Justia Contracts Opinion Summaries

This was the second appeal in this case. Doctor, who was licensed to practice medicine in Nebraska and Washington, entered into an assurance of compliance with the Attorney General due to unprofessional conduct. The assurance of compliance was made part of Doctor's public record. Consequently, Doctor alleged that the Washington Department of Health learned via public record of the assurance of compliance and initiated a disciplinary action against him. Doctor was also made ineligible with the American Board of Family Medicine. Doctor filed a complaint against the Nebraska Department of Health and Human Services and the Attorney General alleging that the Attorney General fraudulently and negligently misrepresented the adverse effects of the assurance of compliance. The district court granted summary judgment in favor of Defendants, finding the misrepresentation claims to be contract claims subject to, and barred by, the State Contract Claims Act (Act). Doctor again appealed. The Supreme Court affirmed, holding that the district court did not err in finding that Doctor's claims were subject to, and barred by, the Act. View "Zawaideh v. Dep't of Health & Human Servs." on Justia Law

Patients Abby Allen and Walter Moore sought medical treatment at Clarian North Hospital, which was owned by Clarian Health Partners. After Allen, who was uninsured and not covered by Medicare or Medicaid, received services, the hospital billed Allen its "chargemaster" rates in accordance with a contract between Allen and Clarian. Patients' class action complaint alleged breach of contract and sought declaratory judgment that the rates the hospital billed its uninsured patients were unreasonable and unenforceable. The trial court granted Clarian's motion to dismiss for failure to state a claim upon which relief can be granted. The court of appeals reversed, concluding that the issue of reasonableness required resolution by a fact-finder. The Supreme Court vacated the opinion of the court of appeals and affirmed the judgment of the trial court, holding that Patients' agreement to pay the hospital for the medical services they received in the context of a contract they formed with Clarian was not indefinite and referred to Clarian's chargemaster. As a result, the Court could not impute a "reasonable" price term into the contract. View "Allen v. Clarian Health Partners, Inc." on Justia Law

In this appeal, Greater Omaha Packing Company (GOPAC) asked the First Circuit Court of Appeals to vacate a jury's unanimous finding that GOPAC supplied Fairbank Reconstruction Corporation with E. coli-tainted beef, which Fairbank then packaged and shipped to two supermarkets in Maine, resulting in two women who bought meat there becoming seriously ill. The Supreme Court affirmed, holding that there was no basis upon which to upset the jury's verdict, as (1) the evidence was sufficient for a reasonable jury to conclude that GOPAC's meat was contaminated and that such meat was included in the packages the two women purchased; and (2) the trial court did not err in admitting a video deposition of GOPAC's former expert witness. View "Fairbank Reconstruction v. Greater Omaha Packing Co." on Justia Law

Respondent Robert Lego admitted his wife to Porter Hospital's emergency room. She stayed there for approximately two months. The Legos' insurance provider notified Respondent in writing that it would stop covering Mrs. Lego's hospital care after six weeks. Respondent disputed the insurer's position and refused to discharge his wife from the hospital after six weeks. The hospital followed the insurer in notifying Respondent the insurance coverage for Mrs. Lego would end, and that the Legos would be responsible for any uncovered charges. In an effort to recoup those charges Respondent refused to pay, the hospital sued on the grounds of unjust enrichment with recovery in quantum meruit. Respondent moved to dismiss, arguing that the action was barred by a general statute of limitations codified in section 13-80-103.5(1)(a) C.R.S. (2011). The trial court denied the motion; the appellate court reversed, finding the trial court erred in determining the amount the insurance company did not pay was liquidated or determinable damages within the meaning of the statute. The Supreme Court reversed the appellate court, interpreting section 13-80-103.5(1)(a) C.R.S. (2011) to mean its six-year limitations period applied in this case, particularly when the amount owed was ascertainable either by reference to the agreement, or by simple computation using extrinsic evidence. View "Portercare Adventist Health System v. Lego" on Justia Law

A collective bargaining agreement governs the relationship between Acument and its retired employees. Prior to 2008, the company paid healthcare and life-insurance benefits to qualified retirees. When Acument ended these benefits in 2008, a class of 64 retirees claimed that the company had violated the CBA in violation of the Employee Retirement Income Security Act and the Labor Management Relations Act. The district court granted Acument summary judgment. The Sixth Circuit affirmed, characterizing the issue as “a matter of contract.” The relevant language states that the company “reserves the right to amend, modify, suspend, or terminate the Plan,” consisting of: retiree medical coverage; retirement income; disability income; and life insurance. View "Witmer v. Acument Global Tech., Inc." on Justia Law

At issue in this appeal was whether the circuit court erred in allowing Plaintiff to take a nonsuit as a matter of right pursuant to Va. Code Ann. 8.01-380(B) based on its determination that Plaintiff's prior voluntary dismissal in federal court was not a nonsuit under section 8.01-380. In Virginia, a plaintiff may take only one nonsuit as a matter of right. The Supreme Court affirmed, holding that the trial court did not err in finding that Plaintiff was permitted to take a nonsuit as a matter of right pursuant to section 8.01-380(B), holding (1) Va. Code Ann. 8.01-229(E)(3) does not confirm or suggest that a voluntary dismissal taken pursuant to Fed. R. Civ. P. 41(a)(1)(A)(i) is a nonsuit for purposes of section 8.01-380; and (2) Plaintiff's prior voluntary dismissal in federal court was not substantially equivalent to Virginia's nonsuit in this regard. View "Inova Health Care Servs. v. Kebaish" on Justia Law

In two separate actions, seven Massachusetts hospitals and one managed health care organization that disproportionately provided medical care to the poor alleged that the Secretary of the Executive Office of Health and Human Services violated her obligation to reimburse them for the reasonable costs incurred in providing medical services to MassHealth enrollees. A superior court judge granted the Secretary's motion for judgment on the pleadings in one case and the Secretary's motion to dismiss in the other, concluding as a matter of law that the plaintiffs could not prevail even if their allegations were true. The plaintiffs appealed, and the cases were consolidated. The Supreme Court affirmed the decisions denying the plaintiffs' claims, holding that the plaintiffs' redress for their claims rested in the political arena, not in the courts. View "Boston Med. Ctr. v. Sec'y of the Executive Office of Health & Human Servs." on Justia Law

In a 2009 opinion, the Sixth Circuit held that, in a 1998 collective bargaining agreement, CNH agreed to provide health-care benefits to retirees and their spouses for life, but rejected the suggestion that the scope of this commitment in the context of healthcare benefits, as opposed to pension benefits, meant that CNH could make no changes to the healthcare benefits provided to retirees. The court remanded for a determination of reasonableness with respect to CNH’s proposed changes to its retiree healthcare benefits, under which retirees, previously able to choose any doctor without suffering a financial penalty, would be put into a managed-care plan. The court listed three considerations: Does the modified plan provide benefits “reasonably commensurate” with the old plan? Are the proposed changes “reasonable in light of changes in health care”? And are the benefits “roughly consistent with the kinds of benefits provided to current employees”? On remand, the district court granted CNH summary judgment without reaching the reasonableness question or creating a factual record from which the determination could be made on appeal. The Sixth Circuit again remanded.View "Reese v. CNH America LLC" on Justia Law

At issue in this appeal was the question of an agent's authority to bind his or her principal to an arbitration agreement presented with other documents upon the principal's admission to a long-term care facility. Agent in this case was the daughter and executrix of the deceased Principal. Agent brought a claim for negligence against the long-term care facility where Principal spent the last years of her life. Invoking an arbitration agreement executed in conjunction with Principal's admission to the nursing home, Defendants moved the trial court to dismiss the complaint. The trial court denied the motion, holding that Agent, who executed the admissions agreement on behalf of Principal, had no authority to agree to arbitration. The court of appeals reversed, holding that the agreement was enforceable. The Supreme Court reversed, holding that the optional arbitration agreement Agent purported to execute on Principal's behalf was beyond the scope of Agent's authority and was therefore unenforceable. View "Ping v. Beverly Enters., Inc." on Justia Law

A "discrete, narrow legal question" came before the Supreme Court: is a health care provider who has received an assignment of personal injury protection (PIP) benefits from an insured obligated upon request to furnish to the insurer broad information with respect to the provider’s ownership structure, billing practices, and regulatory compliance? Plaintiffs in this matter consist of six “Selective Insurance Company” entities. Individuals insured by Selective sought medical treatment from defendants for injuries received in automobile accidents. Those insureds assigned to defendants the benefits to which they were entitled under their PIP coverage, giving defendants the contractual right to seek PIP reimbursement under those policies. In reviewing claims submitted for payment, Selective detected what it considered to be suspicious patterns in both the treatments defendants had provided and the corporate links among the treating entities. Selective requested that defendant supply to it a variety of data with respect to their ownership, structure, billing practices, and compliance with certain regulations. In support of its request, Selective cited the provision within the insureds’ insurance policies requiring the insureds to cooperate with Selective in the investigation of any claim under the policy. When defendants refused to supply the material Selective sought, Selective sued, alleging that defendants' failure to supply the information was a breach of they duty to cooperate and a violation of the PIP discovery statute. After hearing oral argument, the trial court denied defendants’ motion to dismiss and granted Selective the relief it had requested by directing defendants to respond to Selective’s discovery requests. Defendants thereafter moved for reconsideration, but the trial court denied that motion, together with defendants’ request for a stay. Upon review of the matter, the Supreme Court held that an insured had no duty to provide information to plaintiff with respect to the ownership structure, billing practices, or referral methods of the medical providers from whom he or she sought treatment for his or her injuries. Because an insured had no obligation to supply that information to plaintiff, the assignment of benefits executed by an insured could not serve to impose that duty on the providers.