Nayal v. HIP Network Services IPA, Inc.

620 F. Supp. 2d 566, 2009 U.S. Dist. LEXIS 50203, 2009 WL 1560187
CourtDistrict Court, S.D. New York
DecidedMay 28, 2009
Docket08 Civ. 10170
StatusPublished
Cited by47 cases

This text of 620 F. Supp. 2d 566 (Nayal v. HIP Network Services IPA, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nayal v. HIP Network Services IPA, Inc., 620 F. Supp. 2d 566, 2009 U.S. Dist. LEXIS 50203, 2009 WL 1560187 (S.D.N.Y. 2009).

Opinion

DECISION AND ORDER

VICTOR MARRERO, District Judge. ■

Plaintiff Dr. Christine Nayal (“Nayal”) brought this class action on behalf of herself and all others similarly-situated against defendant HIP Network Services IPA, Inc. (“HIP”), asserting claims of breach of contract, unjust enrichment, and violation of New York General Business Law § 349 (“§ 349”). HIP filed a motion to compel arbitration of Nayal’s claims pursuant to the Federal Arbitration Act (“FAA”), 9 U.S.C. §§ 2-4, or, in the alternative, to dismiss Nayal’s claims pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure (“Rule 12(b)(6)”).

For the reasons discussed below, HIP’s motion to compel arbitration is GRANTED with respect to all claims, and the Court therefore does not consider HIP’s Rule 12(b)(6) motion.

I. BACKGROUND 1

On May 31, 2007, Nayal, a practicing psychologist and medical healthcare provider, signed an agreement with HIP, a health maintenance organization (“HMO”), effective November 1, 2007. (See Declaration of Victoria P. Lane, dated March 16, 2009, Ex B. (Agreement Between HIP Network Services IPA, Inc. and Participating Practitioner (the “Agreement”)).) 2 The Agreement allows for Nayal to provide covered services to members of various government and commercial health plans, and for Nayal to submit claims for reimbursement for her costs of providing those covered services.

The Agreement contains an arbitration clause (the “Arbitration Provision”), which provides:

Arbitration. If any dispute between the parties arises out of or relates to this Agreement, and Practitioner has exhausted all internal appeals and grievance procedures provided in the Provider Manual and the parties cannot settle such dispute by good faith negotiation within thirty (30) business days, and the dispute concerns an amount less than $750,000 the parties agree that the dispute shall be resolved through binding arbitration ... which shall be conducted in New York, New York in accordance with the American Health Lawyers Association (AHLA) Alternative Dispute Resolution Service Rules of Procedure for Arbitration....

(Agreement at 25.) In addition, the Agreement provides that it “shall be governed by and construed under the laws of the State of New York without giving effect to the conflict of laws principles thereof.” (Id. at 24.)

In the Complaint, Nayal alleges that on April 17, 2008 she mailed claims to HIP *569 for services rendered on March 31, 2008 and April 7, 2008 for a total of $130, but that HIP denied payment for the April 7, 2008 claims. Nayal further alleges that she contacted HIP on multiple occasions and that she was twice instructed to resubmit the unpaid claims. Nayal alleges that, after several more unsuccessful attempts to contact HIP, she was first compensated for the April 7, 2008 claims in late July, when HIP sent “some of the money it owed”; however, Nayal did not receive interest, explanation for the late payment, and the payment she did receive was below her rates. 3 (Complaint ¶ 26.) Nayal concludes that HIP: (1) breached the Agreement by failing to have personnel available to address her concerns, failing to reimburse her claims in a timely manner, failing to reimburse her claims at an appropriate rate, and failing to pay interest for overdue payments; (2) was unjustly enriched because it did not make payments in a timely manner and did not pay interest for overdue payments; and (3) violated § 349 by engaging in deceptive acts and practices, resulting in the denial of payments to Nayal, who spent significant time and resources in an effort to obtain those payments.

HIP now moves the Court to compel arbitration on each of these claims pursuant to the Arbitration Provision. Nayal opposes the motion, arguing that the Arbitration Provision is unconscionable, and therefore unenforceable.

II. DISCUSSION

A. LEGAL STANDARD

“The FAA creates a ‘body of federal substantive law of arbitrability, applicable to any arbitration agreement within the coverage of the [FAA].’ ” Mehler v. Terminix Int’l Co. L.P., 205 F.3d 44, 47 (2d Cir.2000) (quoting Moses H. Cone Mem. Hosp. v. Mercury Constr. Corp., 460 U.S. 1, 24, 103 S.Ct. 927, 74 L.Ed.2d 765 (1983)). “The FAA is an expression of ‘a strong federal policy favoring arbitration as an alternative means of dispute resolution.’ ” Ross v. American Exp. Co., 547 F.3d 137, 142 (2d Cir.2008) (quoting Hartford Accident & Indem. Co. v. Swiss Reinsurance Am. Corp., 246 F.3d 219, 226 (2d Cir.2001)). Indeed, “it is difficult to overstate the strong federal policy in favor of arbitration, and it is a policy [the Second Circuit has] often and emphatically applied.” Arciniaga v. General Motors Corp., 460 F.3d 231, 234 (2d Cir.2006) (internal quotation marks omitted). That said, a party may be compelled to arbitrate a dispute only to the extent he or she has agreed to do so. See Bell v. Cendant Corp., 293 F.3d 563, 566-67 (2d Cir.2002).

Under the FAA, “[a] written provision in any ... contract evidencing a transaction involving commerce to settle by arbitration a controversy thereafter arising out of such contract or transaction ... shall be valid, irrevocable, and enforceable, save upon such grounds as exist at law or in equity for the revocation of any contract.” 9 U.S.C. § 2. The FAA provides the Court with the authority to compel arbitration if the parties have entered into an agreement to arbitrate and one party refuses to honor that agreement. See id. § 4.

In deciding whether an action should be sent to arbitration, the Court must conduct the following inquiry:

*570 [F]irst, it must determine whether the parties agreed to arbitrate; second, it must determine the scope of that agreement; third, if federal statutory claims are asserted, it must consider whether Congress intended those claims to be nonarbitrable; and fourth, if the court concludes that some, but not all, of the claims in the case are arbitrable, it must then decide whether to stay the balance of the proceedings pending arbitration.

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620 F. Supp. 2d 566, 2009 U.S. Dist. LEXIS 50203, 2009 WL 1560187, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nayal-v-hip-network-services-ipa-inc-nysd-2009.