Valued Pharmacy Services of the Midwest, LLC v. Avera Health Plans, Inc.

CourtDistrict Court, E.D. Missouri
DecidedFebruary 14, 2022
Docket4:21-cv-00400
StatusUnknown

This text of Valued Pharmacy Services of the Midwest, LLC v. Avera Health Plans, Inc. (Valued Pharmacy Services of the Midwest, LLC v. Avera Health Plans, Inc.) is published on Counsel Stack Legal Research, covering District Court, E.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Valued Pharmacy Services of the Midwest, LLC v. Avera Health Plans, Inc., (E.D. Mo. 2022).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION

VALUED PHARMACY SERVICES ) OF THE MIDWEST, LLC DBA ) NFP RX SOLUTIONS, ) ) Plaintiff, ) ) No. 4:21-CV-400 RLW v. ) ) AVERA HEALTH PLANS, INC., ) ) Defendant. )

MEMORANDUM AND ORDER This matter is before the Court on Defendant Avera Health Plans, Inc.’s Motion to Dismiss or Transfer. (ECF No. 16). Plaintiff Valued Pharmacy Services (“VPS”) opposes the Motion (ECF No. 20) and it is fully briefed. The Court will grant Avera’s Motion for the reasons below. BACKGROUND The following facts are alleged in VPS’s Amended Complaint. (ECF No. 15). VPS is a pharmacy benefits management consulting firm that helps employers and health plan providers develop customized pharmacy benefit plans. Id. at ¶ 15. VPS is a limited liability company organized under the laws of Missouri with its principal office in Chesterfield, Missouri. Id. at ¶ 10. VPS’s members are citizens of New York and Delaware. Id. Defendant Avera is a health plan provider that serves more than 85,000 customers. Id. at ¶ 16. Avera is incorporated under the laws of South Dakota with its principal office in Sioux Falls, South Dakota. Id. at ¶ 11. In or around February 2020, Avera contacted VPS through Avera’s agent, Axia Strategies. Id. at ¶ 17. Avera sought VPS’s assistance in redesigning its specialty pharmacy benefits plan. Id. at ¶¶ 18-22. Avera had contacted another St. Louis-based firm, PillarRX Consulting, LLC, before reaching out to VPS. Id. at ¶ 22. At the start, Avera told VPS it did not have the funds to pay VPS’s upfront consulting fee. Id. at ¶ 23. The parties thus agreed to a shared savings model in which VPS would receive 20% of the savings produced by its program. Id. at ¶ 24. In February, March, and May of 2020, Luke

Merkel—Avera’s Director of Pharmacy (ECF No. 17-1)—represented to VPS that Avera understood the commission structure. Id. During a call in May 2020, Merkel told VPS that Avera was moving forward with the agreement. Id. at ¶ 26. During a call in June 2020, Merkel told representatives from Avera, Axia, VPS, and CVS Health that Avera was “in operation mode” with VPS’s program. Id. at ¶ 27. VPS alleges it provided information, services, and work product to Avera in reliance on Avera’s representations. Id. at ¶ 28. The parties entered a non-disclosure agreement (“NDA”) on March 23, 2020. Id. at ¶ 29. VPS alleges it undertook significant work for Avera throughout 2020. Id. at ¶ 30-34. VPS alleges it provided “crucial, proprietary information regarding limited distribution drugs, and

specialty drugs that did not offer copay cards or other incentives.” Id. at ¶ 41. In May 2020, Avera decided to formally change its plan design in two states, effective January 1, 2021. Id. at ¶ 43. Around this time, VPS prepared language for Avera’s summary benefits guide and its summary of plan documents. Id. at ¶ 44. Avera requested additional copies of the language in a May 2020 email. Id. at ¶ 46. Avera also asked VPS to draft and send a master services agreement (“MSA”) to Axia. Id. at ¶ 47. As part of its efforts in 2020, VPS secured an agreement with CVS to recognize and work with Avera’s specialty pharmacy. Id. at ¶ 48-60. VPS developed the technology and relationships necessary to create a secure flow of information between CVS, Avera, and each of Avera’s specialty pharmacies. Id. at ¶ 56. VPS also taught personnel at three specialty pharmacies how to implement the new program. Id. at ¶ 57. According to VPS, it saved Avera “countless hours of research and setup time.” Id. at ¶ 58. On August 20, 2020, Avera told VPS to prepare to launch the program on January 1, 2021. Id. at ¶ 60. VPS alleges it agreed to do so because Avera had agreed to the fee structure, signed an NDA, and continued to engage on the project. Id. at ¶ 64.

VPS sent a detailed MSA to Axia in July 2020. Id. at ¶ 62. The parties continued negotiations in September 2020. Id. at ¶ 65. VPS asserts that, by this time, the program was “essentially operable and ready to go live on January 1, 2021.” Id. at ¶ 66. The next month, VPS sent a final draft of the MSA to Avera through Axia. Id. at ¶ 67. The parties then engaged in negotiations via telephone for several days. Id. According to VPS, the MSA included terms previously agreed upon by the parties, including the 20% commission structure. Id. at ¶ 68. VPS then drafted a notification letter to send to approximately 1,100 Avera customers. Id. at ¶ 70. VPS printed out and prepared the letters for mailing. Id. at ¶ 71. During a call in October 2020, Avera asked VPS if Avera could manage customer communications. Id. at ¶ 72. Because

VPS had already done the work, it declined Avera’s request. Id. VPS did, however, offer Avera a 10% discount if Avera would handle customer communications going forward. Id. VPS alleges “it was not until after Avera had everything that it needed from VPS to implement the new program” that it requested a discount. Id. at ¶ 76. VPS also alleges Avera then “feigned surprise at one component of the program.” Id. at ¶ 73. In response to Avera’s concerns, VPS developed two alternatives to the component in question and proposed them to Avera three days later. Id. at ¶ 77- 78. Avera declined the alternatives and stated it no longer wished to move forward with the new program. Id. at ¶ 79. Then, on November 5, 2020, Avera insisted that VPS “had provided nothing of value.” Id. at ¶ 80. Avera stated it would keep the plan changes for Minnesota and South Dakota, but would make the changes without VPS’s assistance. Id. at ¶ 80. Avera told VPS it would not implement any other part of the program except a specific change to its coinsurance policy. Id. On December 7, 2020, Merkel called Dave Lee—VPS’s managing director—and indicated he would not use the plan-related letters developed by VPS. Id. at ¶ 83. Merkel told Lee that VPS’s program was not proprietary and Avera would not pay VPS for its work. Id. at ¶ 84. VPS learned

in January 2021 that Avera had sent letters to customers explaining policy changes that contained VPS’s phone number and the language VPS provided in the spring of 2020. Id. at ¶¶ 85-92. VPS filed this action on April 5, 2021. (ECF No. 1). VPS’s Complaint asserts claims for fraudulent inducement, breach of contract, quantum meruit, and unjust enrichment. (ECF No. 15, ¶¶ 93-125). VPS seeks actual and exemplary damages with interest, attorney’s fees, legal expenses, and court costs. Id. LEGAL STANDARD Rule 12(b)(2) of the Federal Rules of Civil Procedure allows a party to move to dismiss for lack of personal jurisdiction. To survive such a motion, a plaintiff must state sufficient facts to

support a reasonable inference that the defendant can be subjected to jurisdiction within the state. K-V Pharm. Co. v. J. Uriach & CIA, S.A., 648 F.3d 588, 592-93 (8th Cir. 2011) (citing Dever v. Hentzen Coatings, 380 F.3d 1070, 1072 (8th Cir. 2004)). Generally, the Court must make two separate inquiries: one to establish if the defendant’s conduct is covered by Missouri’s long-arm statute, and another to analyze whether the exercise of jurisdiction comports with due process requirements. Myers v. Casino Queen, Inc., 689 F.3d 904, 909 (8th Cir. 2012) (citing Bryant v. Smith Interior Design Grp., Inc., 310 S.W.3d 227, 231 (Mo.2010)).

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Valued Pharmacy Services of the Midwest, LLC v. Avera Health Plans, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/valued-pharmacy-services-of-the-midwest-llc-v-avera-health-plans-inc-moed-2022.