THE DISCOVERY HOUSE v. ADVANCED DATA SYSTEMS RCM

CourtDistrict Court, D. New Jersey
DecidedNovember 25, 2020
Docket2:19-cv-21602
StatusUnknown

This text of THE DISCOVERY HOUSE v. ADVANCED DATA SYSTEMS RCM (THE DISCOVERY HOUSE v. ADVANCED DATA SYSTEMS RCM) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
THE DISCOVERY HOUSE v. ADVANCED DATA SYSTEMS RCM, (D.N.J. 2020).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

THE DISCOVERY HOUSE, Plaintiff, Civ. No. 19-21602 (KM) (JBC) v. OPINION ADVANCED DATA SYSTEMS RCM, INC., Defendants.

KEVIN MCNULTY, U.S.D.J.: This case arises from a contract between plaintiff The Discovery House (“TDH”) and defendant Advanced Data Systems RCM, Inc. (“ADSRCM”). TDH provides rehabilitation for substance and alcohol abuse patients. It hired ADSRCM to prepare, process, and file certain reimbursement claims TDH submits to commercial and government payers for services provided to its patients. TDH now alleges that ADSRCM committed a series of errors while carrying out its processing obligations, errors which caused over $4 million in alleged damages, nearly bankrupting TDH. The contract between the parties, however, contains a clause which grants an arbitrator exclusive jurisdiction over claims arising out of or in connection with their contract. I find that the provision applies here and requires that TDH’s claims be arbitrated. As discussed below, I am not convinced by TDH’s various arguments which aim to invalidate or avoid the arbitration clause. For the reasons expressed herein, ADSRCM’s motion to compel arbitration and stay this action (DE 6-1) is granted. I. BACKGROUND A. The Purchase and Service Agreements1 TDH is a California LLC which provides rehabilitation for substance and alcohol abuse patients. (Compl. ¶ 2.) ADSRCM is a New Jersey LLC which provides healthcare software solutions. (Id. ¶ 3.) On July 13, 2018, the parties entered a contract comprising two interlinked agreements. (Id. ¶ 6.)2 The first agreement was a two-page document which set out ADSRCM’s pricing terms (the “Purchase Agreement”). (Compl. Exh. A.) The Purchase Agreement explains that ADSRCM anticipated $14 million in TDH collectables, on which it would apply a minimum service fee of $40,000 or 6% of collectables, whichever was higher. (Id.) It also set forth certain monthly subscription fees and a one-time setup fee of $500. (Id.) The second page very briefly described certain steps TDH would need to take in order to work with ADSRCM, such as that it would have to scan insurance cards and “[p]romptly repl[y] to assigned asks.” (Id.) In the middle of the first page of the Purchase Agreement, immediately beneath the “Total Due At Contract” line which set forth how much TDH was required to pay at signing, and in slightly smaller font than the rest of the agreement,3 is a sentence which reads as follows: “By signing this proposal

1 For ease of reference, certain key items from the record will be abbreviated as follows: Compl. = TDH’s Complaint (DE 1) MTA = ADSRCM’s Motion to Compel Arbitration and Stay Proceedings Pending Arbitration (DE 6-1) Opp. = TDH’s Opposition (DE 13) Reply = ADSRCM’s Reply (DE 15) 2 On this motion to dismiss, I presume TDH’s allegations are true except to the extent they are merely legal conclusions. N.J. Carpenters & the Trs. Thereof v. Tishman Const. Corp. of N.J., 760 F.3d 297, 302 (3d Cir. 2014). 3 The font appears to be one size smaller than the bulk of the other writing in the agreement. It is the same size, and in the same location, as the provision that sets the minimum service fee. (Id.) Client accepts the Advanced Data Systems RCM MedicsRCM Service Agreement located at: http://pubftp.adsrcm.com/medicsRCM.serviceagreementv12pdf.” (Id.) That link led to the second agreement (the “Service Agreement”). The Service Agreement is a five-page document which sets forth the parties’ duties in considerable detail. It provides that ADSRCM will process and submit TDH’s claims to the commercial and government payers, and lists twelve transaction types which ADSRCM agrees to process. (Compl. Exh. B ¶ 1.) It details TDH’s obligations in a similar manner. (Id.¶ 2.) It further describes numerous cost- based fees which ADSRCM intended to submit on its monthly invoice, and details the method by which ADSRCM would bill TDH for its work. (Id. ¶ 4.) At the bottom of the Service Agreement is an arbitration clause: Arbitration: Customer and ADSRCM understand and agree that their sole and exclusive remedy for any claims that each may have against the other arising under or in connection with this agreement, other than Paragraph 15 / Liquidated damages, shall be determined by arbitration with ADR Options, Inc., Two Commerce Square, Suite 1100, Market Street, Philadelphia, Pennsylvania 19103-7044, having exclusive jurisdiction over such claims. It is further agreed by the parties that any hearing before ADR Options shall take place in the State of New Jersey. It is further agreed by customer that each Party should bear their own costs of Arbitration. (Id. ¶ 24.) B. Negotiations, and a Breakdown in the Reimbursement Process The parties negotiated the agreements for approximately a one-and-a- half months, beginning in June 2018 and ending on July 13, 2018. (Compl. ¶ 8.) TDH was represented in the negotiations by one of its principals, McKay Whiting. (Id.) ADSRCM told Ms. Whiting that it would be able to deliver healthcare software solutions which would maximize TDH’s reimbursements and optimize its productivity. (Id.) ADSRCM conducted a presentation for TDH on July 2, 2018 which outlined its services and TDH’s expected benefit from the contract. (Id. ¶ 9.) Ms. Whiting was convinced and signed the agreement. (Id.) Soon after entering the contract, TDH began to experience a significant drop off in reimbursements for claims submitted to the payers, and, at one point, the reimbursements stopped altogether. (Id.) TDH hired a third-party billing company to review ADSRCM’s submissions, and the third party concluded that ADSRCM had committed a variety of mistakes which caused a massive reimbursement bottleneck. (Id. ¶ 11.) TDH claims it was nearly bankrupted by the errors. (Id. ¶ 12.) C. Alleged Fraud TDH admits that it freely entered the Purchase Agreement. It claims, however, that it entered into the Service Agreement (which contains the agreement to arbitrate) as a result of fraud on the part of ADSRCM. According to TDH, ADSRCM fraudulently induced TDH to enter into the agreement by making the text of the link to the Service Agreement smaller than much of the other text in the agreement, thus preventing Ms. Whiting from seeing the link and realizing that she was committing to the provisions in the linked Service Agreement. (Id. ¶ 14.) TDH further alleges that ADSRCM never discussed the terms set forth in the Service Agreement during negotiations and that ADH never would have assented to the statute of limitations or arbitration provisions in the Service Agreement if ADSRCM had not concealed them. (Id. ¶¶ 14–16.) Finally, TDH alleges that because the arbitration provision in the Service Agreement did not clearly state that TDH was waiving its right to a jury trial, it is invalid. (Id. ¶ 17.) D. Procedural History TDH filed its complaint on December 19, 2019, asserting fraudulent misrepresentation, breach of contract, breach of the implied covenant of good faith and faith dealing, negligent misrepresentation, and violations of the New Jersey Consumer Fraud Act. (Compl. ¶¶ 18–42.) It alleges that ADSRCM committed misrepresentations by failing to mention the arbitration clause during negotiations, “hiding” the link to the Service Agreement in the body of the Agreement, and overstating its ability to offer superior healthcare processing solutions. (Id. ¶ 19.) ADSRCM filed a motion to compel arbitration and stay the complaint pending arbitration, (DE 6-1), which TDH opposed, (DE 13), and ADSRCM filed a reply, (DE 15.) II. STANDARDS OF REVIEW A. Motions to Compel Arbitration The Federal Arbitration Act, 9 U.S.C. §§ 1 et seq.

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THE DISCOVERY HOUSE v. ADVANCED DATA SYSTEMS RCM, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-discovery-house-v-advanced-data-systems-rcm-njd-2020.