Complaint and Demand for Jury Trial against Magellan Health, Inc. alleging that Magellan failed to pay an employee more than $1 million+ in earned bonus compensation. United States District Court, Middle District of Florida, 2018. Pollard PLLC.
This document brings together a set
of latest data points and publicly
available information relevant for
Healthcare Industry. We are very
excited to share this content and
believe that readers will benefit from
this periodic publication immensely.
This document brings together a set
of latest data points and publicly
available information relevant for
Healthcare Industry. We are very
excited to share this content and
believe that readers will benefit from
this periodic publication immensely.
This presentation provides a comprehensive explanation of the Community Assistance Program (CAP) and the outreach effort behind the Rx discount card to help the un-insured and under-insured fill their medications more affordably at their local pharmacies.
claim settlement ratio is the ratio of the claims settled by a health insurance company to the claims submitted to them during a particular time-period. If all the claims submitted to the company are not settled, it shows that they have rejected some claims
Beneplan is an employee benefits co-operative representing tens of thousands of Canadians. Members receive premium refunds when their claims are low. To learn more, visit beneplan.ca.
HealthCompare Insurance - Understanding other types of insuranceHealth Compare
Understanding your options when it comes to Health Plans or Health Insurance can be a complicated experience, especially if you are unfamiliar with your options. HealthCompare has put together this slideshare to help you navigate and know your options. Learn more at HealthCompare.com
Controlling Workers’ Compensation Costs by as Much as 20% - 50%Richard Swartzbaugh
What is Workers’ Compensation?
Who Benefits from Workers’ Compensation Cost Control? Everyone!!!
Worker’s Comp costs can be one of your Company’s greatest “out of control” costs, or, YOU can but in a proven 19-step system to reduce Workers’ Comp costs by as much as 20% - 50%, and utilize critical metrics to address:
- Why workers’ compensation metrics are important
- The formulas for how to calculate 5 critical metrics
- How to leverage these metrics to make an impact at your organization
Following the step-by-step instructions in 19-Step system for the calculation and application of critical metrics will address:
- Workers’ comp viewed as a cost of doing business
- Getting management to understand value of return to work
- Convincing policy holders to embrace a worker recovery program
- Lack of informed and effective employer involvement in WC claims issues
- Stakeholder apathy
- Managers and supervisors not taking seriously their duty to protect workers
Avoiding Workers’ Comp mistakes & loopholes will help drive three major points:
- Drivers of human behavior
- Disincentives to “Return to Work”
- Most common employer mistakes
Finally:
- Evidence-based medicine will create better Workers’ Comp claim outcomes.
- In organized environments, executing successful return to work programs with Unions (and members) is essential.
- As part of a comprehensive workers compensation program, employers should maintain close communications with injured employees to ensure they recover quickly, do not drop out of the workforce and return to work rapidly. Get Well Cards are part of a positive, proactive communication strategy.
Chapter 6Alternative Responses and Initiatives of Institutions aJinElias52
Chapter 6
Alternative Responses and Initiatives of Institutions and Professions
Nongovernmental health care organizations provide most medical services and handle the financing of much of the system. For-profit and nonprofit institutions operate side by side, often competing directly for the same business.
This chapter identifies a number of strategies that individuals and organizations adopt in response to governmental programs or initiate on their own to influence health policy. We start with Table 6-1, which outlines the actors and the alternatives for responding to government actions and the marketplace. Where alternatives have been addressed and terms defined in earlier chapters, we try not to repeat that information.
6.1 COMMON RESPONSES
All of the players listed in Table 6-1 employ strategies to influence the marketplace and its regulators. These can be classified into three main types of interventions:
• Public relations
• Marketing and education
• Lobbying
Table 6-1 Responses and Initiatives of Institutions and Professions
Common Approaches
• Public relations
• Marketing and education
• Lobbying
Payers
• Employers
• Eligibility
• Subsidy offered
• Plans offered
• Relationship with insurers/self-insurance
• Worker education and training
• Insurers
• Method of organization
• Method of payment
• Plans offered
• Case management/carve-outs
• Utilization constraints
• Consumer education
Providers
• Professionals
• Organization of practice
• Services offered
• Incentives
• Pricing
• Patient relationships
• Primary versus specialty care
• Efficiency
• Institutions
• Organizational structure
• Scope and scale of services
• Pricing/discounts
• Efficiency
• Quality improvement
• Consumer information
• Credentialing decisions
• Involving payers in change processes
• Professions
• Quality improvement
• Provider education
• Consumer education
Consumers
• Plan selection
• Provider selection
• Self-help
Each player manages its relationships with the media and with politicians and regulators directly, and each acts indirectly through trade associations and professional groups. You will see illustrations of this throughout the cases included in this text and in subsequent chapters dealing with political feasibility and values. The focus of each intervention changes depending on the nature of the specific market. Lobbying is particularly intense in administered markets such as Medicare and Medicaid, especially when new legislation is under consideration. Lobbying also goes on continuously with the relevant executive branch agencies. Public relations and education are used more assertively when regulators are considering changes, and marketing, especially advertising, is most intense where the market is less regulated. The term education can apply to the many different types of efforts to influence behavior. Government antismoking campaigns can be characterized as education, for example, but the term can also ...
ACA Healthcare legislation and attempts at increasing regulation of self-funding and stop loss coverage are driving more employers toward stop loss captives.
American Green Rush: Business Opportunity & RisksAncella Simoes
This is a report I wrote recently on the impact of the growing legalized Marijuana industry, on the Insurance industry. The legal marijuana market is slated to grow about 700 percent in the next few years; for insurers, this means a specialized market with growing needs and immense business opportunity to determine the basic coverages which can be provided along with other specialized ones.
Pharma Sales Crediting: Incentives for Accurate & Compliant ProcessesCognizant
For pharmaceuticals organizations, sales incentive compensation is complicated and labor-intensive - and crucial for avoiding regulatory problems or sales rep dissatisfaction. We analyze the sales crediting process and offer key guidelines for ensuring it is accurate and efficient.
This presentation provides a comprehensive explanation of the Community Assistance Program (CAP) and the outreach effort behind the Rx discount card to help the un-insured and under-insured fill their medications more affordably at their local pharmacies.
claim settlement ratio is the ratio of the claims settled by a health insurance company to the claims submitted to them during a particular time-period. If all the claims submitted to the company are not settled, it shows that they have rejected some claims
Beneplan is an employee benefits co-operative representing tens of thousands of Canadians. Members receive premium refunds when their claims are low. To learn more, visit beneplan.ca.
HealthCompare Insurance - Understanding other types of insuranceHealth Compare
Understanding your options when it comes to Health Plans or Health Insurance can be a complicated experience, especially if you are unfamiliar with your options. HealthCompare has put together this slideshare to help you navigate and know your options. Learn more at HealthCompare.com
Controlling Workers’ Compensation Costs by as Much as 20% - 50%Richard Swartzbaugh
What is Workers’ Compensation?
Who Benefits from Workers’ Compensation Cost Control? Everyone!!!
Worker’s Comp costs can be one of your Company’s greatest “out of control” costs, or, YOU can but in a proven 19-step system to reduce Workers’ Comp costs by as much as 20% - 50%, and utilize critical metrics to address:
- Why workers’ compensation metrics are important
- The formulas for how to calculate 5 critical metrics
- How to leverage these metrics to make an impact at your organization
Following the step-by-step instructions in 19-Step system for the calculation and application of critical metrics will address:
- Workers’ comp viewed as a cost of doing business
- Getting management to understand value of return to work
- Convincing policy holders to embrace a worker recovery program
- Lack of informed and effective employer involvement in WC claims issues
- Stakeholder apathy
- Managers and supervisors not taking seriously their duty to protect workers
Avoiding Workers’ Comp mistakes & loopholes will help drive three major points:
- Drivers of human behavior
- Disincentives to “Return to Work”
- Most common employer mistakes
Finally:
- Evidence-based medicine will create better Workers’ Comp claim outcomes.
- In organized environments, executing successful return to work programs with Unions (and members) is essential.
- As part of a comprehensive workers compensation program, employers should maintain close communications with injured employees to ensure they recover quickly, do not drop out of the workforce and return to work rapidly. Get Well Cards are part of a positive, proactive communication strategy.
Chapter 6Alternative Responses and Initiatives of Institutions aJinElias52
Chapter 6
Alternative Responses and Initiatives of Institutions and Professions
Nongovernmental health care organizations provide most medical services and handle the financing of much of the system. For-profit and nonprofit institutions operate side by side, often competing directly for the same business.
This chapter identifies a number of strategies that individuals and organizations adopt in response to governmental programs or initiate on their own to influence health policy. We start with Table 6-1, which outlines the actors and the alternatives for responding to government actions and the marketplace. Where alternatives have been addressed and terms defined in earlier chapters, we try not to repeat that information.
6.1 COMMON RESPONSES
All of the players listed in Table 6-1 employ strategies to influence the marketplace and its regulators. These can be classified into three main types of interventions:
• Public relations
• Marketing and education
• Lobbying
Table 6-1 Responses and Initiatives of Institutions and Professions
Common Approaches
• Public relations
• Marketing and education
• Lobbying
Payers
• Employers
• Eligibility
• Subsidy offered
• Plans offered
• Relationship with insurers/self-insurance
• Worker education and training
• Insurers
• Method of organization
• Method of payment
• Plans offered
• Case management/carve-outs
• Utilization constraints
• Consumer education
Providers
• Professionals
• Organization of practice
• Services offered
• Incentives
• Pricing
• Patient relationships
• Primary versus specialty care
• Efficiency
• Institutions
• Organizational structure
• Scope and scale of services
• Pricing/discounts
• Efficiency
• Quality improvement
• Consumer information
• Credentialing decisions
• Involving payers in change processes
• Professions
• Quality improvement
• Provider education
• Consumer education
Consumers
• Plan selection
• Provider selection
• Self-help
Each player manages its relationships with the media and with politicians and regulators directly, and each acts indirectly through trade associations and professional groups. You will see illustrations of this throughout the cases included in this text and in subsequent chapters dealing with political feasibility and values. The focus of each intervention changes depending on the nature of the specific market. Lobbying is particularly intense in administered markets such as Medicare and Medicaid, especially when new legislation is under consideration. Lobbying also goes on continuously with the relevant executive branch agencies. Public relations and education are used more assertively when regulators are considering changes, and marketing, especially advertising, is most intense where the market is less regulated. The term education can apply to the many different types of efforts to influence behavior. Government antismoking campaigns can be characterized as education, for example, but the term can also ...
ACA Healthcare legislation and attempts at increasing regulation of self-funding and stop loss coverage are driving more employers toward stop loss captives.
American Green Rush: Business Opportunity & RisksAncella Simoes
This is a report I wrote recently on the impact of the growing legalized Marijuana industry, on the Insurance industry. The legal marijuana market is slated to grow about 700 percent in the next few years; for insurers, this means a specialized market with growing needs and immense business opportunity to determine the basic coverages which can be provided along with other specialized ones.
Pharma Sales Crediting: Incentives for Accurate & Compliant ProcessesCognizant
For pharmaceuticals organizations, sales incentive compensation is complicated and labor-intensive - and crucial for avoiding regulatory problems or sales rep dissatisfaction. We analyze the sales crediting process and offer key guidelines for ensuring it is accurate and efficient.
7 Biggest Medical Malpractice Insurance Mistakeshcpnational
“7 Biggest Mistakes MD’s Make in their Medical Malpractice Insurance Coverage” contains many tips on what to avoid, information on choosing Risk Retention Groups, how to deal with insurance brokers, and industry insurance terms that doctors should know.
For healthcare providers that bill to Medicaid, this surety bond ensures that providers keep accurate records, bill correctly, and handle funds properly.
Similar to Complaint against Magellan Health, Inc. for $1 Million Unpaid Bonus Compensation (20)
Pollard PLLC lawsuit seeking (a) declaratory judgment holding a non-compete agreement unenforceable and damages for (b) unpaid wages under the Fair Labor Standards Act (c) defamation per se and (d) tortious interference.
Pollard PLLC represents 7 real estate brokers and their new company KD Premier Realty against their former employer, Properties of the Villages. In the attached document, the Magistrate Judge has recommended that Plaintiff's Motion for Preliminary Injunction be denied. The case is pending in the United States District Court for the Middle District of Florida. The Firm can be reached at 954-332-2380.
Complaint - Bartender Non-Compete Case - Tampa Federal CourtPollard PLLC
This Complaint arises out of a hospitality and staffing company's assertion that several bartenders are subject to non-compete restrictions. The at issue non-compete agreements were never signed.
Pollard PLLC has initiated a lawsuit against the company WTS International, Inc. for tortious interference, defamation, and a declaratory judgment holding that no such non-compete agreements exist, or, that such restrictions are not enforceable.
The plaintiff in this case runs a janitorial service that primarily cleans restaurants. They have sued a former employee, Altman, for breach of a non-compete agreement and theft of trade secrets.
To state the obvious: The identity and contact information of the Cheesecake Factory is not a trade secret. Knowing how to clean a restaurant is not a trade secret. Quoting a price for cleaning services is not a trade secret.
Pollard PLLC represents Altman and has countersued for the following:
1. Declaratory judgment holding the non-compete agreement unenforceable.
2. False advertising under the Lanham Act.
3. Defamation. The Plaintiff has gone to multiple customers and told them that Altman stole their trade secrets and even stole equipment. Altman maintains that these allegations are total fabrications.
4. Tortious interference.
5. Breach of contract for failure to pay certain commissions.
Altman, now the Defendant/Counter-Plaintiff is seeking at least $10 million in damages in addition to corrective advertising to clear her name.
Complaint - Woodbridge Liquidation Trustee vs. Woodbridge's LawyersPollard PLLC
The trustee of the Woodbridge Liquidation Trust has brought a $500 million+ lawsuit against the lawyers and law firms that it alleges helped facilitate the Woodbridge Ponzi scheme.
Representatives Nunes Sues CNN for Defamation & $435 Million in DamagesPollard PLLC
Representative Devin Nunes has sued CNN for defamation and is seeking $435 million in damages. Per the Complaint: Nunes alleges that CNN knowingly published numerous false statements about his alleged involvement in Ukraine.
Per the Complaint: Nunes was not in Ukraine - as alleged - digging up dirt of the Bidens. This was a false narrative invented by Parnas to obtain leverage and cut a deal.
Let's unpack this:
The Complaint is full of theatrics but probably survives a motion to dismiss. Plaintiff has alleged that the statements at issue were false. The truth or falsity of those statements is a factual dispute. As for the defamatory nature of the statements: The statements could be defamatory, but probably don't rise to the level of defamation per se.
The Washington DC Attorney General's Office has filed a lawsuit against DoorDash. The Complaint alleges that DoorDash engaged in false and deceptive practices regarding its tipping policies. Basically, DoorDash used "tips" to subsidize worker pay---- while representing to the consuming public that the tip was exactly that--- a tip that went to the driver.
The reason why lawsuits by state AG's are so important here: Most people - whether workers or consumers - probably can't sue DoorDash because of arbitration provisions and class action waivers. But those things are no obstacle to a state AG.
SDFL - Order Dismissing Various Claims - Jurisdiction - Trade SecretsPollard PLLC
The Plaintiff filed a 20 count lawsuit alleging, among other counts, theft of trade secrets, unjust enrichment, breach of fiduciary duty, trademark infringement, violations of the Computer Fraud Abuse Act and more.
This is the classic shock and awe, everything and the kitchen sink approach to litigation.
In this instance, that approach backfired spectacularly. The Court dismissed 17 of the counts on jurisdictional grounds -- holding they cannot be refiled in federal court but must be pursued, if at all, in state court.
The court also dismissed one count with prejudice. Denied the motion to dismiss with respect to one count. And granted leave to amend on one count--- but warned plaintiff and its counsel to mind Rule 11 if they decide to amend.
Think twice before you file a 20 count complaint in federal court where you are literally throwing everything at the wall and hoping something sticks.
Motion to Dismiss Claims for Misappropriation of Trade Secrets and Tortious Interference under Florida law. Tampa, Florida. Hillsborough County Circuit Court - Complex Business Litigation Division.
Pollard PLLC
P. 954-332-2380
Appellate Brief - Appeal of Preliminary Injunction - United States Court of A...Pollard PLLC
On brief with my former colleagues from Boies Schiller. This is a major appeal of a preliminary injunction from the United States District Court for the Middle District of Florida to the United States Court of Appeals for the Eleventh Circuit.
Critical issues addressed herein:
1. Enforceability of restrictive covenants under CT law.
2. Application of CT's multi-factor test for reasonableness of restrictive covenants and/or non-compete agreement.
3. The public interest inquiry under FRCP 65.
4. The defense of prior breach under CT law.
5. The concept of irreparable under FRCP 65.
6. Whether protracted delay precludes a finding of irreparable harm and forecloses preliminary injunctive relief.
7. Whether the existence of settlement discussions/negotiations can justify a party's protracted delay in seeking injunctive relief.
Jonathan Pollard
Pollard PLLC
P: 954-332-2380
Middle District of Florida - Recent Decision Denying Trade Secret InjunctionPollard PLLC
This is a great example of how courts should evaluate a request for a preliminary injunction in a misappropriation of trade secrets case.
Courts and judges should never credit boilerplate, generic allegations about trade secrets and misappropriation. All such allegations should be put to the test. The key questions:
What is the trade secret? Has it been identified? Has it been boiled down to something concrete and tangible? Is the same thing publicly available? Does it have economic value? Has it been misappropriated? Were there reasonable efforts to keep it secret?
Even when the plaintiff has good answers to all of these questions, they still have to prove irreparable harm.
The 11th Circuit repeatedly has made this clear: Preliminary injunctions are supposed to be extraordinary and drastic remedies. They should be issued only in dire circumstances where there is a clear, imminent threat of irreparable.
Great read.
Jonathan Pollard
Pollard PLLC
Non-Compete & Trade Secret Lawyers
954-332-2380
Order Denying Motion to Dismiss False Advertising & Defamation ClaimsPollard PLLC
Order denying Motion to Dismiss claims for false advertising under the Lanham Act and defamation. Southern District of Florida 2019. Pollard PLLC. Jonathan Pollard.
FLSA Litigation - Federal Court - MDFL Tampa - Fee Entitlement & MootnessPollard PLLC
Lawyers in FLSA cases and particularly on the defense side should view this as a cautionary tale: Tendering a check for the wages at issue does not moot the plaintiff's claim. FLSA claims are live until there is a judgment or a settlement approved by the court. And plaintiffs DO get their fees for litigating over the issue of attorneys' fees.
Simply put: A legitimate FLSA case, a skilled attorney on the plaintiff side, and defense counsel who do not understand the applicable legal framework make for disastrous results.
MDFL - Order Denying Motion to Dismiss Trade Secret & Fraud ClaimsPollard PLLC
In this order, the United States District Court for the Middle District of Florida, Tampa Division, denies the defendants' motions to dismiss claims for breach of contract, theft of trade secrets in violation of the Defend Trade Secrets Act, 18 USC 1836 et. seq., fraud and aiding and abetting fraud.
In relevant part, the Court rejects the defendants' efforts to impose a summary judgment like burden at the pleading stage. Notable holdings include: (1) The question of whether information constitutes a trade secret is a question of fact normally resolved by a jury after full presentation of evidence. (2) A claim for misappropriation may exist not only where the defendant itself is alleged to have stolen trade secrets, but where the defendant is alleged to have obtained the trade secrets while knowing that they were acquired by improper means. (3) The allegation that a defendant induced a plaintiff to enter an NDA with no intention of honoring it states a claim for fraud in the inducement that is not barred by the independent tort doctrine.
The plaintiff is represented by Fort Lauderdale, Florida based Pollard PLLC. The firm has extensive experience litigating complex non-compete, trade secret, trademark and unfair competition claims. Their office can be reached at 954-332-2380.
Complaint for legal malpractice, fraud, breach of fiduciary duty, aiding and abetting breach of fiduciary duty, aiding and abetting fraud, and civil conspiracy. Pollard PLLC, Fort Lauderdale, FL 33301.
Order Denying Motion to Dismiss False Advertising & Defamation ClaimsPollard PLLC
Order of the United States District Court for the Southern District of Florida denying Defendant's Motion to Dismiss various claims, including claims for false advertising and defamation per se.
The at issue advertisements and statements consisted of the following: A company allegedly advised numerous customers and vendors in the industry that the plaintiff had stolen its trade secrets and engaged in illegal conduct.
Fort Lauderdale, Florida competition lawyer Jonathan Pollard presents on Non-Compete Agreements, Antitrust & the Rule of Reason. This presentation covers (1) the antitrust underpinnings of non-compete law (2) the classic antitrust rule of reason framework, which is the basis for all non-compete legitimate business interest tests and (3) antitrust risks in connection with non-compete agreements. This presentation is particularly timely given the Department of Justice's recent statement that it intends to pursue criminal prosecutions of firms engaged in no-poaching agreements.
To reach Pollard PLLC, please call their office at 954-332-2380.
Federal False Advertising & Trade Libel LawsuitPollard PLLC
This is an example of a recent case filed by Pollard PLLC, a litigation firm based in Fort Lauderdale, Florida that focuses on competition law.
This case involves a dispute between former business colleagues. The Plaintiff left the Defendant's company to start his own business. There was no non-compete, non-solicitation or confidentiality agreement. Fearing fair competition by the Plaintiff, the Defendant set out on a campaign to destroy Plaintiff's reputation in the industry.
For more information, visit https://www.pollardllc.com or call 954-332-2380.
Answer, Counterclaims & Third Party Claims - Non-Compete & Tortious InterferencePollard PLLC
This is one of our cases in Volusia County, Florida. Our clients - all of the defendants in the case - were sued for breach of a non-compete agreement, breach of fiduciary duty and tortious interference.
We responded with counterclaims for a declaratory judgment holding the non-compete agreement(s) unenforceable, third party claims for breach of fiduciary duty and breach of contract and a demand for indemnification.
This is a good example of our level of work. We have extensive experience litigating non-compete and tortious interference cases on both sides. We prosecute and defend these types of cases.
In every case, we have a process: First, we master the facts. Many lawyer and law firms get involved in a case and immediately focus on law. In our view, that is the wrong approach. All cases are driven by facts. Any legal strategy must be tailored to the specific facts of a specific case.
We do not take anything for granted. We do not default to the same tired boilerplate pleadings. In every new case, we fashion a specific strategy for that case.
If you have a non-compete or tortious interference case, just give us a call at 9543-32-2380. That's what we're here for.
How to Obtain Permanent Residency in the NetherlandsBridgeWest.eu
You can rely on our assistance if you are ready to apply for permanent residency. Find out more at: https://immigration-netherlands.com/obtain-a-permanent-residence-permit-in-the-netherlands/.
Responsibilities of the office bearers while registering multi-state cooperat...Finlaw Consultancy Pvt Ltd
Introduction-
The process of register multi-state cooperative society in India is governed by the Multi-State Co-operative Societies Act, 2002. This process requires the office bearers to undertake several crucial responsibilities to ensure compliance with legal and regulatory frameworks. The key office bearers typically include the President, Secretary, and Treasurer, along with other elected members of the managing committee. Their responsibilities encompass administrative, legal, and financial duties essential for the successful registration and operation of the society.
Car Accident Injury Do I Have a Case....Knowyourright
Every year, thousands of Minnesotans are injured in car accidents. These injuries can be severe – even life-changing. Under Minnesota law, you can pursue compensation through a personal injury lawsuit.
WINDING UP of COMPANY, Modes of DissolutionKHURRAMWALI
Winding up, also known as liquidation, refers to the legal and financial process of dissolving a company. It involves ceasing operations, selling assets, settling debts, and ultimately removing the company from the official business registry.
Here's a breakdown of the key aspects of winding up:
Reasons for Winding Up:
Insolvency: This is the most common reason, where the company cannot pay its debts. Creditors may initiate a compulsory winding up to recover their dues.
Voluntary Closure: The owners may decide to close the company due to reasons like reaching business goals, facing losses, or merging with another company.
Deadlock: If shareholders or directors cannot agree on how to run the company, a court may order a winding up.
Types of Winding Up:
Voluntary Winding Up: This is initiated by the company's shareholders through a resolution passed by a majority vote. There are two main types:
Members' Voluntary Winding Up: The company is solvent (has enough assets to pay off its debts) and shareholders will receive any remaining assets after debts are settled.
Creditors' Voluntary Winding Up: The company is insolvent and creditors will be prioritized in receiving payment from the sale of assets.
Compulsory Winding Up: This is initiated by a court order, typically at the request of creditors, government agencies, or even by the company itself if it's insolvent.
Process of Winding Up:
Appointment of Liquidator: A qualified professional is appointed to oversee the winding-up process. They are responsible for selling assets, paying off debts, and distributing any remaining funds.
Cease Trading: The company stops its regular business operations.
Notification of Creditors: Creditors are informed about the winding up and invited to submit their claims.
Sale of Assets: The company's assets are sold to generate cash to pay off creditors.
Payment of Debts: Creditors are paid according to a set order of priority, with secured creditors receiving payment before unsecured creditors.
Distribution to Shareholders: If there are any remaining funds after all debts are settled, they are distributed to shareholders according to their ownership stake.
Dissolution: Once all claims are settled and distributions made, the company is officially dissolved and removed from the business register.
Impact of Winding Up:
Employees: Employees will likely lose their jobs during the winding-up process.
Creditors: Creditors may not recover their debts in full, especially if the company is insolvent.
Shareholders: Shareholders may not receive any payout if the company's debts exceed its assets.
Winding up is a complex legal and financial process that can have significant consequences for all parties involved. It's important to seek professional legal and financial advice when considering winding up a company.
A "File Trademark" is a legal term referring to the registration of a unique symbol, logo, or name used to identify and distinguish products or services. This process provides legal protection, granting exclusive rights to the trademark owner, and helps prevent unauthorized use by competitors.
Visit Now: https://www.tumblr.com/trademark-quick/751620857551634432/ensure-legal-protection-file-your-trademark-with?source=share
Complaint against Magellan Health, Inc. for $1 Million Unpaid Bonus Compensation
1. UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
ORLANDO DIVISION
JAMES P. LARWETH, an individual,
Plaintiff,
vs.
MAGELLAN HEALTH, INC., a Delaware
corporation,
Defendant.
CASE NO:
COMPLAINT AND DEMAND FOR JURY TRIAL
Plaintiff James P. Larweth, through his undersigned counsel, files this Complaint
against Magellan Health, Inc., and in support states:
INTRODUCTION
1. James P. Larweth is a former employee of Magellan Health, Inc., a multi-billion-dollar
healthcare entity. Larweth brokered drug price contracts between pharmaceutical and
insurance companies for Magellan. Larweth was good at his job: He generated tens of millions
of dollars in revenue for Magellan. For the year 2015, Larweth relied upon and operated under
the commission plan presented by Magellan. Under the terms of that commission plan,
Magellan owed Larweth more than $1 million in additional compensation. But in 2016, when
payment came due, Magellan refused to honor its representations regarding those
commissions. Unbeknownst to Larweth, from the outset, Magellan never intended to honor the
commission plan, despite repeated representations by high-level executives that it would.
2. 2
2. In early 2018, Magellan terminated Larweth, in no small part because he refused to
drop the issue of his unpaid commissions or waive his legal right to receive those commissions.
Magellan offered him a severance package but conditioned it on the release of his claims for
his unpaid commissions. Larweth refused the severance package.
3. Following his termination, Magellan’s executives engaged in a smear campaign to
destroy Larweth’s reputation throughout the healthcare industry.
4. This action seeks redress for damages stemming from Magellan’s refusal to pay
Larweth’s 2015 commissions, fraudulent conduct, and concerted effort to damage his
professional reputation.
PARTIES, JURISDICTION, AND VENUE
5. This Court has subject matter jurisdiction over this action pursuant to 28 U.S.C. § 1332
because the amount in controversy exceeds $75,000.00, exclusive of interest, costs, and
attorneys’ fees, and is between parties of different states.
6. James P. Larweth (“Plaintiff” or “Larweth”) is a citizen and resident of Florida and a
resident of this District.
7. Magellan Health, Inc. f/k/a Magellan Health Services, Inc. (“Defendant” or
“Magellan”), is a Delaware corporation with its principal place of business located at 4800
Scottsdale Road, Suite 4400, Scottsdale, Arizona 85251.
8. Magellan conducts a significant amount of business in this District and its contacts
within this District give rise to Plaintiff’s claims.
3. 3
9. Magellan is a resident of this District for purposes of venue. 28 U.S.C. § 1391(b)(1)
and (c)(2). Venue in this District is also proper as a substantial part of the events or omissions
giving rise to the claims in this action occurred in this District. 28 U.S.C. § 1391(b)(2).
GENERAL ALLEGATIONS
10. Magellan is a publicly traded specialty health care management company.
11. Specialty healthcare refers to the provision of healthcare services by healthcare
professionals with specialized knowledge or experience.
12. Magellan is divided into two primary divisions: Magellan Healthcare and Magellan Rx
Management (“Magellan Rx”).
13. In addition to other services, Magellan Rx manages pharmaceutical rebate contracts by
negotiating deals for drug discounts between Drug Companies1
and Insurance Companies.2
The Carve-Out Drug Rebate Business
14. Insurance Companies hold considerable leverage when negotiating drug costs with
Drug Companies: By determining what their health plans will cover, Insurance Companies
ultimately control the public’s access to drugs.
15. To incentivize their drugs’ inclusion in health plans, Drug Companies offer rebates—
price discounts—to Insurance Companies in exchange for covering specific drugs. These
1
Pharmaceutical manufacturers such as Pfizer, Inc., Novartis AG, AbbVie Inc., and Amgen,
Inc.
2
Public and private health insurance providers such as Blue Cross and Blue Shield
Association, Tufts Associated Health Plans, Inc., Independent Health Association, Inc.,
Priority Health Managed Benefits, Inc., and UPMC Health Plan, Inc.
4. 4
discounts are memorialized in “rebate contracts” executed by Drug Companies and Insurance
Companies.
16. Insurance Companies leverage competition among Drug Companies to achieve lower
drug prices by way of higher rebates. Thus, if multiple Drug Companies produce the same or
similar drugs, the rebate amount will increase.
17. A massive industry grew out of the demand for and use of rebate contracts, leading to
the rise of intermediaries like Magellan Rx. Such companies broker and manage rebate
contracts on behalf of Drug and Insurance Companies.
18. Magellan Rx extracts hundreds of millions of dollars annually from rebate contracts in
two ways: (1) Charging Drug Companies administrative fees for brokering and processing
payments and rebates, and (2) retaining a portion of the “spread” — the gap between the
negotiated discount that an Insurance Company is willing to accept for a given drug and the
actual discount the Drug Company offers. Intermediaries such as Magellan Rx are known as
“Drug Rebate Brokers”.
19. Rebate contracts are tailored to the needs of Insurance Companies and the nature of the
drug covered. In 2015, Magellan Rx generated revenue from three types of rebates:
a. “Base Rebate.” Magellan collects a profit spread between the discounted drug price
it contracts from Drug Companies and the price it passes on to Insurance Companies.
For example, if a Drug Company offers Magellan a 10% discount on a drug,
Magellan passes a percentage of the discount to an Insurance Company and retains
the remainder of the discount for itself.
5. 5
b. “Price Protection Rebate.” A Drug Company agrees with Magellan to place a price
limit on a given drug for a specified amount of time. If the Drug Company, for
whatever reason, increases that drug’s price by more than the specified amount, an
additional rebate is passed on to the Insurance Company that is a party to the rebate
contract. Magellan retains a portion of this rebate.
c. “Term Improvement Rebate.” Magellan renegotiates the terms of an existing
rebate contract with a Drug Company for a larger discount. As with Base Rebates,
Magellan retains a portion of the discount while passing the rest on to the Insurance
Company.
20. Drug and Insurance Companies’ understanding of Magellan’s spread is opaque at best.
Often, neither Drug Companies nor Insurance Companies are made aware of the total rebate
acquired or the spread Magellan retains.
21. With little regulation and a constantly changing industry, trust amongst Drug
Companies, Insurance Companies, and Drug Rebate Brokers is essential to negotiating,
acquiring, and maintaining rebate contracts.
22. To maximize profits, Magellan regularly and as a matter of practice retains a significant
portion of the Price Protection and Term Improvement Rebates negotiated with Drug
Companies, rather than passing the rebates to Insurance Companies.
23. Magellan also earns rebate revenue by negotiating Term Rebate Improvement contracts
with Drug Companies under the pretense that an additional rebate is necessary to maintain the
relationship with the Insurance Company.
6. 6
24. Insurance Companies routinely cancel rebate contracts if a better deal—i.e., a larger
rebate—presents itself. As a result, rebate contracts are short-term by design, frequently lasting
only as long as the contract’s “termination without cause” provision, which is generally 30, 60,
or 90-days.
25. Magellan incentivizes its individual brokers (e.g., Larweth) to aggressively acquire and
retain rebate contracts through commission-based compensation plans.
Larweth’s Industry Experience
26. Larweth began his career at Sanofi, S.A, a Drug Company. During his twelve-year
tenure, he held several senior level positions, developed relationships with dozens of Insurance
Companies, and learned the ins-and-outs of rebate contract negotiations.
27. In October 2006, ICORE Healthcare, LLC (“ICORE”), a Magellan subsidiary, hired
Larweth as Vice President of Account Management to take advantage of his extensive industry
experience and reputation.
28. In October 2011, Larweth left ICORE and joined CDMI, LLC (“CDMI”), a start-up
health care management company created by a founder of ICORE. There, Larweth brokered
rebate contracts between Drug and Insurance Companies.3
Larweth Returns to Magellan
29. Larweth rejoined Magellan in March 2014. He was hired as Senior Vice President of
Business Development in Magellan Rx’s Specialty Carve-Out Rebate Division.
3
Roughly nine months after he joined CDMI, Magellan sued Larweth, CDMI, and CDMI’s
owner for an alleged breach of a non-compete agreement, among other claims. See Magellan
Health Services, Inc. v. CDMI, LLC, et al, Case No. 3:12-CV-01250 (JBA) (D. Conn. 2012).
That matter settled when Magellan purchased CDMI.
7. 7
30. Larweth hired a team of salespeople and developed, managed, and negotiated rebate
contracts.
31. Magellan Rx’s Specialty Carve-Out Rebate Division is split into two subdivisions:
Manufacturer/Pharmaceutical Relations and Health Plan Sales.
32. The Manufacturer/Pharmaceutical Relations division has a handful of employees
dedicated to negotiating rebate terms with Drug Companies. Those negotiated terms are
memorialized in a draft contract that is passed on to the Health Plan Sales division, which
works to sell the Insurance Companies on the rebate contracts.
33. Larweth worked in Health Plan Sales. The Health Plan Sales division’s goal is to broker
rebate contracts with Insurance Companies, thereby generating revenue for Magellan.
34. Although the Manufacturer/Pharmaceutical Relations and Health Plan Sales divisions
were separate, Magellan Rx’s brokers in both divisions worked together to retain and develop
relationships with Drug and Insurance Companies.
Larweth Receives and Relies Upon the 2015 Commission Plan
35. On or about March 18, 2015, Mostafa Kamal (“Kamal”), then Senior Vice President
and General Manager of Magellan Rx, emailed Larweth and other brokers a Proposed
Commission Plan for Carve-Out Rebate Business Development (“Commission Plan”). The
Commission Plan is attached hereto as Exhibit “A”. Kamal authored the Commission Plan.
36. Although titled “Proposed”, this document was the only operative 2015 commission
plan, retroactively effective January 1, 2015. It, and it alone, governed Larweth’s 2015
commissions.
8. 8
37. Larweth needed to meet a baseline rebate revenue target to earn commissions under the
Commission Plan. If the baseline was met, Larweth received 0.3% of the baseline amount.
38. The Commission Plan further provides that rebate revenue acquired in excess of the
baseline target would pay out in the following incremental commission tiers, in addition to the
baseline .3% commission:
a. $1-$1,000,000 – 7% of the incremental value;
b. $1,000,000 – $2,000,000 – 8% of the incremental value;
c. $2,000,000 – $3,0000,000 – 9% of the incremental value;
d. $3,000,000 + – 10% of the incremental value.
See Ex. A.
39. The Commission Plan allowed Magellan to “adjust for any unforeseen market
conditions that result in material changes” to the incentive structure. Id. No such conditions
arose in 2015.
40. By the Commission Plan’s March 2015 circulation, the majority of market pressures
that could or would impact Term Improvement rebate contracts in 2015 were known to
Magellan Rx.
41. Magellan also knew that the Commission Plan created the real possibility that Larweth
would earn a seven-figure bonus in 2015. But Magellan had a contingency plan: If, at the end
of the year, it deemed Larweth’s commissions too high, it would refuse to honor the
Commission Plan.
9. 9
42. From March 2015 through March 2016, Kamal and other Magellan Rx executives
repeatedly referred to the Commission Plan as governing Larweth’s 2015 commission
compensation.
43. From March to December 2015, Larweth negotiated rebate contracts in reliance on the
Commission Plan and generated tens of millions of dollars in revenue for Magellan through
(a) Base Rebate, (b) Price Protection Rebate, and (c) Term Improvement Rebate contracts.
Magellan Refuses to Pay Larweth’s 2015 Commissions
44. In July 2015, Kamal was promoted to CEO of Magellan Rx. In his first year as CEO,
Kamal was under immense pressure from Magellan’s Board of Directors. To justify his
promotion, he desperately needed strong 2015 financials.
45. There was one problem: Larweth’s commissions. Under the Commission Plan that
Kamal drafted and adopted on behalf of Magellan, Larweth earned over $1 million in
commissions in 2015 and nearly $2 million in overall compensation. Other employees in
Larweth’s division would also have been highly compensated.
46. In the Summer of 2015, Kamal and other upper level management at Magellan Rx
realized that Larweth’s compensation under the Commission Plan was going to be significant.
47. Kamal did not want to explain to Magellan’s Board of Directors how or why Larweth
earned a seven-figure commission payout based on an incentive structure that he created.
Kamal’s face-saving solution: Magellan would continue to misrepresent its intent to honor the
Commission Plan until payment became due in the first quarter of 2016, at which point it would
refuse to pay Larweth’s proper commissions.
10. 10
48. Kamal would have faced a mutiny without the assistance of Several Magellan Rx
executives, including Mark Lederer (“Lederer”), Vice President of Financial Operations, and
Kevin Fletemeyer (“Fletemeyer”), Chief Financial Officer and Senior Vice President.
49. Magellan, through Kamal or otherwise, never informed Larweth that it did not intend
to honor the Commission Plan. To the contrary, throughout 2015 and into 2016 Magellan
repeatedly represented to Larweth that he would be compensated in accordance with the
Commission Plan.
50. Larweth justifiably relied on Magellan’s representations.
51. In fact, he excelled. Larweth retained over $10 million in rebates above his baseline
target, qualifying all rebate revenue he generated in excess of his baseline target to a 10%
commission. See Ex. A.
52. Specifically, he retained, above his baseline target, approximately $5,200,000 in Price
Protection Rebates (by negotiating deals between Drug Companies such as AbbVie, Inc.,
Amgen, and Teva Pharmaceutical Ltd., and Insurance Companies such as Priority Health
Managed Benefits, Inc., UPMC Health Plan, Inc., Blue Cross and Blue Shield of Florida, Tufts
Health Plan, and Independent Health Association, Inc.), and $5,800,000 in Term Improvement
Rebates (by negotiating deals between AbbVie, Inc., Amgen and Priority Health Managed
Benefits, Inc., UPMC Health Plan, Inc., Blue Cross and Blue Shield of Florida, Tufts Health
Plan, and Independent Health Association, Inc.).
53. In March 2016, Magellan paid Larweth $575,000.00 in commissions for Base Rebate
contracts. However, he was entitled to $676,000.00 in commissions related to Base Rebate
contracts per the Commission Plan. Magellan never paid Larweth the additional $101,000.
11. 11
54. Further, Magellan informed Larweth that he was entitled to only $52,000 in excess
commissions above his baseline target for Price Protection Rebates, calculated as 1% of the
$5.2 million he retained in Price Protection Rebate revenue above his baseline target. This
number was wholly arbitrary and ignores the $520,000 he was entitled under the Commission
Plan.
55. Magellan outright denied commissions for revenue Larweth captured on Term
Improvement Rebates, ignoring the $5.8 million he generated above his baseline commission-
-thus depriving him of $580,000 owed under the Commission Plan.
56. Magellan refused to produce a detailed audit of its commission calculations, despite
Larweth’s repeated requests.
57. In February and March 2016, Lederer told Larweth that he was only entitled to a 1%
commission on Price Protection Rebates, rather than the 10% commission detailed in the
Commission Plan, because Larweth was not responsible for any of the Price Protection or Term
Improvement Rebates Magellan retained. This was false. Lederer knew it to be so: One of
Lederer’s subordinates, Denise McGinnis, worked extensively with Larweth on securing Price
Protection and Term Improvement Rebate contracts.
58. In mid-2016, Larweth met with Lederer at an airport hotel meeting room in Boston.
There, Lederer again tried to persuade Larweth that he was not entitled to commissions beyond
what he received.
59. Lederer’s story had changed: He now stated that 2015 revenue generated by Term
Improvement Rebates were “unforeseen” manufacturer term changes, rendering them non-
compensable by the Commission Plan. Again, Lederer refused to produce an accounting or
12. 12
documentation of Magellan’s delineation between “foreseen” v. “unforeseen” term
improvements, information essential to such calculation.
60. When the conversation turned to Price Protection Rebates, Lederer stated that Larweth
was lucky to receive a 1% commission, as all 2015 Price Protection Rebates were negotiated
with Drug Companies prior to Larweth’s reemployment with Magellan and without his
involvement.
61. Magellan’s position was a duplicitous reimagining of the Commission Plan’s purpose.
As Kamal wrote in the Commission Plan, the 2015 incentive structure was designed to
maintain accounts: “[I]t is important to create a structure that heavily incents behavior
that will support retention of accounts, not just new sales.” Ex. A. Thus, the Commission
Plan’s aim was to incentivize not just Base Rebate contracts, but Term Improvement and Price
Protection Rebate contracts.
62. Soon thereafter, Lederer produced a final commission report for 2015. The report
indicated that Larweth owed Magellan money for overpaying his commissions. Notably,
Magellan never attempted to claw back the money Larweth supposedly owed.
63. On or about August 21, 2016, Larweth attended Magellan’s annual Specialty Summit
in New York City.
64. After the Summit meeting, Larweth confronted Kamal about the unpaid 2015
commissions. Kamal stated that Larweth’s large commissions would make him look poorly in
the eyes of the Board of Directors. Kamal also stated that Larweth had been compensated
“enough.”
13. 13
65. These statements reveal a cold truth: From the Commission Plan’s inception, Magellan
never intended to honor its terms.
Magellan Terminates Larweth
66. In January 2017, Magellan Rx’s Specialty Carve-Out Rebate Division was restructured.
Philip Vecchiolli (“Vecchiolli”) was hired as Senior Vice President of Formulary
Management. Larweth lost his team and reported directly to Vecchiolli.
67. In late December 2017, Magellan gave Larweth notice that he would be terminated
without cause. Larweth was officially terminated on January 5, 2018.
68. Magellan presented Larweth with a Severance Agreement and Release (“Severance
Agreement”). The Severance Agreement provided that Larweth would explicitly waive any
rights or claims to his unpaid 2015 commissions.
69. Larweth refused the Severance Agreement.
Magellan Destroys Larweth’s Industry Relationships
70. Soon after Larweth was terminated, multiple Magellan executives, including Kamal
and Vecchiolli, launched a smear campaign to destroy Larweth's reputation.
71. In an industry as fiercely competitive as the drug rebate business, one’s reputation is of
paramount importance. Magellan knew this so it began targeting Insurance Companies with
which Larweth had worked for years, including companies that Larweth worked with prior to
his most recent tenure at Magellan.
72. On or about March 9, 2017, Vecchiolli, on behalf of Magellan Rx and at the behest of
Kamal, called the President & CEO of AscellaHealth, LLC (“AscellaHealth”). This call was
14. 14
made with the knowledge that Larweth had a great reputation with AscellaHealth that predated
his time at Magellan. During the call, Veccholli stated that Larweth:
a. Was attempting to raid the company and encouraging individuals to leave
Magellan Rx;
b. Was unlawfully competing against Magellan and supplying seed money to help a
former Magellan Rx sales executive start a competing company; and
c. Was engaging in illegal conduct and unfair competition and would soon be
“buried” in legal fees.
73. These statements are false. Magellan made these statements fully aware of their falsity
and the impact they could have on Larweth's reputation.
74. Vecchiolli also told AscellaHealth that because Larweth declined to sign the Severance
Agreement, he knew that Larweth was illegally competing against Magellan. Vecchiolli failed
to mention Larweth had been denied the majority of his 2015 commissions or that the
Severance Agreement required he waive his entitlement to same.
75. Vecchiolli also stated that he intended to call every Magellan client he could and tell
them what he had told AscellaHealth.
76. He began doing just that: On or around March 12, 2018, Vecchiolli, on behalf of
Magellan Rx and at the behest of Kamal, contacted Health Partners Plans, Inc. (“Health
Partners”) in Philadelphia, Pennsylvania. Vecchiolli, knowing that Larweth had worked with
Health Partners both prior to and during his Magellan tenure, warned Health Partners to avoid
Larweth. But he didn’t stop there. Vecchiolli again impugned Larweth’s character, indicating
15. 15
that he was unlawfully and unfairly competing against Magellan, engaging in illegal conduct,
and could not to be trusted. At least one of these conversations happened at Vecchiolli’s home.
77. Vecchiolli and other Magellan executives disseminated these same false statements to
Horizon Blue Cross Blue Shield, EmblemHealth/ConnectiCare, and Sentara Healthcare. As
with AscellaHealth and Health Partners, Larweth had a long-standing relationship with these
entities that predated his Magellan employment.
78. Next, Magellan executives, at the behest of Kamal, spread falsehoods regarding
Larweth’s character to numerous Magellan employees.
79. Through these and other conversations, Magellan, in minutes, intentionally destroyed
much of the good reputation that Larweth had spent years cultivating.
COUNT I – BREACH OF CONTRACT
(in the alternative to Count II and Count III)
80. Plaintiff realleges and incorporates paragraphs 1 through 79 as if fully set forth herein.
81. Defendant presented the Commission Plan to Plaintiff in March 2015.
82. The Commission Plan outlined that in exchange for Plaintiff’s services negotiating
rebate contracts, Magellan would pay Plaintiff commissions during the first quarter of 2016 in
the manner and amount outlined in the Commission Plan.
83. Plaintiff agreed to the Commission Plan’s terms and the Parties became bound by it.
84. The Commission Plan applied to the entire calendar year of 2015 and was the sole
document governing Plaintiff’s compensation. It sufficiently specified all essential terms.
85. The Commission Plan is a binding and enforceable contract.
16. 16
86. Under the Commission Plan, Plaintiff was entitled to 0.3% commission for reaching
his baseline revenue target in 2015 and additional incentives for surpassing his baseline
revenue target.
87. Plaintiff generated over ten million dollars in revenue above his baseline revenue target
for the year 2015.
88. Plaintiff was entitled to a 10% commission for all revenue generated in excess of his
baseline target, plus 0.3% of his total baseline revenue threshold.
89. Defendant materially breached the Commission Plan when it refused to pay Plaintiff
commissions owed under the Commission Plan during the first quarter of 2016.
90. As a direct and proximate cause of Defendant’s breach of the Commission Plan,
Plaintiff suffered damages in excess of one million dollars and in an amount to be determined
at trial.
COUNT II – QUANTUM MERUIT
(in the alternative to Count I and Count III)
91. Plaintiff realleges and incorporates paragraphs 1 through 79 as if fully set forth herein.
92. In 2015, Defendant wanted to increase its rebate contract revenue. To do so, Defendant
incentivized Plaintiff through promises of commission payments for successfully meeting
various benchmarks beyond his baseline target.
93. One such benchmark was a 10% commission on all revenue Plaintiff generated above
his baseline target if he generated $3,000,000 or more above his baseline target.
94. Plaintiff worked throughout 2015, providing services that were accepted by Defendant,
under the reasonable belief that he would receive a 10% commission on all revenue he
generated above his baseline target that exceeded his baseline target by $3,000,000 or more.
17. 17
95. Defendant was aware that Plaintiff reasonably expected to receive a 10% commission
on all revenue exceeding his baseline target by $3,000,000 or more.
96. Defendant was unjustly enriched as a result of its failure to pay Plaintiff the fair value
of his services in 2015.
COUNT III – UNJUST ENRICHMENT
(in the alternative to Count I and Count II)
97. Plaintiff realleges and incorporates paragraphs 1 through 79 as if fully set forth herein.
98. From March 2015 to March 2016, Defendant repeatedly indicated to Plaintiff that the
Commission Plan was the operative 2015 incentive structure.
99. Plaintiff justifiably relied on the Commission Plan governing his commission
compensation for 2015.
100.Defendant derived a benefit from Plaintiff by allowing him to work under the belief
that the Commission Plan was the operative compensation structure. To wit: The Commission
Plan incentivized stronger performance by Larweth.
101.Defendant knowingly and voluntarily accepted and retained the benefit of Plaintiff’s
work - millions of dollars in additional revenue - but did not compensate Plaintiff in accordance
with the Commission Plan.
102.Instead, Defendant improperly absorbed Plaintiff’s commissions into its earnings.
103.As a result of Defendant’s failure to pay Plaintiff’s commissions, Plaintiff has sustained
damages in excess of $1 million and in an amount to be determined at trial and Defendant has
been unjustly enriched at Plaintiff's expense.
104.Plaintiff lacks an adequate remedy at law.
18. 18
105.In equity and good conscience, Defendant should not be permitted to retain monies
wrongfully withheld from Plaintiff.
COUNT IV – FRAUD
106.Plaintiff realleges and incorporates paragraphs 1 through 79 as if fully set forth herein.
107.Defendant knew when it presented the Commission Plan to Plaintiff in March 2015
that it would not honor the terms of that Plan.
108.Plaintiff was not aware of this because (1) It was hidden from him and (2) Kamal,
Lederer, and Fletemeyer, as Defendant’s agents, repeatedly and materially represented to
Plaintiff that the Commission Plan was the operative compensation structure for the 2015 year.
109.Defendant intended for those representations to induce Plaintiff to continue working
with the belief that he would be compensated in accordance with the Commission Plan.
110.Plaintiff relied on Defendant’s material misrepresentations and continued to work and
thrive for the benefit of Defendant, believing his hard work would pay off in the form of
commissions.
111.Plaintiff’s reliance on Defendant’s representations was justifiable and caused him
harm.
112.Plaintiff has been harmed by Defendant’s fraud as he has been deprived of over $1
million dollars.
113.Only after 2015 passed, and Plaintiff’s commissions became due, did Defendant reveal
that Plaintiff would not be paid in accordance with the Commission Plan.
114.As a direct and proximate cause of Defendant’s fraud, Plaintiff suffered damages in
excess of $1 million and in an amount to be determined at trial.
19. 19
COUNT V – DEFAMATION PER SE
115.Plaintiff realleges and incorporates paragraphs 1 through 79 as if fully set forth herein.
116.In the Drug Rebate business, a good reputation is worth more than an existing
relationship. Plaintiff worked for over twenty years to cultivate his reputation amongst his
peers, as well as actual and prospective clients throughout the industry.
117.Defendant knowingly made false statements regarding Plaintiff’s character, skill, and
professional integrity in the Drug Rebate industry to numerous Insurance Companies.
118.Defendant’s false statements impugned the character, skill, and professional integrity
of Plaintiff in relation to the industry in which he dutifully served Defendant for over eleven
years.
119.Defendant’s false statements were published willfully, recklessly, and/or negligently.
120.Defendant’s false statements were repeated to a group of Plaintiff’s peers and contacts
within the industry, the full scope of which has yet to be determined.
121.Defendant’s statements have subjected Plaintiff to public ridicule and humiliation
within the Drug Rebate industry.
122.As a direct result of Defendant’s false statements, Plaintiff has suffered actual and
reputational damages.
20. 20
PRAYER FOR RELIEF
Plaintiff requests:
a. Compensatory damages for Defendant’s breach of contract to the fullest
extent permitted by law;
b. The value of services Plaintiff rendered on behalf of Defendant in 2015,
to the fullest extent of the law;
c. Restitution for Defendant’s unjust enrichment to the fullest extent
permitted by law, including disgorgement of profits netted by Defendant as a result
of its unjust enrichment;
d. Compensatory and punitive damages for Defendant’s fraud to the fullest
extent permitted by law;
e. Compensatory damages for reputational and actual loss caused by
Defendant’s per se defamation of Plaintiff, to the fullest extent permitted by law;
f. Punitive damages for reputational and actual loss attributable to
Defendant’s per se defamation of Plaintiff, to the fullest extent permitted by law;
g. Plaintiff’s costs;
h. Pre-judgment and post-judgment interest; and
i. Such other relief this Court deems just and proper.
JURY TRIAL DEMAND
Plaintiff demands a jury on all issues so triable.
21. 21
Dated: May 25, 2018 Respectfully submitted,
By: /s/ Jonathan Pollard
Jonathan Pollard
Florida Bar No.: 83613
jpollard@pollardllc.com
Trial Counsel
Christopher S. Prater
Florida Bar No.: 105488
cprater@pollardllc.com
David J. Yaffe
Florida Bar No.: 125488
dyaffe@pollardllc.com
Pollard PLLC
401 E. Las Olas Blvd.
Suite, #1400
Fort Lauderdale, FL 33301
Telephone: 954-332-2380
Facsimile: 866-594-5731
Attorneys for Plaintiff