Overview
International law firm McDermott Will & Emery achieved a complete victory on behalf of Firm client Biomed Pharmaceuticals, Inc. (Biomed) in obtaining affirmance of summary judgment on all claims brought against Biomed by Oxford Health Plans NY, Inc. and United Healthcare Services, Inc. (Oxford).
“We are thrilled that our client was fully vindicated,” said Andrew B. Kratenstein, team lead for this case and a New York-based litigation partner. “Leveraging business-savvy and creativity, we successfully made this result happen, including by emphasizing Biomed’s integrity.”
In August 2012, Oxford filed a complaint alleging that Biomed had fraudulently misrepresented billed charges and tortiously interfered with Oxford’s contracts with its patients by waiving those patients’ deductible and coinsurance obligations without obtaining evidence of financial hardship. After discovery concluded in 2016, the parties cross-moved for summary judgment where the New York Supreme Court granted Biomed summary judgment on all claims in February 2017.
Oxford appealed and, on March 18, 2020, the Appellate Division, Second Department unanimously affirmed, agreeing with every single one of McDermott’s arguments. Specifically, the appellate division held that: Biomed did not make any misrepresentations to Oxford about patients’ financial hardship; financial hardship waivers are permitted; and Oxford failed to demonstrate that Biomed had a general practice of waiver. The appellate division also agreed that Oxford did not rely on Biomed’s bills when determining how much to reimburse each claim, but rather reimbursed based on customary and reasonable rates. Finally, the appellate division agreed that there was no evidence that, had Biomed not waived patients’ financial obligations, patients would have sought care from less expensive in-network providers or that Biomed tortiously interfered with Oxford’s contracts with its members.
Andrew B. Kratenstein (LIT-NY) is the lead McDermott lawyer who argued the appeal.
The official case is Oxford Health Plans (NY), Inc. and United Healthcare Services, Inc. v. Biomed Pharmaceuticals, Inc. in the New York State Appellate Division, Second Department.
About McDermott
McDermott Will & Emery partners with leaders around the world to fuel missions, knock down barriers and shape markets. With more than 20 locations on three continents, our team works seamlessly across practices, industries and geographies to deliver highly effective—and often unexpected—solutions that propel success. More than 1,100 lawyers strong, we bring our personal passion and legal prowess to bear in every matter for our clients and the people they serve.
