New York Medscan LLC v. New York University School of Medicine

430 F. Supp. 2d 140, 2006 U.S. Dist. LEXIS 25286, 2006 WL 1140720
CourtDistrict Court, S.D. New York
DecidedMay 1, 2006
Docket05 Civ. 4653(DC)
StatusPublished
Cited by8 cases

This text of 430 F. Supp. 2d 140 (New York Medscan LLC v. New York University School of Medicine) 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
New York Medscan LLC v. New York University School of Medicine, 430 F. Supp. 2d 140, 2006 U.S. Dist. LEXIS 25286, 2006 WL 1140720 (S.D.N.Y. 2006).

Opinion

OPINION

CHIN, District Judge.

Plaintiffs bring this suit claiming that defendants, providers and administrators of radiology services, violated the antitrust laws. Specifically, they bring this action pursuant to Sections 1 and 2 of the Sherman Act and Section 4 of the Clayton Act. 15 U.S.C. §§ 1, 2,15.

Defendants move pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure to dismiss the complaint for failure to state a claim upon which relief may be granted. For the reasons that follow, the motion is denied.

BACKGROUND

A. The Facts

For purposes of this motion, the facts alleged in the complaint are assumed to be true.

1. The Parties

Plaintiff Karolyn Kerr, M.D., is a radiologist, specializing in interpreting diagnostic imaging scans used to detect health conditions in the human body. Plaintiff New York Medscan, LLC (“Medscan”) provides diagnostic imaging services at its office at 751 Second Avenue in New York City. Medscan has invested millions of dollars in high-technology imaging scanners, other equipment, and non-medical staff to provide patients with state-of-the-art diagnostic imaging. (Compl. ¶¶ 3, 4, 20, 22).

Defendant New York University (“NYU”) School of Medicine is an administrative unit of the NYU Medical Center. (Compl. ¶ 15). Defendant Andrew W. Litt, M.D., is a professor at the NYU School of Medicine and a neuroradiologist with clinical responsibility at the NYU Medical Center and Bellevue Hospital. Litt also serves as vice-chairman of Financial Affairs of the NYU School of Medicine. (Compl. ¶¶ 13-14). Through his position at NYU, Litt obtains a direct financial benefit from providing diagnostic imaging services. Additionally, Litt is the chairman of former defendant CareCore National LLC (“CCN”). 1 Litt, in his capacity as a board member of CCN, has directly controlled and thereby eliminated competition with NYU radiologists. NYU and its radiologists, including Litt, are competitors of Dr. Kerr and have a personal stake in the unlawful acts alleged by plaintiffs. (Compl. ¶¶ 3-4,13-15).

2. The Provision of Diagnostic Imaging Scanning Services

The newest diagnostic imaging scanning, PET/CT imaging, integrates the technology of two diagnostic imaging techniques: Positron Emission Tomography (“PET”) and Computerized Axial Tomography (“CAT” or “CT”). PET/CT scanning, used for diagnoses in the area of oncology, provides the highest accuracy in detecting abnormal tumors and identifying whether tumors are malignant. Physicians refer patients for PET/CT scans, which are per *143 formed at equipped facilities such as the one operated by Medscan. Radiologists then interpret the scans for the referring physicians. PET/CT scans assist referring physicians in making better and more informed decisions in diagnosing and treating cancerous tumors. (Compl. ¶¶ 17-18, 21).

When an insured patient receives a PET/CT scan, the performing radiologist bills the patient’s health plan for the costs of administering the scan and the radiologist’s fee for interpreting the scan. The health plan will then pay most or all of these costs, either directly or through a contractual administrator such as CCN. (Compl. ¶ 21).

CCN describes itself as “the fastest growing radiology benefit management company in the county” and as “the nation’s leading diagnostic imaging management company.” CCN authorizes certain radiologists and facilities to provide diagnostic imaging services and facilities. CCN has entered into exclusive, long-term contracts with health benefit plans (“CCN Plans”), such as Aetna, Oxford, and HIP, to provide diagnostic imaging services to these plans’ subscribers. Under these contracts, patients who are members of CCN Plans must obtain PET/CT services only through CCN-approved providers and facilities to receive reimbursement from the CCN Plans. (Compl. ¶¶ 28-30).

CCN, through its exclusive contracts with CCN Plans, controls the PET/CT services for more than 22 million subscribers, including some 3.5 million subscribers in New York City. This represents a dominant share of both the patient market and the “covered lives” market in New York City. (Compl. ¶ 33). Thus, approval by CCN is necessary for a radiologist or scanning facility to effectively compete in the New York market. (Compl. ¶ 34). By determining which facilities and radiologists CCN will authorize to provide PET/CT services, CCN and its board members, who are radiologists competing with each other and with the radiologists and facilities they determine to authorize or refuse, effectively control the diagnostic imaging market. (Compl. ¶¶ 6, 30).

3. The NYU/Medscan Turnkey Agreement

Around March 1, 2002, Medscan entered into a “turnkey administrative services and license agreement” with the NYU School of Medicine (the “NYU Agreement”), signed by Litt on behalf of the NYU School of Medicine. The NYU Agreement obligated Medscan to provide office facilities, equipment, and services for NYU radiologists for a PET/CT outpatient diagnostic scanning practice at Medscan’s premises for a three-year period. Under the terms of the contract, NYU could provide PET/CT scans at locations owned or leased directly by NYU, but it could not enter into a similar turnkey arrangement with any other non-affiliated NYU entity at any location in Manhattan south of 57th Street, north of Canal Street, and east of 5th Avenue, with certain exceptions. NYU was to pay Medscan $1500 per scan for use of the office space, supplies, personnel, and equipment. Around this time, Medscan was approved as a CCN-facility, enabling it to provide PET/CT scans to patients who were subscribers of CCN Plans. Also around this time, NYU obtained approval for certain NYU radiologists to be approved as CCN providers. (Compl. ¶¶ 23, 36-40).

From July 21, 2002, Kerr was employed at Beth Israel Hospital in New York City and was a CCN-approved radiologist. In November 2004, Medscan entered into a practice management services agreement with Kerr (the “Kerr Agreement”) pursuant to which Medscan would provide Kerr *144 with office space, medical and non-medical equipment, and technicians and Kerr would read and interpret PET/CT scans taken at Medscan. The Kerr agreement was to commence at the conclusion of the NYU Agreement. Since Kerr was a CCN-approved provider and Medscan was a CCN-approved facility, plaintiffs expected services would continue to be pre-approved and paid for on behalf of the patients covered by CCN Plans. In December 2004, Kerr moved to Medscan and began reviewing scans with the knowledge and consent of Litt and NYU. (Compl. ¶¶ 42-43).

As the NYU Agreement approached its expiration, Medscan and NYU engaged in negotiations for the renewal of the NYU Agreement.

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Bluebook (online)
430 F. Supp. 2d 140, 2006 U.S. Dist. LEXIS 25286, 2006 WL 1140720, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-york-medscan-llc-v-new-york-university-school-of-medicine-nysd-2006.