Nevarre, D. v. Highmark, Inc. ( 2021 )

J-S07019-21
NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
DANIEL R. NAVARRE, M.D. : IN THE SUPERIOR COURT OF
: PENNSYLVANIA
Appellant :
:
:
v. :
:
:
HIGHMARK, INC. D/B/A HIGHMARK, : No. 1014 WDA 2020
AND ACTING AS AGENTS OF :
MEDICARE AND MEDICAID IN :
PENNSYLVANIA; AND UPMC D/B/A :
UPMC HEALTH PLAN AND UPMC :
INSURANCES DIVISION, AND :
ACTING AS AGENTS OF MEDICARE :
AND MEDICAID IN PENNSYLVANIA :
Appeal from the Order Dated September 4, 2020
In the Court of Common Pleas of Cambria County Civil Division at No(s):
No. 2020-1973
BEFORE: SHOGAN, J., DUBOW, J., and KING, J.
JUDGMENT ORDER BY DUBOW, J.: FILED: MARCH 18, 2021
Appellant, Daniel R. Navarre, M.D., appeals pro se from the September
4, 2020 Order sustaining the Preliminary Objections filed by Appellees,
Highmark Inc. (“Highmark”) and UPMC and UPMC Health Plan (“UPMC”) and
dismissing Appellant’s Complaint with prejudice in this Breach of Contract
Action. We dismiss this appeal.
The relevant facts and procedural history are as follows. Appellant was
a plastic surgeon. In 2018, following an investigation by the Pennsylvania
Office of the Attorney General into Appellant’s improper and fraudulent billing
practices, Appellant entered a guilty plea to one count each of Provider
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Prohibited Acts—False Information/Claims and Insurance Fraud. The trial
court sentenced Appellant to a term of house arrest followed by probation and
to pay costs and restitution in the amount of $288,974 to UPMC Health Plan,
Highmark, Medicaid, and Medicare.
On May 21, 2020, Appellant commenced this pro se Breach of Contract
action against Appellees in which he principally sought repayment of the
restitution he paid to Appellees as part of the sentence imposed following his
guilty plea.
Both Highmark and UPMC filed, separately, Preliminary Objections to
Appellant’s Complaint. Appellees asserted that Appellant had failed to state a
Breach of Contract claim because he could not set forth sufficient facts to
satisfy the elements of the claim—including the existence of a contract
between the parties. They further asserted that Appellant’s claim improperly
relied on a collateral attack of his criminal conviction and that punitive
damages are not available in Breach of Contract actions.
On July 16, 2020, Appellant filed a separate Response to each of the
Preliminary Objections, arguing that his claim was viable and that his prior
guilty plea from his criminal case did not bar his civil claim because “the
charges [underlying the plea] were fabricated and false.” See, e.g., Response
to UPMC’s Preliminary Objections, 7/16/20, at 7 (unpaginated)
Following oral argument on the Preliminary Objections, on September
4, 2020, the trial court sustained the Preliminary Objections and dismissed
Appellant’s Complaint. As to UPMC, the court determined that no contract
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existed between UPMC and Appellant. The trial court also found that “the case
law precludes [Appellant] from using this civil forum to litigate unfavorable
criminal proceedings[.]” Opinion, 9/4/20, at 3.
This pro se appeal followed. Appellant filed a court-ordered Rule
1925(b) Statement. The trial court filed a Rule 1925(a) Opinion directing this
Court to its September 4, 2020 Opinion and Order.
The pro se Brief that Appellant has submitted to this Court fails to
conform to the basic requirements of appellate advocacy. Appellant’s Brief
does not include: (1) any statement of the scope and standard of review;1 (2)
a statement of questions involved; and (3) a copy of his Rule 1925(b)
Statement. See Pa.R.A.P. 2111(a) (listing required contents for appellate
briefs).
Most notably, the argument section of Appellant’s Brief is devoid of any
citation to the record or relevant controlling case law applied and analyzed
under the facts of this case. See Appellant’s Brief at 13-24 (unpaginated).
“The Rules of Appellate Procedure state unequivocally that each question an
appellant raises is to be supported by discussion and analysis of pertinent
authority.” Eichman v. McKeon, 824 A.2d 305, 319 (Pa. Super. 2003)
(citations omitted). See Pa.R.A.P. 2111 and Pa.R.A.P. 2119 (listing argument
____________________________________________
1 Appellant’s Brief includes a section entitled “Standard of Review,” which
consists of a series of paragraphs identified as either “Law,” “Fact,” or
“Fact/Law” but does not does not include any case law setting forth this
Court’s scope or standard of review over orders sustaining preliminary
objections. Appellant’s Brief at 24-27 (unpaginated).
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requirements for appellate briefs). Furthermore, “[w]hen issues are not
properly raised and developed in briefs, when the briefs are wholly inadequate
to present specific issues for review, a Court will not consider the merits
thereof.” Branch Banking and Trust v. Gesiorski, 904 A.2d 939, 942-43
(Pa. Super. 2006) (citation and brackets omitted). See Pa.R.A.P. 2101
(explaining that substantial briefing defects may result in dismissal of appeal).
“While this court is willing to liberally construe materials filed by a pro
se litigant, we note that appellant is not entitled to any particular advantage
because [he] lacks legal training.” Gesiorski, at 942 (citation omitted). “As
our [S]upreme [C]ourt has explained, any layperson choosing to represent
[himself] in a legal proceeding must, to some reasonable extent, assume the
risk that [his] lack of expertise and legal training will prove [his] undoing.”
Id. (citation omitted).
In the present case, even a liberal construction of Appellant’s Brief
cannot remedy the serious inadequacies. Accordingly, we dismiss the appeal
due to the substantial briefing defects in Appellant’s Brief, which hamper our
ability to conduct meaningful appellate review. See Pa.R.A.P. 2101.
Appeal dismissed.
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Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 3/18/2021
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