Riverboat Group, LLC v. Ivy Creek of Tallapoosa, LLC

          MEMORANDUM OPINION AND ORDER

          WALLACE CAPEL, JR. CHIEF UNITED STATES MAGISTRATE JUDGE.

         Plaintiff Riverboat Group, LLC, has brought claims against Defendant Ivy Creek of Tallapoosa, LLC, for breach of contract, open account, and unjust enrichment. Plaintiff filed a Motion for Summary Judgment (Doc. 17), and Defendant filed a response (Doc. 21). Plaintiff's motion is briefed and ripe for consideration. For the reasons below, the Court finds that Plaintiff's Motion for Summary Judgement is due to be DENIED.

         I. STANDARD OF REVIEW

         Under Rule 56(a) of the Federal Rules of Civil Procedure, a reviewing court shall grant a motion for “summary judgment if the movant shows that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56(a). Only disputes about material facts will preclude the granting of summary judgment. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). “An issue of fact is ‘genuine' if the record as a whole could lead a reasonable trier of fact to find for the nonmoving party. An issue is ‘material' if it might affect the outcome of the case under the governing law.” Redwing Vehicleriers, Inc. v. Saraland Apartments, 94 F.3d 1489, 1496 (11th Cir. 1996) (quoting Anderson, 477 U.S. at 248).

         Under Rule 56, summary judgment is appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). The party asking for summary judgment “always bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of ‘the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any,' which it believes demonstrates the absence of a genuine issue of material fact.” Id. at 323. The movant can meet this burden by presenting evidence showing there is no dispute of material fact, or by showing that the nonmoving party has failed to present evidence in support of some element of his case on which he bears the ultimate burden of proof. Id. at 322-23.

         Once the movant has satisfied this burden, the nonmoving party must “go beyond the pleadings and by his own affidavits, or by the ‘depositions, answers to interrogatories, and admissions on file,' designate ‘specific facts showing that there is a genuine issue for trial.'” Id. at 324. In doing so, and to avoid summary judgment, the nonmovant “must do more than simply show that there is some metaphysical doubt as to the material facts.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). The parties must support their assertions “that a fact cannot be or is genuinely disputed” by “citing to particular parts of materials in the record, including depositions, documents, electronically stored information, affidavits or declarations, stipulations[], admissions, interrogatory answers, or other materials” or by “showing that the materials cited do not establish the absence or presence of a genuine dispute, or that an adverse party cannot produce admissible evidence to support the fact.” Fed.R.Civ.P. 56(c)(1)(A) & (B).

         If the nonmovant “fails to properly address another party's assertion of fact” as required by Rule 56(c), then the court may “consider the fact undisputed for purposes of the motion” and “grant summary judgment if the motion and supporting materials - including the facts considered undisputed - show that the movant is entitled to it.” Fed.R.Civ.P. 56(e)(2) & (3).

         In determining whether a genuine issue for trial exists, the court must view all the evidence in the light most favorable to the nonmovant. McCormick v. City of Fort Lauderdale, 333 F.3d 1234, 1243 (11th Cir. 2003). Likewise, the reviewing court must draw all justifiable inferences from the evidence in the nonmoving party's favor. Anderson, 477 U.S. at 255. However, “mere conclusions and unsupported factual allegations are legally insufficient to d efeat a summary judgment motion.” Ellis v. England, 432 F.3d 1321, 1326 (11th Cir. 2005) (per curiam). Furthermore, “[a] mere ‘scintilla' of evidence supporting the opposing party's position will not suffice; there must be enough of a showing that the jury could reasonably find for that party.” Walker v. Darby, 911 F.2d 1573, 1577 (11th Cir. 1990); see also Anderson, 477 U.S. at 249-50 (“If the evidence [on which the nonmoving party relies] is merely colorable, or is not significantly probative, summary judgment may be granted.”) (internal citations omitted).

         II. FACTUAL BACKGROUND

         The evidentiary materials submitted by parties, construed in a light most favorable to the non-movant, establish the following facts:

         Plaintiff, a Delaware limited liability company, provides clinical laboratory services on a per-request basis to health care facilities. Doc. 1 ¶¶ 1, 12. Defendant is the owner of and operator of Lake Martin Community Hospital (“LMCH”) in Dadeville, Alabama. Doc. 22 ¶ 3. Michael Bruce is the CEO of operations and administration at LMCH. Doc. 22 ¶ 4 . In the Fall of 2015, Bruce was contacted by a Kevin Robson, a representative of Plaintiff about a possible business opportunity for LMCH. Doc. 22 ¶ 5. Robson explained to Bruce that he had a network of several hundred physicians and clinics in Alabama who provided chronic pain management services for patients who were required to have monthly routine drug screens. Id. Although Plaintiff at one point could bill Blue Cross Blue Shield Insurance Company (“BCBS”) directly, recent changes by BCBS required that (1) only an Alabama health care provider could be reimbursed for Alabama insureds and (2) only a hospital laboratory with a BCBS approved provider number could remit invoices to BCBS for payment of laboratory services. Doc. 22 ¶ 5. Plaintiff was looking for a referring lab in Alabama that would accept urine specimens, deliver them to Plaintiff's laboratory in New Orleans where the drug screens would be performed, and bill BCBS for services provided by Plaintiff. Id. As a result of these discussions and further discussions with representatives of Plaintiff, Defendant entered into a contract with Plaintiff on May 11, 2016. Doc. 1 ¶ 13.

         At some point after the contract was executed, the volume of urine specimens to be tested increased from an average of thirty per month to 1, 100 per month. Doc. 22 ¶ 8. Both parties performed under the terms of the contract until September 2016, when BCBS notified LMCH that it would be conducting an audit based on the increased number of drug screens. Id. at ¶ 11. With respect to an audit, the parties' contract contains the following provision:

If any payor requires that [Defendant] provide the ordering physician/practitioner's medical records for a pre-payment or post-payment review or audit being conducted by payor, [Defendant] will notify [Plaintiff] in writing (via email is permissible), and [Plaintiff] shall assist in obtain[ing] the pertinent medical records and provide them to [Defendant] within the timeline designated by [Plaintiff] such that [Plaintiff] can meet the timeline required by payor.

Doc. 1-1 at 3, ¶5. During the audit by BCBS, Plaintiff did not provide to Defendant the necessary physician records, charts, or other documents establishing that the drug screening for each patient was reasonably and medically necessary. Doc. 22 at ¶ 13. Because Defendant could not produce this documentation to BCBS for each drug screen, BCBS denied all pending claims and requested reimbursement for all previously paid claims. Doc. 22 ¶ 13. Under the contract and before BCBS conducted its audit, Plaintiff provided laboratory services in the amount of $399, 128.70. Doc. 17-1 ¶ 12. Defendant paid Plaintiff for $154, 103.89, leaving a balanced of $245, 024.81. Id. Plaintiff has sued Defendant for the remaining balance, alleging claims of breach of ...