Umeze, MD v. New York State Department of Health

Background

Ben Umeze, MD, a doctor proceeding without a lawyer, had provided care to Medicaid recipients through a contract with Healthfirst. Healthfirst sent Umeze a notice on October 1, 2024, stating that it would not renew the contract effective January 1, 2025. Healthfirst later sent patients a letter stating that Umeze would no longer be in its network.

Umeze sued the New York State Department of Health, its commissioner, the New York State Medicaid Director, the New York State Office of Medicaid Management, New York State, and later added Healthfirst entities and Pat Wang. He asserted breach-of-contract claims, claims under 42 U.S.C. § 1983 alleging violations of due process and equal protection, and a claim concerning Medicaid payment rates. He sought an order requiring Healthfirst to delay the non-renewal and requiring the State to make Healthfirst do so.

The court first issued a temporary restraining order directing Healthfirst to temporarily maintain Umeze’s participation in its provider network. After a hearing, the court vacated that order. This opinion addresses Umeze’s renewed request for a preliminary injunction, which would provide temporary relief while the case continues.

Preliminary-injunction standard

The court explained that a preliminary injunction generally requires a showing of likely irreparable harm, a likelihood of success on the merits or sufficiently serious questions combined with a favorable balance of hardships, and consistency with the public interest. A mandatory injunction that changes the existing situation requires a stronger showing of a clear or substantial likelihood of success.

The court construed Umeze’s filings liberally because he was representing himself, but it stated that this did not require the court to create new claims or disregard evidence contradicting his allegations.

Court’s analysis

The court identified the operative agreement as the 2017 contract between Healthfirst entities and Lovina Medical P.C., Umeze’s professional medical corporation. The contract stated that, after it had been in effect for at least 12 months, either party could choose not to renew it at the annual January 1 expiration date by giving at least 60 days’ notice.

The court held that Umeze could not obtain an injunction based on alleged nonpayment because money damages would adequately compensate him if he ultimately prevailed. The court also concluded that Umeze had shown no likelihood of success on his claim that Healthfirst improperly refused to renew the contract. The contract expressly allowed non-renewal, Umeze acknowledged that the contract had been in effect for more than 12 months, and Healthfirst gave more than 60 days’ notice.

The court rejected Umeze’s argument that the non-renewal right depended on both parties’ having fulfilled all their contractual obligations. It found that the contract made the right to non-renew conditional only on the contract’s having been in effect for at least 12 months and the required notice being given.

The court treated Umeze’s due-process, equal-protection, and Medicaid-rate arguments as claims concerning money. It concluded that those claims could not support a preliminary injunction because Umeze had not offered authority or evidence showing that Healthfirst should have paid him at a higher rate, and monetary relief would be available for payment-related injuries.

The court also concluded that the State could not be held liable for breach of the 2017 contract because the State was not a party to that agreement. Although Healthfirst had contracts with the State and its provider contracts were affected by state rules and policies, the evidence did not show that the State could require Healthfirst to continue its relationship with Umeze.

Alleged temporary-order violation and disposition

The court liberally construed Umeze’s argument that Healthfirst violated the temporary restraining order as a request for sanctions. The court denied that request. It stated that Healthfirst might have removed Umeze from its network prematurely while the order was in effect, but found no evidence of the bad faith required for sanctions. The court accepted Healthfirst’s counsel’s representation that Healthfirst had attempted to comply with the order and intended to comply.

The court denied Umeze’s request for a preliminary injunction and directed the Clerk of Court to terminate that motion. The opinion did not enter a final ruling on the underlying claims.