Scroggins v. Andalusia Regional Hospital

CourtDistrict Court, M.D. Alabama
DecidedMarch 6, 2020
Docket2:16-cv-00338
StatusUnknown

This text of Scroggins v. Andalusia Regional Hospital (Scroggins v. Andalusia Regional Hospital) is published on Counsel Stack Legal Research, covering District Court, M.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Scroggins v. Andalusia Regional Hospital, (M.D. Ala. 2020).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF ALABAMA NORTHERN DIVISION

MARILYN R. SCROGGINS, ) ) Plaintiff, ) ) v. ) CASE NO. 2:16-cv-338-ALB ) LIFEPOINT HEALTH, INC., et al, ) ) Defendants. ) MEMORANDUM OPINION AND ORDER This is a contract dispute between Plaintiff Marilyn R. Scroggins (“Scroggins”) and several corporations associated with Andalusia Regional Hospital (the “hospital”)1 in Andalusia, Alabama, where Scroggins received medical treatment following a car accident. After Scroggins received a settlement from the tortfeasor, the hospital sought to collect from the settlement. Scroggins believes the hospital should have billed her health insurance company instead. Rather than sue the hospital, however, she sued parent companies in the hospital’s corporate hierarchy. This matter comes to the Court on numerous motions to dismiss the operative complaint. After extensive briefing and oral argument, the Court concludes that these motions are due to be GRANTED.

1 In the Second Amended Complaint, Scroggins refers to the treating hospital as “Community Hospital of Andalusia, LLC.” (Doc. 47 ¶ 3). The LifePoint Defendants refer to the hospital as “Andalusia Regional Hospital.” (Doc. 102 at 1). PARTIES The operative pleading in this case is the Second Amended Complaint (the

“Complaint”) (Doc. 47). The following motions are pending before this Court: - Defendant Medical Reimbursements of America, Inc.’s (“MRA”) Motion to Dismiss, (Doc. 96); - Defendants Parallon Business Solutions, LLC (“Parallon”) and HSS Systems, LLC’s (“HSS”) Motion to Dismiss. (Doc. 99). - Defendant LifePoint Health, Inc., f/k/a LifePoint Hospitals, Inc.’s (“LHI”) Motion to Dismiss. (Doc. 101). - Defendants LifePoint Holdings 2, LLC (“LifePoint 2”), LifePoint Hospitals Holdings, LLC (“LifePoint Hospitals Holdings”), Historic LifePoint Hospitals, LLC (“Historic LifePoint Hospitals”), HSCGP, LLC, and Shared Business Services, LLC a/k/a LifePoint Health Business Services’ (“Shared Business Services”) Motion to Dismiss. (Doc. 103). - Defendant LifePoint Corporate Services, General Partnership’s (“LifePoint Corporate Services”) Motion to Dismiss. (Doc. 105). - Scroggins’s Motion for Leave to File Surreply in Opposition to Defendants’ Motions to Dismiss. (Doc 138). - Defendants’ Motion for Leave to File Replies to Scroggins’s Supplemental Memorandum in Opposition to Defendants’ Motions to Dismiss. (Doc. 151).

The following Defendants are collectively referred to as “LifePoint Defendants”:

- LHI - LifePoint 2 - LifePoint Hospitals Holdings - Historic LifePoint Hospitals - LifePoint Corporate Services - Shared Business Services - HSCGP, LLC

The following Defendants are collectively referred to as “Billing Defendants”: - Parallon2 - HSS - MRA Scroggins did not name the hospital as a party to this action. However, Scroggins acknowledges that her claims against all other named parties flow exclusively through the services she received at the hospital, including billing issues

under a contract to which the hospital is a party. Apart from those services provided by the hospital and its contract, she had no other contact, claim, or cause of action with any other named party to this action. Accordingly, it is ORDERED pursuant to Rule 19(a)(2), Fed. R. Civ. P., that Andalusia Regional Hospital be and is made a

party to this action. BACKGROUND The relevant facts for the purposes of these motions to dismiss have been

outlined by a prior Memorandum Opinion and Order of this Court. (Doc. 26 at 5– 10). The specific factual allegations at issue here are taken from the operative complaint and are assumed to be true for the purposes of this opinion.

Scroggins received treatment at the hospital for injuries she sustained in an automobile accident on May 19, 2015. At the time of her treatment, Scroggins was covered by a health insurance policy issued by United Healthcare Insurance (the

2 Plaintiff concedes lack of personal jurisdiction over Parallon. (Doc. 132 ¶ 1). Accordingly, Parallon is dismissed in this order. “insurer”). LifePoint is a healthcare company that owns or operates hospitals in twenty-two states, including hospitals in the State of Alabama such as Andalusia

Regional Hospital. (Doc. 47 at ¶ 14). Scroggins alleged “LifePoint has created a maze of numerous entities that are affiliated with the ownership, management, operation, and control of its hospitals, all of these affiliated entities are ultimately

owned, directly or indirectly, by LifePoint, and the profits from these entities flow through them to LifePoint.” Id. at ¶ 15. Scroggins further alleged that she is a third- party beneficiary of the contract between the hospital and her health insurance company, which the defendants breached:

[P]ursuant to the terms of the managed-care contracts negotiated by LifePoint Corporate Services, LifePoint-affiliated hospitals are required to submit their insured patients’ bills to their respective health insurance carriers; accept the health insurers’ contractually agreed- upon discounted payment as full payment for the bills, to the extent the patient does not owe a co-pay or deductible; and hold the patients harmless for any charges that exceed the patients’ financial responsibility under their respective managed-care plans. Id. at ¶ 23. The crux of the Second Amended Complaint is Scroggins’s allegation that the hospital should have billed her insurance for the treatment she received: Through their billing and bill-collection practices, the [LifePoint] Defendants attempt to maximize the amounts collected by [the Billing] Defendants for covered services by seeking from patients with health insurance, when sources of payment other than health insurance are available, the full amount of the hospitals’ charges (which is more than the hospitals are entitled to receive for the covered services), rather than accepting the discounted amount the hospitals have contractually agreed to accept as full payment, except for copays and deductibles, from the patients’ health insurance carriers. Doc. 47 at ¶ 34. Scroggins alleged the following counts: - Count I – Intentional Interference with Contractual Relations against all Defendants.3 - Count II – Breach of Contract as a third-party beneficiary against the LifePoint Defendants. - Count III – Unjust Enrichment against all Defendants. - Count IV – Declaratory Judgment against Billing Defendants.4 - Count V – Civil Conspiracy against all Defendants.5

STANDARD When evaluating a motion to dismiss, the court assumes the factual allegations are true and construes them in the light most favorable to the plaintiff. Hishon v. King & Spalding, 467 U.S. 69, 73 (1984); Duke v. Cleland, 5 F.3d 1399, 1402 (11th Cir. 1993). “To avoid dismissal the complaint must contain sufficient factual matter … to state a claim to relief that is plausible on its face.” Gates v. Khokhar, 884 F.3d 1290, 1296 (11th Cir. 2018) (quoting Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009)) (internal quotation marks omitted). Whether a complaint is plausible depends on whether “it contains sufficient facts to support a reasonable inference that the

defendant is liable for the misconduct alleged.” Id.

3 Scroggins has stipulated to the dismissal of Count I as to the LifePoint Defendants. (Doc. 163 ¶ 1). 4 Scroggins has stipulated to the dismissal of Count IV. (Doc. 163 ¶ 2). 5 Scroggins has stipulated to the dismissal of Count V as to the LifePoint Defendants. (Doc. 163 ¶ 3). DISCUSSION Defendants have filed multiple motions to dismiss that raise dozens of

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