Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Miller v. Medical Mutual of Ohio

Court of Appeals of Ohio, Fifth District

July 18, 2013

ELISE MILLER, et al. Plaintiffs-Appellants
v.
MEDICAL MUTUAL OF OHIO Defendant-Appellee

Civil Appeal from the Court of Common Pleas, Case No. 2012CI0138

For Plaintiffs-Appellants RICHARD T. ROBOL RACHEL CHODERA MONAGHAN

For Defendant-Appellee CHRISTOPHER S. WILLIAMS MAURA L. HUGHES LAURA MCBRIDE MOLLY A DRAKE, DAVID J. WIGHAM STEVE J. SHROCK

Hon. W. Scott Gwin, P. J. Hon. John W. Wise, J. Hon. Craig R. Baldwin, J.

OPINION

Wise, J.

{¶1} Appellants Elise Miller and Pharmaceutical Alternatives, Inc. appeal from the October 4, 2012, decision entered in the Coshocton County Court of Common Pleas granting Appellee Medical Mutual of Ohio's Civ.R. 12(B)(6) Motion to Dismiss.

STATEMENT OF THE FACTS AND CASE

{¶2} Pharmaceutical Alternatives, Inc. (PAI) is a "closed-door pharmacy" and provider of certain specialty pharmaceuticals which contracted with Medical Mutual of Ohio (MMO), an Ohio provider of health insurance. Elise Miller is the sole owner of PAI.

{¶3} In 2000, PAI and MMO entered into an agreement which provided for reimbursement to PAI for certain services and medications PAI would provide to MMO's insureds (the "Participation Agreement"), and two additional agreements, which provided for reimbursement to PAl on an in-network basis (the "Provider Agreements") (collectively, the "Agreements").

{¶4} During the course of the relationship between PAI and MMO, several disputes arose with regard to the Agreements. One such dispute resulted in a lawsuit filed on July 11, 2006, captioned Pharmaceutical Alternatives. Inc. v. Medical Mutual of Ohio, Case No. 06-CIV-525, currently pending in the Coshocton County Court of Common Pleas, Coshocton County, Ohio.

{¶5} On or about November 5, 2008, PAI filed a voluntary petition for relief under Chapter 11 of the Bankruptcy Code in the United States Bankruptcy Court for the Southern District of Ohio, Eastern Division.

{¶6} Subsequently, on or about March 18, 2009, PAI's case was converted to one under Chapter 7 of the Bankruptcy Code and William B. Logan was appointed the Chapter 7 Trustee ("Bankruptcy Trustee").

{¶7} On September 24, 2010, the Bankruptcy Court issued an agreed order authorizing the Bankruptcy Trustee to sell to Cardinal Health any and all rights, title and interest to claims and litigation held by PAI against MMO free and clear of any liens and encumbrances.

{¶8} On or about March 29, 2012, Plaintiffs-Appellants Pharmaceutical Alternatives Inc. and Elise Miller filed their Complaint against Defendant Medical Mutual of Ohio in the Court of Common Pleas for Coshocton County.

{¶9} Appellants' Complaint included claims for breach of written contract ("Count I"), breach of implied covenant of good faith and fair dealing ("Count II"), promissory estoppel ("Count III"), conversion ("Count IV"), tortious interference with contractual relations and with prospective business relations ("Count V"), negligent and intentional misrepresentation/fraud ("Count VI"), "destruction of business through bad faith in processing and paying insurance and guaranteed claims" ("Count VII"), and civil conspiracy ("Count VIII").

{¶10} On May 25, 2012, Defendant filed a motion to dismiss all claims for failure to state a claim under Civ.R. 12(B)(6).

{¶11} On July 16, 2012, Plaintiffs-Appellants filed their memorandum in opposition to the motion to dismiss.

{¶12} On October 4, 2012, the trial court granted the motion to dismiss.

{¶13} Appellants filed an appeal and assigned the following Assignments of Error:

ASSIGNMENTS OF ERROR

{¶14} "I. THE DECISION BELOW ERRS IN HOLDING THAT PLAINTIFF PAI IS BARRED FROM ANY AND ALL CLAIMS AGAINST DEFENDANT MMO BY A SEPTEMBER 24, 2010 ORDER OF THE U.S. BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF OHIO.

{¶15} "II. THE DECISION BELOW ERRS IN HOLDING THAT COMPLAINT FAILS TO STATE A CLAIM FOR "[TORTIOUS] INTERFERENCE" BECAUSE MILLER'S CLAIM "INVOLVES A POTENTIAL BUSINESS AGREEMENT BETWEEN PAI AND THE WEINBERG & BELL GROUP."

{¶16} "III. THE DECISION BELOW ERRS IN HOLDING THAT THE COMPLAINT FAILS TO STATE A CLAIM FOR PROMISSORY ESTOPPEL AS TO PLAINTIFF MILLER "BECAUSE MILLER FAILS TO IDENTIFY ANY STATEMENT, PROMISE OR ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.