Document Type

Article

Publication Date

5-19-2006

Abstract

Plaintiffs-appellants appeal from a summary judgment entered October 20, 2004, in the United States District Court for the Eastern District of New York (Amon, J.) dismissing their claims for breach of contract, breach of a third-party contract, unjust enrichment, and engaging in a pattern of deceptive practices in an action brought to secure reimbursement for hospital services rendered. The District Court dismissed plaintiffs' claims for breach of contract after determining that (i) NEW YORK PUBLIC HEALTH LAW § 2807-c completely abrogated the parties' pre-existing written contracts; (ii) all parties were performing under implied-in-fact contracts; (iii) those implied-in-fact contracts were illegal under § 2807-c; (iv) all parties were equally at fault for non-compliance with § 2807-c; and (v) it would not invoke its equitable powers to apply the rates set by § 2807-c to the implied-in-fact contracts. The District Court dismissed plaintiffs' claims for unjust enrichment on the ground that it was "not against `equity and good conscience'" for plaintiffs to have been paid as they were. The District Court also determined that plaintiffs could not establish claims for breach of a third-party contract or for engaging in a pattern of deceptive practices.

Comments

(2006)

BETH ISRAEL MEDICAL CENTER, LENOX HILL HOSPITAL, MONTEFIORE MEDICAL CENTER, NYU HOSPITALS CENTER, THE NEW YORK AND PRESBYTERIAN HOSPITAL, THE NEW YORK EYE AND EAR INFIRMARY, NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED, MAINTAINING THE HOSPITAL FOR SPECIAL SURGERY, ST. LUKE'S-ROOSEVELT HOSPITAL CENTER, SAINT VINCENT'S HOSPITAL OF NEW YORK, and STATEN ISLAND UNIVERSITY HOSPITAL Plaintiffs-Appellants,

v.

HORIZON BLUE CROSS AND BLUE SHIELD OF NEW JERSEY, INC., Defendant-Appellee.

No. 04-5783-cv.

United States Court of Appeals, Second Circuit.

Argued: October 19, 2005. Decided: May 19, 2006.

New York Law School location: File #3417, Box #150

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