Managed Care Solutions, Inc. v. Essent Healthcare, Inc.

736 F. Supp. 2d 1317, 2010 U.S. Dist. LEXIS 141872, 2010 WL 3368654
District Court, S.D. Florida·Decided August 23, 2010·No. Case 09-60351-CIV·Published·Cited by 22 cases

Opinion

ORDER

JOHN J. O’SULLIVAN, United States Magistrate Judge.

THIS CAUSE comes before the Court on the Plaintiffs Motion for Sanctions, Including the Entry of a Default Judgment and an Award of Attorney’s Fees and Request for Hearing (DE# 152, 6/10/10). This matter was referred to the undersigned by the Honorable Patricia A. Seitz, United States District Court Judge for the Southern District of Florida, pursuant to 28 U.S.C. § 636(b). Having reviewed the applicable filings and law, it is

ORDERED AND ADJUDGED that the Plaintiffs Motion for Sanctions, Including the Entry of a Default Judgment and an Award of Attorney’s Fees and Request for Hearing (DE# 152, 6/10/10) is DENIED for the reasons stated herein.

BACKGROUND

Managed Care Solutions, Inc. (hereinafter “MCS” or “plaintiff’) is in the business *1319 of “collecting] amounts due and owing from patient accounts receivable when those accounts go unpaid in whole or in part due to third-party payors’ denial or failure to pay, [such as] insurance companies, who refuse to reimburse part or all of an outstanding bill.” Amended Complaint (DE#28 at ¶ 7, 7/29/10); Answer and Affirmative Defenses of Defendant Essent Healthcare, Inc. (DE# 34 at ¶ 7, 8/17/09) (hereinafter “Answer”) (admitting ¶ 7 of the Amended Complaint). Essent Healthcare, Inc. (hereinafter “Essent” or “defendant”) “is engaged in the business of owning and managing hospitals.” Answer (DE# 34 at ¶ 5, 8/17/09). During the relevant time, the defendant “owned and operated the following five hospitals: Merriack Valley Hospital (Haverhill, MA), Nashoba Valley Medical Center (Ayer, MA), Paris Regional Medical Center (Paris, TX), Sharon Hospital (Sharon, CT), and Southwest Regional Medical Center (Waynesburg, PA).” Id. at ¶ 5.

On February 20, 2006, the plaintiff and the defendant entered into a three-year Professional Services Agreement (hereinafter “PSA”). 1 Under the PSA, the plaintiff agreed to provide certain services to the defendant including denial management services. 2 See PSA (DE# 152-1 at ¶ 3.1.1, 6/10/10). The defendant agreed to, inter alia, “transfer all accounts, regardless of services, with a balance greater than $100 that have been denied by a Third Party Payor, within 72 hours of receipt of a qualified ‘denial’ on the claim.” Id. at ¶ 6.1.1. The PSA further provided as follows:

EXCLUSIVE RIGHTS OF MCS. [The defendant’s engagement of [the plaintiff] to provide the “Services” is exclusive. During the Term of this Agreement, [the plaintiff] shall have the sole and exclusive right to perform the Services on behalf of [the defendant]. Accordingly, [the defendant] shall not, directly or indirectly, employ or engage any other person or entity to provide the Services, whether as an employee, consultant, independent contractor or on any other basis, with the exception of accounts that were assigned to other vendors prior to the effective date of this Agreement.

Id. at ¶ 8 (emphasis in original). The PSA permitted either party to terminate the agreement. However, in the event that the defendant terminated the agreement during the initial three years, the defendant was required to pay the plaintiff “a lump sum payment of $50,000 and associated software license fee[s] paid by [the plaintiff] to a third party.” Id. at ¶ 9.2.

“[0]n or about September 29, 2006, Steven Wylie, [ ] the Vice President of Financial Operations for Essent, provided MCS with written notice to terminate the PSA.” Answer (DE# 34 at ¶ 13, 8/17/09); see also Affidavit Steven Wylie (DE# 152-7 at ¶ 28, 6/10/10). On May 18, 2007, the plaintiff sought to recover from the defendant software licensing fees totaling $125,000. *1320 Affidavit Steven Wylie (DE# 152-7 at ¶ 34, 6/10/10). On January 18, 2008, the plaintiff advised the defendant that it owed the plaintiff $135,312.50 for software licensing fees under the PSA. Id. at ¶ 44. 3 At some point, the plaintiff accused the defendant of breaching additional provisions of the PSA including the exclusivity provision. On February 11, 2009, counsel for the defendant sent correspondence to counsel for the plaintiff outlining issues that had been previously discussed by the parties including the defendant’s alleged breach of the exclusivity provision. See Letter (DE# 181-1, 7/9/10). The parties were unable to resolve their disputes and litigation ensued.

On March 6, 2009, the plaintiff filed its Complaint seeking damages resulting from the defendant’s alleged breach of the PSA. See Complaint (DE# 1, 3/6/09). The Complaint asserted claims for breach of contract (Count I), breach of implied covenant of good faith and fair dealing (Count II) and sought an accounting (Count III). Id. The plaintiff filed an Amended Complaint (DE# 28) on July 29, 2009 pursuant to the Court’s Order requiring “an Amended Complaint with additional factual allegations in support of [the plaintiffs] request for common law accounting .... ” See Order (DE# 23, 7/13/09).

On or about September 18, 2009, the plaintiff propounded its First Request for Production on the defendant seeking certain documents from the defendant including:

Request No. 24: Copies of any and all contract(s) and or addendum(s) between Essent and Preferred Medical Marketing Company also known as PMMC pri- or [sic] from January 1, 2005 through June 30, 2009.
Request No. 25: Copies of any and all documentation and communication whether in paper or electronic including emails between Essent and PMMC and/or their agent/broker/contact person and/or sales-representative from January 1, 2005 through June 30, 2009.
Request No. 26: Copies of any and all eontraet(s) and or addendum(s) between Essent and National Healthcare Payer Network Company also known as NHPN prior [sic] from January 1, 2005 through June 30, 2009.
Request No. 27: Copies of any and all documentation and communication whether in paper or electronic including emails between Essent and NHPN and/or their agent/broker/contact person and/or sales-representative from January 1, 2005 through June 30, 2009.
Request No. 30: For all of Essent vendors working on collections and/or recovery of accounts receivable on January 1, 2005 through June 30, 2009:
a) Copies of all internal email communications between such vendors and Essent.
b) Copies of al internal email communications between Essent employees regarding such vendors.

See Defendant Essent Healthcare, Inc.’s Responses and Objections to Plaintiffs First Request for Production of Documents (DE# 152-3 at 14-17, 6/10/10) (emphasis added).

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Managed Care Solutions, Inc. v. Essent Healthcare, Inc., 736 F. Supp. 2d 1317, 2010 U.S. Dist. LEXIS 141872, 2010 WL 3368654 (S.D. Fla. 2010).

736 F. Supp. 2d 1317 (Managed Care Solutions, Inc. v. Essent Healthcare, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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