NAL Appeals from summary judgment.
A group of neonalogists.
Obstetrix perinatologists were formerly employed by PPA.
Obstetrix neonatologists formerly practiced as NSL, where there was not
(Obstetrix Medical Group)
PPA and NSL
Managed by Pediatrix Medical Group.
PPA physicians typically referred their NEONATAL patient-members to NAL
No more referrals to NAL.
Obstetrix Medical Group now however referred their patients to
Obstetrix neonatologists, who have treated the patients without
compensation if the patients' plans refused to pay for Obstetrix
Alleging that Obstetrix's practice of referring patients out-of-network
to its own neonatologists rather than to NAL physicians
constitutes interference with NAL's contractual relationship
with the relevant plans and unfair competition.
Motion for Summary Judgment
Obstetrix filed a motion for summary judgment.
- NAL files timely appealed.
Tort of Intentional Interference
To prove the tort of intentional interference with contractual
A plaintiff must show the existence of a valid
contractual relationship or business expectancy,
the interferer's knowledge of the relationship or
intentional interference inducing or causing a breach or termination of the relationship
or expectancy, and
to the party whose relationship or expectancy has been
In addition, the interference must be improper as to motive
or means before liability will attach.
Says conduct was improper.
Disagrees that there is any genuine issue of material fact.
To be actionable, interference with a contractual relation must be
both intentional and
If the interferer is to be held liable for committing a wrong, his
liability must be based on more than the act of interference
particular action is improper for purposes of a tortious
interference claim is determined by a consideration of seven
the nature of the actor's conduct,
the actor's motive,
the interests of the other with which the actor's
the interests sought to be advanced by the actor,
the social interests in protecting the freedom of action of the
actor and the contractual interests of the other,
the proximity or remoteness of the actor's conduct to the interference
the relations between the parties.
Element focuses on the actors mental
determined by weigh the
social importance of the
interest the Df seeks to advance against the
deviation for the standard industry practice
Obstetrix refers both in network and out of network patients to its own
practice group instead of referring them to NAL like they did in
In addition, Obstetrix absorbs out of network fees for plans that
refuse to pay.
This is what NAL is pissed about.
Nothing on record says this should apply.
are entitled to their bill
A physical does not have to treat patients.
Patients do not have to use their insurance.
Impropriety: Obstetrix breached its own contract relationship
Each insurance provider agrees to refer patients EXCLUSIVELY to other
in network physicians.
NAL does not have a relationship with 2 of the insurance providers.
There is no record that says Obstetrix cannot refer perinatal patients
to out of network physicals for non-covered treatment.
question of fact exist as to Obstetrix's motive for referring
patients to its own neonatologists
Obstetrix's self-referral practice is business-driven and does not
involve the exercise of medical judgment."
Rule Question of Fact to a Specific Motive
A question of fact as to a specific motive is only material if one of
the possible motives supported by the record may be considered
Rule Business-driver Motive
A business-driven motive, in and of itself, is not an improper motive.
A business competitor does not act improperly if its purpose at least
in part is to advance its own economic interests.
NAL has neither presented evidence of anything more nefarious [evil]
than business competition nor evidence from which a reasonable
jury could find that Obstetrix acted improperly.
Therefore, summary judgment on NAL's claim for tortious interference
with contract was appropriate.