Medical Benefits Admin. v. Nivano Physicians CA3

CourtCalifornia Court of Appeal
DecidedDecember 23, 2021
DocketC091841
StatusUnpublished

This text of Medical Benefits Admin. v. Nivano Physicians CA3 (Medical Benefits Admin. v. Nivano Physicians CA3) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Medical Benefits Admin. v. Nivano Physicians CA3, (Cal. Ct. App. 2021).

Opinion

Filed 12/23/21 Medical Benefits Admin. v. Nivano Physicians CA3 NOT TO BE PUBLISHED California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA THIRD APPELLATE DISTRICT (Nevada) ----

MEDICAL BENEFITS ADMINISTRATION, INC. et C091841 al., (Super. Ct. No. CU17082413) Plaintiffs and Appellants,

v.

NIVANO PHYSICIANS, INC.,

Defendant and Appellant.

Defendant and appellant Nivano Physicians, Inc. (Nivano) appeals from the trial court’s decision to enforce a settlement agreement between Nivano and plaintiffs and respondents Medical Benefits Administration, Inc., and its founder and president Keely L. Smith (collectively MBA). On appeal, Nivano contends the trial court erred when it enforced the settlement agreement despite assuming it to be illegal. We agree with Nivano, and therefore reverse the judgment. Based on that holding, we need not and do not reach other claims raised by Nivano, nor do we reach MBA’s cross-claim.

1 FACTS AND PROCEEDINGS MBA provided professional billing and management services for physicians and physician groups. Nivano, an independent practice association, contracted with MBA to provide administrative and management services.1 Under this agreement, Smith, who was the founder and president of MBA, served as Nivano’s chief executive officer (CEO), a role she held until October 2016. LuminX Agreement In 2004, MBA purchased the right to use a piece of healthcare software known as LuminX from Acclamation Systems, Inc., which in turn was purchased by Ebix, Inc. (Ebix) in or around 2010. MBA used LuminX to perform a number of essential functions for Nivano’s operations. MBA paid Ebix $237,415 for the right to use LuminX, and further agreed to pay Ebix a monthly “maintenance fee” in connection with MBA’s continued use of the software. The agreement to purchase the right to use LuminX (LuminX agreement) authorized MBA to use LuminX for “its internal business purposes but not for the internal purposes of third parties or on any timesharing, renting, or service bureau basis.” The LuminX agreement specifically prohibited and made “void” any efforts by MBA to sublicense or otherwise profit from Ebix’s property. It provided: “Licensee [MBA] acknowledges that the Software (including all methods, concepts or techniques utilized therein) and its related documentation are commercially valuable to [Ebix] and/or its suppliers and are treated as confidential, proprietary and containing of trade secrets. Except for the rights expressly granted to Licensee [MBA] hereunder, no right in or title to the Software, or any intellectual property rights therein or associated therewith, shall be deemed to have been vested in or transferred to Licensee [MBA] under the terms of

1 Nivano was known as Sierra Nevada Medical Associates, Inc. until 2017.

2 the Agreement. All title to and ownership of the Software, and the intellectual property rights therein or associated therewith, remain with [Ebix] and its suppliers. Subject to the terms protecting Confidential Information, Licensee [MBA] acknowledges that [Ebix] may use any ideas, concepts, modifications and information arising out of the Services and relating to [Ebix] Software in the development and distribution of new products, enhancements or applications.” The agreement defined “ ‘Software’ ” to refer to any “software application or suite of applications licensed and delivered to Licensee [MBA] hereunder, including any New Release or custom development software, which may be delivered to Licensee [MBA] either with the initial delivery of the Software or at any time thereafter.” The LuminX agreement covered MBA’s use of LuminX when MBA was administering and managing Nivano; MBA had the right to assign access to the LuminX software to up to 25 users. MBA’s in-house programmers worked with Ebix personnel to customize the base software package to suit Nivano’s specific business needs. Smith acknowledged that the “customizations” or “modules” provided by MBA did not enhance, change, or involve the LuminX software itself, while Nivano acknowledged that LuminX would not be able to function as required to suit Nivano’s needs without MBA’s additions to the base software. Licensing Agreement In 2015 and 2016, Nivano converted the MBA employees responsible for performing professional services for Nivano to Nivano employees. This change did not affect the services being delivered. However, Nivano began to pay Ebix directly (rather than through MBA) for the monthly maintenance fees associated with Nivano’s use of the base LuminX software package. Neither Ebix nor Nivano raised any concerns with this change. Nivano employees worked directly with Ebix to resolve technical issues.

3 Smith remained Nivano’s CEO until October 2016, when she was replaced by Dr. Venu Kondle, who was a Nivano shareholder and was not affiliated with MBA. According to Nivano, around this time, MBA reiterated to Nivano that MBA created, developed, and owned LuminX, and that Nivano would need to contract with MBA if it wanted to continue using LuminX. MBA, on the other hand, contends that Nivano simply realized that MBA might decide to refuse to allow it to continue using LuminX. Under either version, due to the costs associated with moving to a different software and hardware platform, and in order to protect Nivano’s ability to continue using the LuminX software, Kondle insisted that Nivano contract with MBA such that Nivano would pay MBA monthly fees in exchange for continued delivery of services. MBA did not inform Kondle or anyone else at Nivano that MBA neither created nor owned LuminX. At all times, LuminX was created and owned by Ebix. Nivano’s counsel prepared and presented to MBA a “Software and Hardware Licensing Agreement” (licensing agreement) regarding LuminX.2 MBA did not draft the text of the agreements, but both MBA and Nivano reviewed and revised the licensing agreement until they agreed on a version to execute. On February 16, 2017, while the parties were negotiating the licensing agreement, Nivano employee Jami Lopez e-mailed Ebix regarding a possible update to the LuminX program. Mark Brown, Ebix’s vice-president, responded that Ebix’s contract was with MBA, and he wanted to gain a better understanding of Nivano’s use of LuminX. Lopez e-mailed David Scribner, Nivano’s general counsel: “I reached out to Ebix (they own Luminex- our current product) in regards to system upgrades, etc. [¶] I spoke to the

2 Nivano’s counsel also prepared an independent contractor agreement for Smith in her individual capacity, which recognized that Smith “desire[d] to contract with [Nivano] to provide insight on project development, contracting, network expansion and membership growth”; the independent contractor agreement provided that Smith was to be paid $10,000 per month for her services.

4 rep[resentative], Mark Brown, this morning and he was very confused as he had never heard of [Nivano] . . . . I am concerned that there is a potential problem given that [MBA] is the owner of the license and he made a remark in regards to leasing agreements in reference to [MBA’s] contract. With MBA no longer involved, I do not know what the legal implications are. [¶] I wanted this on your radar immediately.” Scribner forwarded the e-mail chain to another Nivano employee, recognizing that Nivano “will need all LuminX licensing paperwork” in MBA’s possession to determine if there was any “exposure” to Nivano.

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Medical Benefits Admin. v. Nivano Physicians CA3, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medical-benefits-admin-v-nivano-physicians-ca3-calctapp-2021.