Premera Et Ano, V. Everett Clinic Et Ano

Court of Appeals of Washington·Decided August 16, 2021·No. 81684-5·Unpublished

Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

THE EVERETT CLINIC, PLLC, a No. 81684-5-I Washington limited liability company, DIVISION ONE

Respondent,

UNPUBLISHED OPINION

v.

PREMERA, a Washington corporation, and PREMERAFIRST, INC., a Washington corporation,

Appellants.

PREMERA, a Washington corporation, and PREMERAFIRST, INC., a Washington corporation,

Appellants,

v.

THE EVERETT CLINIC, PLLC; EASTSIDE FAMILY MEDICINE CLINIC, P.S.,

Respondents.

APPELWICK, J. — Premera appeals from orders granting defendants EFMC’s and TEC’s CR 12(b)(6) motions to dismiss. It asserts the trial court erred in dismissing its complaint for breach of contract requesting declaratory relief. It further asserts the trial court erred in awarding attorney fees and costs. We

Citations and pin cites are based on the Westlaw online version of the cited material.

reverse the dismissal of Case II, vacate the award of attorney fees, and remand for further proceedings consistent with this opinion.

FACTS

The dispute at issue involves four parties and three agreements. Premera and its affiliate, PremeraFirst, Inc., (collectively “Premera”), provide health care coverage and related services in Washington. Premera negotiates contracts with health care providers to provide services to its health plan enrollees. The Everett Clinic, PLLC (TEC) is a physician group operating multiple sites in Snohomish and King Counties. TEC and Premera entered into an agreement under which TEC provides services to Premera enrollees and Premera reimburses TEC at agreed upon rates (TEC Agreement).

Premera also had an agreement (EFMC Agreement) with a single site group practice, Eastside Family Medicine Clinic, PC (EFMC). Premera reimbursed TEC under the TEC Agreement at a higher rate than it reimbursed EFMC under the EFMC Agreement.

In December 2018, TEC purchased certain assets from EFMC (TEC-EFMC Asset Sale Agreement), including its medical clinic site lease (Bellevue clinic). TEC also hired physicians and other employees of EFMC.

After the asset sale, TEC and Premera disagreed over the rate that Premera was required to reimburse TEC for Bellevue clinic services: the TEC Agreement rate or the EFMC Agreement rate.

A. Case I: TEC Complaint In September 2019, TEC filed a complaint against Premera for breach of the TEC Agreement (Case I). It did not include EFMC as a defendant. It sought declaratory relief to enforce the terms of the TEC Agreement for services provided at the Bellevue clinic.

In its answer, Premera asserted four counterclaims: (1) breach of the TEC Agreement by TEC, (2) breach of the EFMC Agreement by EFMC, (3) tortious interference with the EFMC Agreement by TEC and the doctors who previously owned EFMC (Doctors), and (4) violation of Washington’s Consumer Protection Act, RCW 19.86.020, against TEC. As an affirmative defense, it asserted that TEC is bound by the EFMC Agreement under the successor liability doctrine. It did not assert its second counterclaim against TEC, the opposing party to its suit.

EFMC filed a motion to dismiss Premera’s claims against EFMC and the Doctors. EFMC argued the Doctors could not have tortiously interfered with their own contract. It further argued that the breach of contract counterclaim against EFMC should have been pleaded as a counterclaim against an opposing party and EFMC should have been added as a third party to that counterclaim. The trial court granted its motion. It dismissed the breach of contract claim against EFMC, dismissing EFMC from the case, without prejudice. It dismissed the Doctors with prejudice.

Before the counterclaims were dismissed, Premera moved to amend its complaints twice. Its first motion to amend sought to add TEC and the Doctors to its counterclaim against EFMC for breach of the EFMC contract. The trial court

denied the motion without prejudice. Its second motion sought to add a claim against TEC for breach of the EFMC Agreement. The trial court denied the second motion and awarded TEC its attorney fees and costs associated with the motion.

B. Case II: Premera Complaint Premera subsequently initiated a separate suit against EFMC for breach of the EFMC Agreement and TEC for breach of the EFMC and TEC Agreements under a successor liability theory (Case II). It alleged that pursuant to the TEC- EFMC Asset Sale Agreement, TEC acquired EFMC’s business operations and those operations continued largely the same as before the transaction. It argued the Asset Sales Agreement was a de facto merger or consolidation and that the current Bellevue clinic is a mere continuation of EFMC. Further, it argued the parties structured TEC’s acquisition of EFMC as a transfer of assets, rather than as a merger, for the fraudulent purpose of escaping EFMC’s contractual obligations to Premera.

The complaint sought a declaratory judgment that “the EFMC Agreement continues in full force and effect” and “TEC has breached the TEC Agreement and the EFMC Agreement.”

Premera moved to consolidate the two cases. The trial court consolidated the two lawsuits, but the cases retained their separate identities. TEC then moved to dismiss Premera’s claims in Case II, enforce the trial court’s prior orders in Case I, and for sanctions. EFMC also moved to dismiss Premera’s claims in Case II. The trial court granted their motions. TEC moved for an award of its attorney fees

and costs incurred in Case II. The trial court granted the motion, awarding TEC’s requested fees and costs, finding Premera initiated the lawsuit in bad faith.

Premera appeals.

DISCUSSION

Premera asserts that the trial court erred in granting the defendants’ CR 12(b)(6) motions to dismiss. It argues the court further erred in awarding TEC attorney fees.

I. Motion to Dismiss A trial court's ruling on a motion to dismiss for failure to state a claim upon which relief can be granted under CR 12(b)(6) is a question of law and is reviewed de novo by an appellate court. Cutler v. Phillips Petroleum Co., 124 Wn.2d 749, 755, 881 P.2d 216 (1994). Courts should dismiss a claim under CR 12(b)(6) only if it appears beyond a reasonable doubt that no facts exist that would justify recovery. Id. In making this determination, a court must consider hypothetical facts proffered by the plaintiff. Gorman v. Garlock, Inc., 155 Wn.2d 198, 214, 118 P.3d 311 (2005). “[A]ny hypothetical situation conceivably raised by the complaint defeats a CR 12(b)(6) motion if it is legally sufficient to support [the] plaintiff's claim.” Id. (first alteration in original) (quoting Bravo v. Dolsen Cos., 125 Wn.2d 745, 750, 888 P.2d 147 (1995)).

Premera’s complaint sought to resolve the rights of the parties under the three agreements. It requested a declaration that the EFMC Agreement was “in full force and effect.” It also sought a declaration that “TEC has breached the TEC Agreement and the EFMC Agreement.” TEC and EFMC disagree with Premera

over whether the TEC Agreement or the EFMC Agreement governs the reimbursement rate for services provided at the Bellevue clinic. This may depend upon whether the existence or contents of the TEC-EFMC Asset Sales Agreement means that TEC is a successor to EFMC.

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