ORDER ON MOTION TO DISMISS AND MOTION FOR SUMMARY
Michaela Murphy Justice
Stephen Doane, M.D. is a licensed physician by the State of
Maine Board of Licensure in Medicine (the "Board").
His primary practice is at PrimeCare Physicians in Biddeford,
which is affiliated with Southern Maine Medical Center. His
last employer, Webber Hospital, enrolled Dr. Doane in
Maine's Medicaid program ("MaineCare"),
allowing reimbursement by the Department of Health and Human
Services ("DHHS") for care provided. The enrollment
documentation between MaineCare and Webber Hospital
("Provider Agreement") incorporates 10-144 C.M.R.
Ch. 101, sub-ch. I, that provides DHHS with the authority to
terminate a rendering provider from the MaineCare program
for: "1) violating regulations or ethical codes
governing professional conduct, and 2) failing to meet State
and federal standards for participation, and 3) being
formally reprimanded or censured by a peer association for
unethical practice." 10-144 C.M.R. ch. 101, sub-ch. I.
The Provider Agreement provides that Webber Hospital will not
employ individuals excluded from the MaineCare program.
March 10, 2015, Dr. Doane was issued a letter by the Board
stating that Dr. Doane had demonstrated incompetence in the
treatment of a patient who died of drug intoxication. The
Board renewed Dr. Doane's license, but censured him,
imposed terms of probation and required a practice monitor to
review all cases in which Dr. Doane writes prescriptions for
more than one week of controlled substances. (Mot. Dismiss
Ex. B at 32-33.) As a result of the finding of the Board, on
April 9, 2015, DHHS issued a letter to Dr. Doane at Webber
Hospital stating that he was no longer eligible to
participate in Maine's Medicaid program
("MaineCare"). The letter explains "The general
practical effect of this restriction is to prohibit
employment in any capacity by a provider that receives
reimbursement, indirectly or directly, from MaineCare or
other Medicaid programs." MaineCare Exclusion Ltr. April
Doane sought informal review of the determination. In its
Final Informal Review Decision dated September 11, 2015, DHHS
affirmed its earlier determination. Dr. Doane has since
sought administrative appeal of the determination in addition
to pursuing the current action. In this action, Dr. Doane
seeks a declaration by the Superior Court that DHHS's
exclusion of Dr. Doane from the MaineCare program constituted
a revocation of a license that, pursuant to 4 M.R.S. §
152(a) and 5 M.R.S. § 10051(2), can only be revoked by
the Maine District Court.
the second time in recent years that this issue has come
before the Kennebec County Superior Court. In Corrado v.
DHHS, KENSC-CV-2015-084(Me. Super. Ct., Ken. Cty.,
2015), plaintiff Corrado similarly seeks a determination that
his approval for the MaineCare program be declared a license
for purposes of revocation, thereby requiring DHHS to bring
the matter before the District Court. In that case, the
plaintiff is a pharmacist who was reprimanded by the Board.
Following the reprimand, DHHS issued a letter excluding
Corrado from the MaineCare program. Corrado brought an action
for declaratory relief similar to the action brought in this
case. Because Corrado filed the action for declaratory relief
simultaneously to filing for administrative appeal, the Court
stayed the case pending determination by DHHS.
current matter, DHHS has moved the court for dismissal and
Dr. Doane has moved the Court for summary judgment.
DHHS moves to dismiss Plaintiff Doane's Complaint for
declaratory relief. In his Complaint, Dr. Doane asserts that
DHHS terminated his participation in the MaineCare program
and disqualified him from receiving reimbursement for
professional services rendered to any participant in a
medical assistance program administered by DHHS. (Pl's
Compl. ¶ 5.) Dr. Doane contends that this action
constitutes a revocation of a license that, pursuant to 4
M.R.S. § 152(a) and 5 M.R.S. § 10051(2), can only
be done by the Maine District Court. (Pl's Compl. ¶
argues that Dr. Doane's Complaint should be dismissed
because DHHS did not revoke any "license" held by
Dr. Doane or engage in any "licensing" action.
Instead, DHHS contends that it simply terminated a contract
it had entered into with Dr. Doane. Dr. Doane opposes this
motion and simultaneously moves for summary judgment arguing
that DHHS's revocation of Dr. Doane's ability to
participate in, and receive reimbursement from, MaineCare
constitutes a licensing action and has been recognized as
such by federal courts.
reasons discussed below, the Court denies DHHS's Motion
to Dismiss and grants Dr. Doane's Motion for Summary
Standard of Review
review of a motion to dismiss for failure to state a claim,
the Court accepts the facts alleged in the complaint as true.
Saunders v. Tisher, 2006 ME 94, ¶ 8, 902 A.2d
830. The Court "examine[s] the complaint in the light
most favorable to plaintiff to determine whether it sets
forth elements of a cause of action or alleges facts that
would entitle the plaintiff to relief pursuant to some legal
theory." Doe v. Graham, 2009 ME 88, ¶ 2,
977 A.2d 391 (quoting Saunders, 2006 ME 94, ¶
8, 902 A.2d 830). "For a court to properly dismiss a
claim for failure to state a cause of action, it must appear
'beyond doubt that [the] plaintiff is entitled to no
relief under any set of facts that might be proven in support
of the claim.'" Dragomir v. Spring Harbor
Hosp., 2009 ME 51, ¶ 15, 970 A.2d 310 (quoting
Plimpton v. Gerrard, 668 A.2d 882, 885 (Me. 1995)).
judgment, on the other hand, "is appropriate if the
record reflects that there is no genuine issue of material
fact and the movant is entitled to judgment as a matter of
law." Dussault v. RRE Coach Lantern Holdings,
LLC,2014 ME 8, ¶ 12, 86 A.3d 52 (quoting F.R.
Carroll, Inc. v. TD Bank, N.A.,2010 ME 115, ¶ 8, 8
A.3d 646). "A material fact is one that can affect the
outcome of the case, and there is a genuine issue when there
is sufficient evidence for a fact- finder to choose between
competing versions of the fact." McIlroy v.