. 2:18-cv-00506-JRS-DLP ) BIO-MEDICAL APPLICATIONS OF INDI- ) ANA, INC., et al., ) ) Defendants. )

Entry Granting Defendants’ Motion to Dismiss

Plaintiff Internal Medicine Nephrology, Inc. alleges that Defendant Fresenius Medical Care Holdings Inc. and various related entities (collectively, “Fresenius”) at- tempted to monopolize and monopolized the dialysis services market in the Terre Haute area in violation of section 2 of the Sherman Act, 15 U.S.C. § 2. Plaintiff also alleges various related state-law antitrust, tort, contract, and quasi-contract claims.1 Defendants move to dismiss Plaintiff’s Sherman Act claim for lack of antitrust injury and lack of antitrust standing. For the reasons below, Defendants’ motion to dismiss (ECF No. 44) is granted, and Plaintiff’s Sherman Act claim is dismissed without prejudice to amending its complaint. Because courts should generally relin- quish supplemental jurisdiction over pendant state-law claims when all federal claims are dismissed, see Kennedy v. Schoenberg, Fisher & Newman, Ltd., 140 F.3d

1 Some of the state-law claims are also alleged against Defendant Michael Graves, an employee of one or more of the Fresenius entities. 716, 727 (7th Cir. 1998), Plaintiff’s state-law claims are also dismissed without prej- udice. Background2

Plaintiff is a nephrology practice group based in Terre Haute, Indiana. “When a nephrologist’s patient requires dialysis services, the nephrologist refers the patient to a dialysis provider.” (Compl. ¶ 14.) Medicare requires that every dialysis facility have a medical director—“one or more nephrologists who oversee the delivery and quality of care provided at the dialysis facility.” (Compl. ¶ 15.) Due to the time- consuming and repetitive nature of dialysis, patients typically will not drive more

than 30 to 45 minutes for dialysis services. (Compl. ¶ 23.) Plaintiff identifies the relevant market as “dialysis services within a 30–45 minute travel distance of Terre Haute.” (Compl. ¶ 34.) Fresenius provides dialysis services at its dialysis clinics in Terre Haute and the surrounding area. “Fresenius has had significant market power in the provision of kidney dialysis services in that it could control prices by controlling supply, and/or excluding competition with the effect of not keeping historical costs in check which

negatively impact reimbursement rates paid by payors, including Medicare.” (Compl. ¶ 32.) From 2006 until 2017, Fresenius was the only dialysis service provider in the relevant market, and Plaintiff served as medical director at all six facilities—four outpatient and two inpatient. Plaintiff was also involved in Fresenius’s efforts to open a facility in Paris, Illinois, and Defendants promised that Plaintiff would serve

2 Consistent with the Rule 12(b)(6) standard, Plaintiff’s allegations are taken as true and all reasona- ble inferences are drawn in Plaintiff’s favor. as medical director of that facility. (Compl. ¶¶ 45–53.) Plaintiff alleges that under federal law and regulations relating to Medicare reimbursements, “neither a dialysis provider nor a nephrologist can dictate which dialysis facility a patient must use[,]

and a dialysis provider cannot financially reward a patient or a physician for a spe- cific referral.” (Compl. ¶ 17.) In October 2017, DaVita entered the relevant market, opening three dialysis fa- cilities in the Terre Haute area. The only other nephrology practice group in Terre Haute served as medical director of the DaVita facilities. (Compl. ¶ 58.) After DaVita’s entry, Fresenius (1) insisted that Plaintiff interfere with patient choice by

barring its employee-physicians’ nephrology patients from transferring to DaVita fa- cilities; (2) threatened Plaintiff and its employee-physicians that “IMN needs Frese- nius more than Fresenius needs IMN”; (3) ordered Fresenius employees to tell pa- tients that Plaintiff’s physicians were “liars”; and (4) “[c]oerced Fresenius employees and staff to engage in consistent and targeted acts intended to coerce patients” to remain at Fresenius facilities or transfer back to Fresenius facilities. (Compl. ¶ 56.) Plaintiff and its employee-physicians refused to comply with Fresenius’s de-

mands, so Fresenius terminated its medical director agreements with Plaintiff for four facilities and selected a different medical director for the Paris facility, replacing Plaintiff with an Indianapolis-based medical director that acquiesced in Fresenius’s demands. (Compl. ¶¶ 61, 63.) After replacing Plaintiff as medical director, Fresenius began to solicit Plaintiff’s nephrology patients to leave Plaintiff for Fresenius’s new medical director. (Compl. ¶ 61.) Fresenius falsely told others that Plaintiff was re- placed as medical director due to concerns about quality. (Compl. ¶¶ 73, 76.) Plaintiff’s medical director agreements with Fresenius for each facility included

noncompete provisions prohibiting Plaintiff from serving as medical director for a competing dialysis facility within 25 miles of the respective Fresenius facility. (Compl. ¶ 43.) Legal Standard To survive a motion to dismiss for failure to state a claim, a plaintiff must allege “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v.

Twombly, 550 U.S. 544, 570 (2007). In considering a Rule 12(b)(6) motion to dismiss, the court takes the complaint’s factual allegations as true and draws all reasonable inferences in the plaintiff’s favor. Orgone Capital III, LLC v. Daubenspeck, 912 F.3d 1039, 1044 (7th Cir. 2019). The court need not “accept as true a legal conclusion couched as a factual allegation.” Papasan v. Allain, 478 U.S. 265, 286 (1986). “[I]f a plaintiff pleads facts that show its suit [is] barred . . . , it may plead itself out of court under a Rule 12(b)(6) analysis.” Orgone Capital, 912 F.3d at 1044 (quoting Whirlpool

Fin. Corp. v. GN Holdings, Inc., 67 F.3d 605, 608 (7th Cir. 1995)); Bogie v. Rosenberg, 705 F.3d 603, 609 (7th Cir. 2013) (on a motion to dismiss “district courts are free to consider ‘any facts set forth in the complaint that undermine the plaintiff’s claim’”) (quoting Hamilton v. O’Leary, 976 F.2d 341, 343 (7th Cir. 1992)). Discussion Defendants argue that Plaintiff has not suffered “antitrust injury” and that Plain- tiff lacks “antitrust standing.” Section 4 of the Clayton Act, 15 U.S.C. § 15, provides

a private right of action for violation of the antitrust laws: “any person who shall be injured in his business or property by reason of anything forbidden in the antitrust laws may sue therefor in any district court of the United States . . . , and shall recover threefold damages by him sustained, and the cost of suit, including a reasonable at- torney’s fee.” Despite the Clayton Act’s apparent breadth, the Supreme Court—draw- ing on congressional intent and common-law principles—has developed two related

doctrines that limit the scope of the private right of action: antitrust injury and an- titrust standing. Neither antitrust injury nor antitrust standing implicates the limits of the “judicial Power” under Article III. See U.S. Gypsum Co. v. Ind. Gas Co., 350 F.3d 623, 627 (7th Cir. 2003) (noting the “potential for confusion with Article III standing”).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Norris v. Hearst Trust
500 F.3d 454 (Fifth Circuit, 2007)
Brunswick Corp. v. Pueblo Bowl-O-Mat, Inc.
429 U.S. 477 (Supreme Court, 1977)
Blue Shield of Va. v. McCready
457 U.S. 465 (Supreme Court, 1982)
Papasan v. Allain
478 U.S. 265 (Supreme Court, 1986)
Cargill, Inc. v. Monfort of Colorado, Inc.
479 U.S. 104 (Supreme Court, 1986)
Eastman Kodak Co. v. Image Technical Services, Inc.
504 U.S. 451 (Supreme Court, 1992)
Spectrum Sports, Inc. v. McQuillan
506 U.S. 447 (Supreme Court, 1993)
Bell Atlantic Corp. v. Twombly
550 U.S. 544 (Supreme Court, 2007)
Edward Q. Lupia v. Stella D'OrO Biscuit Co., Inc.
586 F.2d 1163 (Seventh Circuit, 1978)
In Re Industrial Gas Antitrust Litigation
681 F.2d 514 (Seventh Circuit, 1982)
James G.P. Collins v. Associated Pathologists, Ltd.
844 F.2d 473 (Seventh Circuit, 1988)

Cite This Page — Counsel Stack

Bluebook (online)
INTERNAL MEDICINE NEPHROLOGY, INCORPORATED v. FRESENIUS BIO-MEDICAL APPLICATIONS OF INDIANA, INC., Counsel Stack Legal Research, https://law.counselstack.com/opinion/internal-medicine-nephrology-incorporated-v-fresenius-bio-medical-insd-2019.