THE ESTATE OF LESTER COTTON v. SENIOR PLANNING SERVICES, LLC

CourtDistrict Court, D. New Jersey
DecidedNovember 30, 2020
Docket3:19-cv-08921
StatusUnknown

This text of THE ESTATE OF LESTER COTTON v. SENIOR PLANNING SERVICES, LLC (THE ESTATE OF LESTER COTTON v. SENIOR PLANNING SERVICES, LLC) 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 ESTATE OF LESTER COTTON v. SENIOR PLANNING SERVICES, LLC, (D.N.J. 2020).

Opinion

*NOT FOR PUBLICATION*

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY ____________________________________ : THE ESTATE OF LESTER COTTON, et al. : : Civil Action No.: 19-8921 (FLW) Plaintiffs, : : OPINION vs. : : SENIOR PLANNING SERVICES, LLC and : PRICE & PRICE LLC, : : Defendants. : ____________________________________ : WOLFSON, Chief Judge: Presently before the Court are motions by defendants Senior Planning Services, LLC (“SPS” or the “Company”) and Price & Price, LLC (“Price”) (collectively, “Defendants”) to dismiss this putative class action filed by plaintiffs the Estate of Lester Cotton and Jennifer Cotton (the “Cotton Plaintiffs”), and the Estate of Raymond J. Wojna, Sr., Raymond J. Wojna, Jr., David Wojna, and Helen B. Wojna (the “Wojna Plaintiffs”) (Wojna Plaintiffs and Cotton Plaintiffs collectively, “Plaintiffs”). In this matter, Plaintiffs, former clients of SPS, assert claims of consumer fraud and breach of fiduciary duty, against SPS alleging, inter alia, that the Company provided illegal Medicaid application assistance services to Plaintiffs. Furthermore, Plaintiffs allege that those services constitute the unauthorized practice of law and that SPS partnered with Price, a law firm, in order to camouflage SPS’s provision of illicit legal advice. Plaintiffs assert breach of the implied of good faith and fair dealing, and unjust enrichment claims against both Defendants. Defendants have separately moved to dismiss Plaintiffs’ Complaint for failure to state a claim, and to strike Plaintiffs’ class action allegations and other purportedly immaterial and prejudicial information from the Complaint. For the reasons set forth below, SPS’s motion is GRANTED IN PART AND DENIED IN PART and Price’s Motion is DENIED. SPS’s motion to dismiss is granted with respect to

Plaintiffs’ New Jersey Consumer Fraud Act (“NJCFA”) claim and Plaintiffs are granted leave to file an amended complaint as to the Cotton Plaintiffs and putative Class A member’s NJCFA claim within 45 days. Further, because this Court’s exercise of jurisdiction, pursuant to the Class Action Fairness Act (“CAFA”) is largely premised on Plaintiffs’ NJCFA claim, as explained infra, the Court does not address the merits of Plaintiffs’ unjust enrichment, breach of fiduciary duty, and breach of the implied covenant of good faith and fair dealing claims; Defendants’ motions are both denied without prejudice with respect to those claims. If Plaintiffs file an amended complaint, Defendants may file renewed motions to dismiss those claims, if appropriate. Defendants’ motions to strike Plaintiffs’ class action allegations and to strike certain factual allegations from the Second Amended Complaint (“SAC”) are also denied without prejudice.

I. FACTUAL BACKGROUND AND PROCEDURAL HISTORY

The following allegations are taken from the SAC and assumed true for purposes of this motion. A. SPS’s Business Model

SPS is a New Jersey company that provides assistance to applicants applying for Medicaid. SAC ¶¶2, 36. In exchange for a fee, SPS handles the Medicaid application process for its clients, including completing the application and representing clients at the Medicaid office. See SAC Ex. D, SPS website “New Jersey Medicaid Planning and Eligibility”; Ex. G, SPS website “Connecticut Medicaid Planning and Eligibility.” SPS provides services in New Jersey, Connecticut, New York, Pennsylvania, Rhode Island and Massachusetts. SAC ¶36. Medicaid is a federal benefit program that provides health insurance, including paying for hospital services, doctor visits, prescriptions, and nursing home care, to eligible beneficiaries. In

order to receive Medicaid, an individual must also meet financial eligibility factors determined by his or her particular state. Id. at ¶44. For instance, “to qualify for institutional care in most states, an individual may not have assets exceeding a total of $2,000, and thus, to qualify for Medicaid, an individual would need to spend-down (or otherwise have properly invested or disposed of) nearly all of [his or her] assets.” Id. According to Plaintiffs, prior to 2016, SPS marketed itself on its website, print and internet ads, and interviews, as qualified to assist families with the “spend- down procedure” in order to meet Medicaid’s qualification requirements. Id. at ¶¶60-62. For example, SPS’s Facebook ads in 2014 and 2015, purportedly described the company as the “Industry Leaders in Optimizing Medicaid Eligibility for Seniors,” and the Company’s Facebook posts provided hypothetical examples of how to analyze Medicaid spend-down issues. See id. at

¶60; see also SAC, Ex. R, Feb. 14, 2015 Facebook Post; Ex. S., July 16, 2014, Facebook Post. Non-party LTC Consulting Services, LLC (“LTC”), a New Jersey company, is an affiliate of SPS, which provides finance, billing, and business management services to long-term care facilities. SAC at ¶¶53-55. Plaintiffs allege that SPS leverages its relationship with LTC to market its services directly to long-term care facilities. Id. at ¶¶56-58; 91-107. In Plaintiffs’ view, “SPS’s true clients are actually the long-term care facilities,” which benefit from the company’s services because “with SPS’s assistance, the facilities [are] less likely to experience any gap in payments between when a private payor’s funds run out and Medicaid kicks in.” Id. at ¶91. As such, Plaintiffs allege that the relationships between SPS and the long term care facilities poses a conflict of interest for SPS’s elderly clients. Id. at ¶¶91-107. B. The New Jersey Committee on the Unauthorized Practice of Law’s May 2016 Opinion

In May 2016, the New Jersey Committee on the Unauthorized Practice of Law (the “Committee” 1) issued an advisory opinion (the “May 2016 Opinion”), advising “that non-lawyers and companies that are not law firms who receive payment or compensation for their services, and/or provide advice regarding Medicaid eligibility, are practicing law.” Id. at ¶67; see also SAC, Ex., May 2016 Opinion. The Committee explained that, under the federal regulations governing Medicaid, states must “must allow individual(s) of the applicant or beneficiary’s choice to assist in the application process or during a renewal of eligibility.” May 2016 Opinion at 2 (quoting 42 C.F.R. §435.908(b)). Consistent with that directive, federal regulations permit states to certify staff and volunteers to assist applicants by providing information on insurance affordability programs and coverage options, helping individuals complete an application or renewal, working with the individual to provide required documentation, submitting applications and renewals to the agency, interacting with the agency on the status of such applications and renewals, assisting individuals with responding to any requests from the agency, and managing their case between the eligibility determination and regularly scheduled renewals.

Id. at 3 (quoting 42 C.F.R. §435.908 (c)(2)). The certified assistors “may not receive payment or compensation for their services.” Id. (citing 42 C.F.R. §435.908 (c)(4)). The Committee “acknowledge[d] that the federal program requires [s]tates to permit nonlawyers to assist

1 The Committee is appointed by the Supreme Court of New Jersey and consists of 21 attorneys and four lay members. N.J. Ct. Rule 1:22-1(a). Upon “request of any person, or in connection with the consideration of any complaint or any investigation made on its own initiative, the committee may render advisory opinions relating to the unauthorized practice of law and arrange for their publication.” N.J. Ct.

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THE ESTATE OF LESTER COTTON v. SENIOR PLANNING SERVICES, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-estate-of-lester-cotton-v-senior-planning-services-llc-njd-2020.