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Tagayun v. Americhoice of New Jersey, Inc.

Superior Court of New Jersey, Appellate Division

August 30, 2013

MYRNA B. TAGAYUN, M.D., Plaintiff-Appellant,
v.
AMERICHOICE OF NEW JERSEY, INC., d/b/a UNITEDHEALTHCARE COMMUNITY PLAN, and MICHELE NIELSON, Defendants-Respondents. and ROBERT S. MANDELL, Plaintiff,

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

Argued August 27, 2013

On appeal from the Superior Court of New Jersey, Law Division, Essex County, Docket No. L-5348-12.

Myrna B. Tagayun, appellant, argued the cause pro se.

Francis X. Manning argued the cause for respondents (Stradley, Ronon, Stevens & Young, LLP, attorneys; L. John Vassalotti, III, on the brief).

Before Judges Harris and Fasciale.

PER CURIAM

Myrna B. Tagayun, M.D., appeals from a January 11, 2013 order compelling her to arbitration.[1] We affirm.

AmeriChoice is a Health Maintenance Organization (HMO) that maintains a network of physicians and other medical professionals who provide medical services to AmeriChoice's members.[2] In April 2003, Tagayun signed a Participating Provider Agreement (PPA). The PPA renews each year unless one party notifies the other in writing of its intent not to renew at least ninety days prior to the renewal date.

On May 1, 2012, Nielsen sent a letter to Tagayun informing her that AmeriChoice could not locate its copy of the PPA, and that Tagayun was required to execute a new one and return it to AmeriChoice by June 1, 2012, if she wanted to continue operating as a Participating Provider. By letter dated May 22, 2012, Mandell enclosed a copy of the purported original PPA and represented that Tagayun would not sign a new agreement.[3]

By letter dated June 6, 2012, Nielsen informed Tagayun that because AmeriChoice had not received an executed copy of the new agreement, it would not be renewing Tagayun as a Participating Provider effective September 4, 2012. By letter dated June 11, 2012, Tagayun demanded rescission of the notice of intent to terminate the PPA. On July 18, 2012, plaintiffs filed their complaint, alleging that defendants had sent Tagayun an improper notice of termination. In the same month, plaintiffs filed an order to show cause (OTSC) seeking a preliminary injunction to prevent AmeriChoice from terminating the PPA.

By letter dated August 1, 2012, Nielson informed Tagayun that AmeriChoice had rescinded the notice of intent to terminate the PPA. On August 10, 2012, the judge conducted a hearing on plaintiffs' OTSC. The judge stated that he would provide a five-day order vacating plaintiffs' OTSC "as defendant has rescinded its notice of intent to terminate" Tagayun. Shortly thereafter, plaintiffs objected to the order. On August 20, 2012, the judge conducted a telephonic conference regarding plaintiffs' objection. By order dated August 20, 2012, the judge denied plaintiffs' OTSC without prejudice and ordered defendants to file a response to the original complaint by September 10, 2012.

On or about September 7, 2012, AmeriChoice moved to stay and compel arbitration as to Tagayun's claims and dismiss Mandell's claims. By letter dated January 7, 2013, Nielsen informed Tagayun that AmeriChoice was exercising its right not to renew her PPA effective on her anniversary date of May 7, 2013.

On January 11, 2013, after briefing was complete, Judge Michelle Hollar-Gregory conducted oral argument and granted AmeriChoice's motion in full. The judge stated that she was going to "stay the matter and compel it to arbitration, based upon the fact that there is a contract that provides for an arbitration provision."[4] On the same date, the judge issued an order reflecting her ruling.

On January 14, 2013, plaintiffs filed an amended complaint.[5]On January 15, 2013, plaintiffs filed this appeal of the January 11 order. By letter dated February 6, 2013, we noted that the filing of the amended complaint and the existence of the two pending motions "ha[d] caused us to question whether the determination being appealed is final." By letter dated February 19, 2013, plaintiffs acknowledged that certain issues remained outstanding in the Law Division, despite arguing that they were "irrelevant" with respect to the present appeal.

On March 6, 2013, AmeriChoice moved for limited remand to the Law Division. On March 18, 2013, plaintiffs filed an opposition and a cross-motion for injunctive relief, requesting that this court stay the nonrenewal of the PPA scheduled to take effect May 7, 2013. By order dated April 17, 2013, we dismissed the appeal as to Mandell, finding his appeal interlocutory; concluded that Tagayun had properly taken an appeal as of right from the January 11 order; and dismissed AmeriChoice's motion for ...


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