University Medical Clinics, Inc. v. Quality Health Plans, Inc.

51 So. 3d 1191, 2011 Fla. App. LEXIS 7, 2011 WL 13721
CourtDistrict Court of Appeal of Florida
DecidedJanuary 5, 2011
Docket4D10-877
StatusPublished
Cited by12 cases

This text of 51 So. 3d 1191 (University Medical Clinics, Inc. v. Quality Health Plans, Inc.) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
University Medical Clinics, Inc. v. Quality Health Plans, Inc., 51 So. 3d 1191, 2011 Fla. App. LEXIS 7, 2011 WL 13721 (Fla. Ct. App. 2011).

Opinion

LEVINE, J.

The appellants, University Medical Clinics, Inc. and Dr. Samuel Sadow, appeal the trial court’s order granting temporary in-junctive relief to appellee Quality Health Plans, Inc. We affirm the trial court’s granting of the injunctive relief but remand for entry of an order with clear and definite factual findings to support the temporary injunction.

Appellee Quality Health Plans, Inc. (“QHP”), is a Medicare HMO that contracted with appellant University Medical Clinic (“UMC”), a management service organization. Pursuant to the agreement, UMC would supply physician services as well as business and financial management services such as claims processing, credentialing, and medical management. Appellant Dr. Sadow signed the agreement as president of UMC. The provider agreement prohibited UMC for one year after expiration or termination of the agreement from directly or indirectly encouraging, soliciting, or influencing members of QHP’s health plan to disenroll from QHP or to enroll in a competing health plan. UMC was also prohibited from disclosing the names and personal information of QHP’s members and from using any of QHP’s information to further UMC’s own business interest. The same provider agreement required UMC to provide to QHP the “medical records of any Member within seven (7) business days of a request by” the health plan. The agreement further stated that at the termination of the agreement, UMC was to provide QHP all property and information in its possession belonging to QHP.

QHP terminated the agreement with UMC. QHP notified its members that they would be assigned to new primary care physicians. QHP requested from UMC the members’ medical records, but UMC did not turn over the records. QHP *1193 subsequently filed a complaint for temporary and permanent injunctive relief, alleging that appellants were advising QHP members to switch to another Medicare HMO because QHP was in financial distress and that appellants were giving incorrect information about staying with a doctor associated with UMC instead of transferring to a doctor affiliated with QHP. At the hearing for injunctive relief, QHP sought an injunction for solicitation and dissemination of the identities and information of QHP members as well as the production of the medical records of the members. The chief operating officer and chief compliance officer of QHP testified that appellants disseminated a letter to QHP members encouraging them to complain to the Center for Medicare and Medicaid Services (“CMS”) about QHP as well as other communications in which appellants encouraged members to enroll in other health plans. The testimony also acknowledged that correspondence to QHP members must first be submitted and approved by CMS, a step which the evidence indicates was not completed in this case.

The chief operating officer testified to the cost and effort expended in the development of membership lists for the plan. She testified further that appellants’ correspondence and refusal to turn over medical records caused irreparable injury to QHP’s business and reputation. The chief operating officer testified to the continuing violations through the date of the injunction hearing. QHP presented testimony of the ongoing violations. A former patient of UMC, who was also a current member of QHP’s plan, testified to receiving a call from UMC regarding a nurse practitioner who had returned to UMC’s employ to encourage the patient to return to UMC as well. The chief operating officer testified to calls like that being made to encourage QHP members to leave and return to appellants. Finally, she testified that appellants promised to provide to QHP’s members out-of-network services free of charge, as an inducement to the members to leave QHP. 1

QHP also provided testimony from former employees of UMC. One testified to observing UMC’s office manager call QHP’s patients, telling them “we could still treat them ... that we would not charge them anything.” This former employee further testified that she heard Dr. Sadow and other individuals tell QHP’s plan members that they could change health plans or return to Medicare and that Dr. Sadow said that he would not charge for treatments. Another former employee of UMC stated that she overheard UMC’s office manager “trying to persuade the patients to switch insurance [from QHP] so that they could stay with UMC Clinics.”

Dr. Sadow testified that after receiving notice of termination from QHP, he contacted QHP members by writing “to let them know of their rights per the CMS.” Dr. Sadow explained that the late delivery of the patients’ medical records was due to UMC’s lack of financial means to copy the records.

The trial court granted injunctive relief based on the testimony elicited during the evidentiary hearing, and stated the following in its order:

3. On or about March 30, 2009, QHP and UMC entered into a Comprehensive Provider Agreement (the “Agreement”), a copy of which is before this Court.
4. The Agreement prohibits UMC, for a period of one (1) year after expiration *1194 or termination of the Agreement, from directly or indirectly: (a) encouraging, soliciting, forcing or otherwise influencing the members of QHP’s health plan (“QHP’s Members”) to disenroll from QHP or enroll in any competing plan; (b) disclosing the names, addresses, or phone or identification numbers of any of QHP’s Members to any third party, except as required by process of law or regulation; or (c) using any of QHP’s materials, including, but not limited to, lists of QHP’s Members, directly or indirectly, to further the business purposes of UMC, its affiliates, consultants and employees, or any of UMC’s principals. 5. ... The Court finds that Sadow is a principal of UMC, is a party to the above-styled action, and had notice and an opportunity to be heard with respect to QHP’s requests for temporary injunc-tive relief.
[[Image here]]
11. The nonsolicitation, nondisclosure and non-interference provision of the Agreement are of the type enforceable under Florida Statutes § 542.335, and other applicable law. Henao v. Professional Shoe Repair, Inc., 929 So.2d 723 (Fla. 5th DCA 2006).
[[Image here]]
13. The Agreement further requires that UMC maintain medical and other records relating to the treatment by its physicians of QHP Members, and that during the term of the Agreement and after, UMC would make such records available to QHP and its Members without charge.
[[Image here]]
15.QHP, through the years it has been in business, has developed and maintained, at a substantial investment, an ongoing concern that has among its assets the relationships with the QHP Members, the lists of QHP’s Members, the participating provider network, contracts, QHP’s reputation, goodwill and other beneficial property.
16. This Injunction is reasonably necessary to protect QHP’s legitimate business interests.
17. The nonsolicitation, nondisclosure and non-interference provisions of the Agreement are reasonable in terms of time and scope.
18.

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

Related

COMPOUNDING DOCS, INC. v. SCSC ENTERPRISES, LLC
District Court of Appeal of Florida, 2022
JOSIE MACHOVEC v. PALM BEACH COUNTY
District Court of Appeal of Florida, 2021
ELIZABETH U. BALDWIN and MANOR AT VERO BEACH, LLC v. PAUL R. WILLET, Individually
259 So. 3d 891 (District Court of Appeal of Florida, 2018)
WALTER B. OLSON, JR. v. CYNTHIA ANN OLSON
260 So. 3d 367 (District Court of Appeal of Florida, 2018)
RONALD N. DUBNER v. FRANK FERRARO
242 So. 3d 444 (District Court of Appeal of Florida, 2018)
Florida High School Athletic Ass'n v. Rosenberg
117 So. 3d 825 (District Court of Appeal of Florida, 2013)
Anarkali Boutique, Inc. v. Ortiz
104 So. 3d 1202 (District Court of Appeal of Florida, 2012)
Meadows v. Medical Optics, Inc.
90 So. 3d 924 (District Court of Appeal of Florida, 2012)
Burtoff v. Tauber
85 So. 3d 1182 (District Court of Appeal of Florida, 2012)

Cite This Page — Counsel Stack

Bluebook (online)
51 So. 3d 1191, 2011 Fla. App. LEXIS 7, 2011 WL 13721, Counsel Stack Legal Research, https://law.counselstack.com/opinion/university-medical-clinics-inc-v-quality-health-plans-inc-fladistctapp-2011.