United States District Court, M.D. Alabama, Eastern Division
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 ...