United HealthCare Services, Inc. v. Corzine

CourtDistrict Court, S.D. Ohio
DecidedMarch 15, 2021
Docket2:21-cv-00319
StatusUnknown

This text of United HealthCare Services, Inc. v. Corzine (United HealthCare Services, Inc. v. Corzine) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United HealthCare Services, Inc. v. Corzine, (S.D. Ohio 2021).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF OHIO EASTERN DIVISION

UNITED HEALTHCARE SERVICES, INC., et al., Case No. 2:21-cv-319 Plaintiffs, JUDGE EDMUND A. SARGUS, JR. Magistrate Judge Kimberly A. Jolson v.

JEFFREY CORZINE,

Defendant.

OPINION AND ORDER This matter is before the Court on Plaintiffs’ Motion for a Preliminary Injunction. (ECF No. 2.) Defendant Jeffrey Corzine submitted a Response in Opposition (ECF No. 25), and Plaintiffs replied (ECF No. 31). The Court held an evidentiary hearing on Plaintiffs’ motion on February 19 and February 22, 2021. The parties submitted post-hearing briefing on the testimony and have each responded to the other side’s briefing. (ECF Nos. 32–35.) For the reasons set forth below, Plaintiffs’ Motion for a Preliminary Injunction is GRANTED IN PART. I. FINDINGS OF FACT Plaintiffs United HealthCare Services, Inc. and UnitedHealth Group, Inc. (collectively, “United”) initiated this action against Defendant Jeffrey Corzine seeking enforcement of non- competition and non-solicitation covenants to which Corzine agreed while employed at United. UnitedHealth Group, a Delaware corporation based in Minnesota, is a national diversified health care company offering health care coverage and benefits through a family of affiliate companies. (Roaldi Decl. ¶ 3.) United HealthCare Services, one of those affiliate companies, is UnitedHealth Group’s health care benefits business. (Id.) United HealthCare Services offers commercial health insurance as well as insurance for Medicaid and Medicare beneficiaries. (Id. ¶ 4.) The UnitedHealthcare Community Plan of Ohio, Inc. (“Ohio plan”) operates under a contract with the Ohio Department of Medicaid (“ODM”) as a benefits plan for Ohio Medicaid beneficiaries—known as a “managed care organization” or “managed care plan.” United obtained

this contract through a competitive procurement in 2012. Defendant Jeffrey Corzine began employment with United’s Ohio plan in 2008. From 2014 to 2019, Corzine worked in a strategic marketing role for the Ohio plan. United terminated Corzine in October of 2019 after a national restructuring. Corzine was subsequently hired by Humana, Inc. in February of 2020. Like United, Humana is large health care company that offers health care benefits, among other services. At the time Humana hired Corzine, Humana operated managed care plans under Medicaid contracts with other states, but not Ohio. However, Humana was actively preparing to enter the Ohio Medicaid market in anticipation of ODM re-procuring the State’s Medicaid contract. In the fall of 2020, ODM initiated the procurement by issuing a Request for Applications, the standard process used to procure a state Medicaid contract. United and

Humana, along with nine other managed care organizations, both submitted applications to obtain a contract with ODM. This dispute began when United learned in January of 2021 that Corzine was involved in Humana’s application to ODM. United alleges that Corzine’s activity at Humana breached the non-competition and non-solicitation covenants contained in Stock Option Awards and Restricted Stock Unit Awards that Corzine signed while at United. A. The Ohio Medicaid Business and the UnitedHealthcare Community Plan This case requires background knowledge of the Ohio Medicaid market. Each state administers Medicaid differently. Ohio contracts with private health insurance companies to provide benefits to Medicaid members through a competitive procurement process. To initiate a competitive procurement, the State issues a Request for Applications (“RFA”). Companies seeking to provide managed care services submit detailed applications per the prompts listed in the RFA. The State then selects organizations from the pool of applicants. At a basic level, ODM

contracts with the selected managed care plans and those plans cover the medical benefits, “including behavioral health services and prescription drugs,” for the individuals enrolled in the plan. (Ex. 159.) The State pays the managed care organizations, and the organizations pay the claims submitted by the Medicaid members enrolled in the plan. Over 3 million Ohioans are covered under the Ohio Medicaid program. Ohio last issued an RFA in 2012. The State selected United and four other plans to provide benefits under the State Medicaid contract beginning in 2013. According to Michael Roaldi, the CEO of United’s Ohio plan, the State selects multiple providers to encourage competition and give Medicaid members choice between competing plans. When a person becomes eligible for Medicaid, the person has an option to enroll in a healthcare plan of their choice or to do nothing.

If the person does nothing, ODM assigns that person to one of the competing plans based on a computer algorithm. The computer algorithm accounts for the performance metrics of each plan as evaluated by ODM; better performance can result in a higher number of Medicaid members assigned to a plan. ODM also divides the State into three regions. Based on performance, some plans are given the choice to service only particular regions, while other plans are selected to service all regions. Under the current Medicaid contract, roughly half of Ohio’s Medicaid members are served by CareSource, a non-profit. That leaves the remaining 1.5 million Medicaid beneficiaries to the other four plans. United’s current Ohio plan provides coverage to roughly 350,000 Ohio Medicaid beneficiaries in all three regions. The plan employs a CEO and other executive leadership, nurses and community health workers, quality staff, and operations staff. Roaldi testified that the plan has over 300 employees. The plan considers its business to have two distinct customers. First is the State of Ohio; the State “hires” the plan and dictates how and where it operates. Second is the

Medicaid member the plan insures. The RFA process is the only way for a company to enter the Ohio Medicaid market. B. The 2020 Ohio RFA In January of 2019, Governor Michael DeWine announced that the State intended to re- procure Ohio’s Medicaid contract. Prior to Governor DeWine’s announcement, United had held occasional strategy meetings to stay prepared in case a new RFA was released. According to Roaldi, it is vital for a managed care plan to stay prepared for a new procurement because the State has discretion end the current contract and request applications for a new Medicaid contract at any time. After Governor DeWine’s announcement, the company moved into the “active solutioning phase” to prepare for the RFA. United created a “core group” of employees from the Ohio plan

and from United’s national Medicaid team. The core group held daily meetings to strategize for the RFA’s release. The questions and criteria for the RFA are unknown until the RFA is released. But in the 18 months leading up to the 2020 RFA’s release, ODM made public announcements indicating its priorities for the upcoming procurement. United’s executive leaders strategized for the upcoming RFA based on these statements and on the plan’s experiences operating under the current contract since 2013. ODM issued the 2020 RFA on September 30, 2020. (Ex. 159.) Written applications were due on November 20, 2020. (Id.) The RFA asked applicants to respond to questions in the following topic areas: (1) the organization’s qualifications and experience; (2) population health; (3) benefits and service delivery; and (4) operational excellence. Applications are typically hundreds of pages long and are highly confidential until the awards are announced. An Evaluation Committee grades the applications. Each topic area has a maximum number of points available, and a total of 1000 points are available on the written application. In addition to the written

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Mona Electric Group, Inc. v. Truland Service Corp.
56 F. App'x 108 (Fourth Circuit, 2003)
Corporate Technologies, Inc. v. Harnett
731 F.3d 6 (First Circuit, 2013)
Savedoff v. Access Group, Inc.
524 F.3d 754 (Sixth Circuit, 2008)
Akron Pest Control v. Radar Exterminating Co.
455 S.E.2d 601 (Court of Appeals of Georgia, 1995)
Ecology Services, Inc. v. Clym Environmental Services, LLC
952 A.2d 999 (Court of Special Appeals of Maryland, 2008)
Charles P. Young Co. v. Leuser
485 N.E.2d 541 (Appellate Court of Illinois, 1985)
Preferred Meal System Inc. v. Guse
557 N.E.2d 506 (Appellate Court of Illinois, 1990)
Knowles-Zeswitz Music, Inc. v. Cara
260 A.2d 171 (Court of Chancery of Delaware, 1969)
VLIW TECHNOLOGY, LLC v. Hewlett-Packard Co.
840 A.2d 606 (Supreme Court of Delaware, 2003)
Laidlaw, Inc. v. Student Transportation of America, Inc.
20 F. Supp. 2d 727 (D. New Jersey, 1998)
Adp, LLC v. Nicole Rafferty Adp, LLC
923 F.3d 113 (Third Circuit, 2019)
D.T. v. Sumner Cty. Sch.
942 F.3d 324 (Sixth Circuit, 2019)
KPMG Peat Marwick LLP v. Fernandez
709 A.2d 1160 (Court of Chancery of Delaware, 1998)
GMG Capital Investments, LLC v. Athenian Venture Partners I
36 A.3d 776 (Supreme Court of Delaware, 2012)
Leary v. Daeschner
228 F.3d 729 (Sixth Circuit, 2000)
Doe v. Ohio State University
136 F. Supp. 3d 854 (S.D. Ohio, 2016)
Wells Fargo Insurance Services USA, Inc. v. McQuate
276 F. Supp. 3d 1089 (D. Colorado, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
United HealthCare Services, Inc. v. Corzine, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-healthcare-services-inc-v-corzine-ohsd-2021.