Supreme Generation, Inc. v Empire Blue Cross Blue Shield |
2025 NY Slip Op 50404(U) |
Decided on January 28, 2025 |
Supreme Court, New York County |
Lebovits, J. |
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
This opinion is uncorrected and will not be published in the printed Official Reports. |
Supreme Generation, Inc., Plaintiff,
against Empire Blue Cross Blue Shield and INTEGRA MLTC, INC., Defendants. |
Plaintiff, Supreme Generation, Inc., provides services to members of managed-long-term-care plans offered by defendant Integra MLTC, Inc., for which plaintiff is paid by Integra.[FN1] This dispute arises from services provided by plaintiff to Integra's members in 2020. Plaintiff billed Integra for those services, and Integra paid the full amount billed. Later, after an audit, Integra concluded that plaintiff had overbilled it by approximately $341,000. To recover the (asserted) overpayments, Integra has been withholding a percentage of current payments to [*2]plaintiff for services rendered.
Plaintiff, alleging that Integra's recoupment measures are unauthorized and improper, brought this action. As relevant here, plaintiff sued Integra on an account stated (first cause of action), for breach of contract (third cause of action), and for unjust enrichment and wrongful retention of funds (fifth and seventh causes of action, respectively). Integra now moves under CPLR 3211 (a) (7) to dismiss plaintiff's account-stated, unjust-enrichment, and wrongful-retention claims.[FN2] The motion is granted.
1. With respect to plaintiff's account-stated claim, the difficulty for plaintiff is that no "account" exists here, properly speaking. That is, "'the very meaning of an account stated is that the parties have come together and agreed upon the balance of indebtedness . . . so that an action to recover the balance as upon an implied promise of payment may thenceforth be maintained.'" (Interman Indus. Prods. v R. S. M. Electron Power, 37 NY2d 151, 154 [1975], quoting Newburger-Morris Co. v Talcott, 219 NY 505, 512 [1916] [Cardozo, J.].) Here, no balance exists with respect to the services invoiced in 2020, because, as plaintiff acknowledges, Integra already paid the full amount invoiced by plaintiff. Plaintiff's grievance is instead that Integra is taking steps to recover amounts already paid. And plaintiff provides no authority to support the proposition that full—not partial—payment of invoices can support a claim for an account stated should the payor later seek to rescind or recoup.
Nor do the allegations of the complaint support an account-stated claim with respect to Integra's refusal to make full payment on new invoices: The complaint reflects that Integra began partially withholding payment on current invoices after notifying plaintiff that Integra believed it had previously overpaid, such that Integra was entitled to withhold invoiced amounts until the overpayment had been fully recovered. That is, Integra has already objected to plaintiff's claim to full payment under those invoices. No account-stated claim lies on these facts as alleged, either.
2. With respect to plaintiff's unjust-enrichment and wrongful-retention causes of action, these claims are subject to dismissal as duplicative. Plaintiff acknowledges that where a valid, enforceable contract covers the subject matter in dispute, a plaintiff may not assert unjust-enrichment/wrongful-retention causes of action in addition to one for breach of contract claim. Plaintiff argues that its contract with Integra does not govern all of plaintiff's claims here because the actions taken by Integra to recover funds were not based on (or authorized by) particular provisions of the contract. This argument is without merit. Plaintiff is not contending that it performed services for Integra that were outside the scope of the contract, but rather that the contract did not permit Integra to withhold payment for contractual services rendered. That contention merely restates plaintiff's breach-of-contract claim itself. Plaintiff may not maintain unjust-enrichment/wrongful-retention causes of action on top of that claim.
Accordingly, it is
ORDERED that Integra's motion to dismiss plaintiff's first, fifth, and seventh causes of action against it is granted, and those causes of action are dismissed; and it is further
ORDERED that plaintiff's third cause of action against Integra is severed and shall continue.
DATE 1/28/2025