Opinion ID: 200100
Heading Depth: 1
Heading Rank: 4

Heading: Summary Judgment on the Merits

Text: 88 The district court concluded that Dr. Singh could not succeed on the merits of his claims. We agree and rely heavily on the district court's astute analysis.
89 Dr. Singh alleged in his complaint that Blue Cross violated the HMO Blue Physician Agreement, the implied covenant of good faith and fair dealing, and the Audit Agreement. Although he renews the good faith argument on appeal, he treats it so perfunctorily that we deem it waived. 17 See United States v. Zannino, 895 F.2d 1, 17 (1st Cir.1990) (explaining that issues adverted to in a perfunctory manner, unaccompanied by some effort at developed argumentation, are deemed waived). On appeal, Dr. Singh only develops his claim that Blue Cross violated the Audit Agreement. 18 90 The complaints are familiar. Dr. Singh states that the first audit violated the Agreement because Blue Cross did not select a mutually agreeable peer review consultant as required under the Audit Agreement, and it took a professional review action before Dr. Singh was able to talk to Dr. Clayton about the audit. However, as explained earlier, the record demonstrates that Singh was largely responsible for this state of affairs. The parties initially could not agree on a peer reviewer, with Dr. Singh refusing to accept any of the physicians nominated by Blue Cross. Although the physician nominated by Dr. Singh (Dr. Criss) worked at the same hospital as Dr. Singh, Blue Cross agreed to permit him to conduct the review. However, when Dr. Criss received the relevant paperwork, he decided not to conduct the review. After Dr. Singh failed to respond to Blue Cross's request that he nominate another physician, Blue Cross appointed Dr. Clayton to perform the review. Therefore, Dr. Singh was at least as responsible for the unfair appointment of Dr. Clayton as was Blue Cross. Dr. Singh cannot claim that Blue Cross's failure to appoint a mutually agreeable peer reviewer made the first audit unfair when his failure to cooperate with Blue Cross led to this result. Moreover, [b]ecause Singh himself was not reliable in meeting the deadlines imposed by the Audit Agreement, he cannot fault Blue Cross for expediting a process which he had done much to delay. Singh, 182 F.Supp.2d at 177. 91 Dr. Singh also claims that some features of Blue Cross's second audit violated the Audit Agreement. However, the Audit Agreement covered only the first audit. The Agreement states that it was made by Blue Cross on behalf of its Bay State Health Care line of business, and addresses an audit to determine whether Blue Cross should admit[] [Dr. Singh] into its Bay State product. The Audit Agreement applied to all inquiries to determine whether Dr. Singh should be admitted to the Bay State line. However, by the time the second audit occurred, those inquiries were over: the RAC had voted not to admit Dr. Singh to the Bay State line, and the Bay State line itself had expired. Nothing in the Audit Agreement restricts Blue Cross's right to conduct a peer review of Dr. Singh with respect to the indemnity or the HMO Blue Products, or places conditions on such an audit. Singh cannot argue that Blue Cross's second audit violated the Audit Agreement because that contract by its own terms did not apply.
Chapter 93A provides a cause of action to 92 [a]ny person who engages in the conduct of any trade or commerce and who suffers any loss of money or property, real or personal, as a result of the use or employment by another person who engages in any trade or commerce of ... an unfair or deceptive act or practice.... 93 Mass. Gen. Laws ch. 93A, § 11; see also id., § 2 (establishing that unfair or deceptive acts or practices in the conduct of any trade or commerce are unlawful). Dr. Singh argues that Blue Cross violated Mass. Gen. L. ch. 93A by 1) failing to meet the HCQIA standards, 2) violating the Audit Agreement, and 3) violating the implied covenant of good faith and fair dealing. 94 We have already determined that no reasonable jury could determine that Blue Cross failed to meet the HCQIA standards. We have also addressed above, as contractual claims, Dr. Singh's arguments that Blue Cross violated the Audit Agreement. Assuming arguendo that Blue Cross's actions may technically have violated a contract that Dr. Singh had already flouted, they by no means reach `a level of rascality that would raise an eyebrow of someone inured to the rough and tumble of the world of commerce.' Quaker State Oil Ref. Corp. v. Garrity Oil Co., Inc., 884 F.2d 1510, 1513 (1st Cir.1989) (quoting Levings v. Forbes & Wallace, Inc., 8 Mass.App.Ct. 498, 396 N.E.2d 149, 153 (Mass.1979)). Chapter 93A only proscribes that level of improbity, and we endorse the district court's holding that Singh has shown no conduct by Blue Cross that a reasonable factfinder could find meets this demanding standard. Singh, 182 F.Supp.2d at 180.
95 Although Dr. Singh sued both Blue Cross and Dr. White for defamation, he only appeals the district court's entry of summary judgment on the defamation claim against Dr. White. Dr. Singh claims that the following elements of Dr. White's report to the RAC were defamatory: 96 a. [Singh's prescription of] large numbers of narcotic analgesics ... raises serious questions about this practitioner. It may need official review; 97 b. narcotic analgesics are liberally prescribed ... raise[s] serious questions about the veracity of this practitioner...; 98 c. This practitioner seems to have a low threshold for prescribing narcotic analgesics; and, 99 d. ? Public Health Menace. 100 Under Massachusetts law, [a] defamatory communication is protected by a conditional common law privilege provided the publisher and recipient share some legitimate mutual interest `reasonably calculated' to be served by the communication. Catrone v. Thoroughbred Racing Ass'ns of N. Am., Inc., 929 F.2d 881, 887 (1st Cir.1991) (internal quotation marks omitted). Here, Dr. White and Blue Cross shared a legitimate mutual interest in peer review. Accordingly, the district court found correctly that these statements are protected by the conditional common law privilege. Singh, 182 F.Supp.2d at 179 (holding that Dr. White's statements in the audit report are protected by the common law privilege, and Singh has presented insufficient evidence to surmount the privilege). 101 Dr. Singh argues that malicious intent abuses the conditional common law privilege. On motion for summary judgment, the plaintiff bears the burden of establishing abuse of the conditional privilege by clear and convincing evidence. Catrone, 929 F.2d at 889 (internal quotation marks and citations omitted). As evidence of such malice, Dr. Singh offers the unreasonable methods used to review Singh's practice. We have already decided in our discussions of immunity that no reasonable jury could find that the methods used to review Dr. Singh's practice were unreasonable. We see no reason to change our minds now. 102
103 The elements of tortious interference with business advantage are: 104 (1) a business relationship or contemplated contract of economic benefit; 105 (2) the defendant's knowledge of such relationship; 106 (3) the defendant's interference with the relationship through improper motive or means; and, 107 (4) the plaintiff's loss of advantage as a direct result of the defendant's conduct. 108 Brown v. Armstrong, 957 F.Supp. 1293, 1304-05 (D.Mass.1997), aff'd, 129 F.3d 1252 (1st Cir.1997) (table opinion). 109 Dr. Singh argues that eight pages of his deposition testimony demonstrated that he suffered a substantial loss of his patient base because of Blue Cross's peer review actions. This deposition testimony begins with Dr. Singh's incorrect assertion that I know for sure my panel was frozen. The RAC only recommended that Dr. Singh's panel be frozen; it never actually took this step. Dr. Singh then asserts that his name was not on a Blue Cross directory, that his patients (and prospective patients) noticed this, that Blue Cross's investigation of him became public knowledge, and that patients started leaving (or failing to sign up for) his practice. Yet Dr. Singh does not name a single member of the public to whom the investigation was disclosed. He repeatedly evaded direct questions on whether anyone actually told him that Blue Cross disclosed the investigation to them. Assuming arguendo that the investigation actually was disclosed to individuals outside of Blue Cross, Dr. Singh does not even estimate how many patients actually left or avoided his practice on account of it. We cannot improve on the district court's evaluation of the evidence: 110 Singh may not speculate about future business relationships when alleging this tort; instead, only a probable future business relationship anticipating a reasonable expectancy of financial benefit suffices. Because Singh has presented no evidence of a specific business relationship that was interfered with by Blue Cross, summary judgment is granted for Blue Cross. 111 Singh, 182 F.Supp.2d at 178 (citation omitted) (quoting Brown, 957 F.Supp. at 1305). The grant of summary judgment was correct.