Corey Musselman, et al v. Blue Cross Blue Shield of Alab, et al

Filing

Opinion issued by court as to Appellants Rick Love, Corey Musselman and Charles Shane. Decision: Affirmed. Opinion type: Non-Published. Opinion method: Per Curiam. The opinion is also available through the Court's Opinions page at this link http://www.ca11.uscourts.gov/opinions.

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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 13-14250
________________________
D.C. Docket No. 1:13-cv-20050-FAM
COREY MUSSELMAN,
RICK LOVE,
CHARLES SHANE,
Plaintiffs - Appellants,
versus
BLUE CROSS AND BLUE SHIELD OF ALABAMA,
PREMERA BLUE CROSS AND BLUE SHIELD OF ALASKA,
ANTHEM BLUE CROSS AND BLUE SHIELD OF CONNECTICUT,
BLUE CROSS AND BLUE SHIELD OF FLORIDA,
BLUE CROSS AND BLUE SHIELD OF GEORGIA, et al.,
Defendants - Appellees.
________________________
Appeal from the United States District Court
for the Southern District of Florida
________________________
(April 5, 2017)

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Before TJOFLAT, JULIE CARNES and GILMAN, ∗ Circuit Judges.
PER CURIAM:
After review and oral argument, we affirm the District Court’s dismissal of
the plaintiff-appellants’ complaint under Federal Rule of Civil Procedure 12(b)(6)
on the basis of the District Court’s thorough and well-reasoned order of August 20,
2013.
AFFIRMED.

∗

Honorable Ronald Lee Gilman, U.S. Circuit Judge for the Sixth Circuit, sitting by designation.
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TJOFLAT, Circuit Judge, concurring specially:
This case comes before us on appeal from an order of the United States
District Court for the Southern District of Florida dismissing the plaintiffs’
complaint for declaratory relief under Federal Rule of Civil Procedure 12(b)(6).
The plaintiffs are three doctors who had previously been plaintiffs in class-action
litigation (the “Shane and Love Litigation”) and party to settlements with most of
the defendants. 1 These settlements included broad releases of claims enforced by
consent decree. Subsequently, the plaintiffs desired to join a different class action
coalescing in the United States District Court for the Northern District of Alabama
(the “Conway Litigation”) asserting similar claims against many of the same
defendants. The plaintiffs petitioned the Southern District of Florida for a
declaratory judgment that the consent decrees from the Shane and Love Litigation
did not bar them from joining the Conway Litigation. The District Court granted
the defendants’ motion to dismiss for failure to state a claim after determining that
the consent decrees clearly enjoined them from joining the Conway Litigation.
I write separately because I would affirm the District Court on the grounds
that a declaratory judgment action is not the appropriate vehicle for determining
the scope of a permanent injunction. The Declaratory Judgment Act was not
intended to provide a route for circumventing the enforcement of an already-

1

See infra note 5.
3

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granted injunction. Allowing a declaratory judgment to issue for these purposes
would significantly defang the injunction as a remedy, which would work a serious
harm on the rule of law and the integrity of the judiciary. As such, no complaint
filed for these purposes can properly state a claim for which declaratory relief may
be granted, and I would affirm the order of dismissal on this basis.

I.
The plaintiffs in this case—Doctors Musselman, Shane, and Love—were
plaintiffs in class-action lawsuits filed in the early 2000s against the entities of the
Blue Cross Blue Shield (BCBS) network of health insurers. Those previous
lawsuits were In re: Managed Care Litigation, No. 00-md-01334 (S.D. Fla.)
(“Shane”) and Love v. Blue Cross and Blue Shield Association, No. 03-cv-21296
(S.D. Fla.) (“Love”). The District Court presided over both Shane and Love, which
involved substantively identical claims under the Racketeer Influenced and Corrupt
Organizations Act (RICO), 18 U.S.C. §§ 1961–19682 against different groups of
health insurers.3

2

The health insurers allegedly altered their automated-payment systems to covertly
undercompensate physicians for medically necessary services. See Klay v. Humana, Inc., 382
F.3d 1241, 1246–50 (11th Cir. 2004) (summarizing the Shane plaintiffs’ allegations). This
scheme was made all the more effective, the plaintiffs alleged, due to the defendants’
“overwhelming economic power and market dominance,” which forced the plaintiffs into doing
business with the insurers despite their unsavory practices.
3

Shane was a consolidated multidistrict litigation against most of the country’s major
health maintenance organizations (HMOs), first filed in 2000. Love was a separate suit against
4

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Between 2005 and 2007, the BCBS defendants settled claims in Shane and
Love in three separate settlement agreements—the WellPoint, Highmark, and Blue
Cross Settlement Agreements. Of the thirty-six BCBS defendants in the present
case, eight were parties to the WellPoint agreement,4 two were parties to the
Highmark agreement, and twenty-five were parties to the Blue Cross agreement.5
The settlements all included broad releases of claims, which were nearly identical. 6

the BCBS defendants in 2003. The same District Judge presided over both suits due to the
Court’s former Local Rule 3.9(c), which provided,“[w]henever an action . . . is filed in the Court
which involves subject matter which is a material part of the subject matter of another action . . .
then pending before this Court, or for other reasons the disposition thereof would appear to entail
the unnecessary duplication of judicial labor if heard by a different Judge, the Judges involved
shall determine whether the newly filed action . . . shall be transferred to the Judge to whom the
earlier filed action or proceeding is assigned.” That rule is now codified under Rule 2.15.00(c) of
the Court’s Internal Operating Procedure.
4

The eight parties to the WellPoint agreement were defendants in both Shane and Love,
whereas the remaining parties were defendants only in Love. The WellPoint agreement settled
both suits.
5

For those counting, only thirty-five of the BCBS defendants are accounted for, but there
are thirty-six BCBS parties in the action below and on appeal. This is because Excellus
Bluecross Blueshield of New York was not a party to any of the three settlement agreements or
consent decrees, a fact actually noted in the Conway amended complaints—the lawsuit the
doctors want to join. See Amended Complaint for Consolidated Provider Track, In re Blue Cross
Blue Shield Antitrust Litigation, Doc. 86 at § 108 MDL 2406, No. 2:13-CV-20000 (N.D. Ala.
July 1, 2013); Corrected Consolidated Second Amended Provider Complaint, Doc. 263 at § 134,
In re Blue Cross Blue Shield Antitrust Litigation MDL 2406, No. 2:13-CV-20000 (N.D. Ala.
Nov. 25, 2014). Its inclusion in these proceedings and failure to object is baffling.
6

A representative example of the broad releases granted by the plaintiffs in the Shane
and Love Litigation comes from the Blue Cross Settlement:
[T]he Blue Parties and each of their present and former parents, divisions, and
Affiliates . . . shall be released and forever discharged by the Signatory Medical
Societies and all Class Members . . . from any and all causes of action, judgments,
liens, indebtedness, costs, damages, obligations, attorneys’ fees, losses, claims,
liabilities, and demands of whatever kind, source, or character whether arising
under any federal or state law, which (consistent with the Parties’ understanding
5

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The District Court approved each settlement agreement, incorporated each into a
court order, 7 and issued injunctions barring the plaintiffs who failed to opt out
from ever prosecuting released claims against settling defendants.8 The orders
further provided that “this Court hereby retains jurisdiction as to all matters
relating to (a) the interpretation, administration, and consummation of the
Settlement Agreement and (b) the enforcement of injunctions in this Order.” No

of the settlements in Shane) includes, but is not limited to, Racketeer Influenced
and Corrupt Organizations Act, antitrust and other statutory and common law
claims, intentional or non-intentional, (each a “Claim”), . . . arising out of, or in
any way related to any of the facts, acts, events, transactions, occurrences, courses
of conduct, business practices, representations, omissions, circumstances, or other
matters referenced in the Action, or addressed in the Settlement Agreement,
whether any such Claim was or could have been asserted by any Releasing Party .
. . or to the business practices that are the subject of Section 7 of the Settlement
Agreement. This includes, without limitation and as to Released Parties only, any
aspect of any fee for service claim submitted by any Class Member to the Blue
Plans . . . .[T]he Releasing Parties are deemed to have forever abandoned and
discharged any and all Claims that exist now or that might arise in the future
against any other Persons which Claims arise from, or are based on, conduct by
any of the Released Parties that occurred on or before the Effective Date and are,
or could have been, alleged in the Complaint.
7

Court orders that incorporate settlement agreements are commonly called consent
decrees. This opinion will occasionally refer to the orders as consent decrees.
8

The District Court’s Final Orders specified:

The Releasing Parties are permanently enjoined from: (i) filing, commencing,
prosecuting, intervening in, participating in (as class members or otherwise), or
receiving any benefits from any lawsuit . . . based on any or all Released Claims
against one or more Released Parties; (ii) instituting, organizing class members in,
joining with class members in, amending a pleading in, or soliciting the
participation of class members in, any action . . . in any jurisdiction against one or
more Released Parties based on, involving, or incorporating, directly or indirectly,
any or all Released Claims.
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one disputes that Musselman, Love, and Shane failed to opt out of the agreements,
and are therefore bound by the injunctions.
On July 24, 2012, a healthcare provider, Jerry Conway, filed a putative
class-action suit against the BCBS defendants in the Northern District of Alabama.
Conway v. Blue Cross & Blue Shield of Alabama, et al., No. 12-cv-02532 (N.D.
Ala. July 24, 2012). Conway, on behalf of most of the nation’s healthcare
providers, alleges that the BCBS licensing and reimbursement arrangements
violate the Sherman Act, 15 U.S.C. §§ 1–2. 9
The plaintiff doctors in the present suit seek to join the Conway Litigation
“as either putative class representatives or class members,” but fear that the
releases they gave to settle the Shane and Love Litigation may cover the claims
asserted in Conway. Were they to join Conway, the doctors would risk being held
in civil contempt for violating the District Court’s orders.10 Rather than take that
risk, they asked the District Court to determine in advance whether joining Conway
would violate the injunctions by filing a declaratory judgment action on January 7,
2013.

9

The Conway Litigation alleges a conspiracy by the BCBS entities using their licensing
agreement in which they agreed not to compete with each other and to divide the healthcare
market into exclusive geographic fiefdoms so that they can systematically underpay healthcare
providers.
10

This concern is not unfounded. The District Court has held former Shane plaintiffs in
contempt for pursuing claims it determined to be released under the injunctions. See, e.g., In re
Managed Care, 756 F.3d 1222, 1224–25 (11th Cir. 2014).
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The defendants moved to dismiss the plaintiff doctors’ complaint under
Federal Rule of Civil Procedure 12(b)(6). They argued that the Conway claims
were within the subject matter and timeframe covered by the injunctions issued in
the Shane and Love Litigation, and that the plaintiffs had thus not made out a claim
for declaratory relief. The plaintiffs countered that the Conway claims covered
different conduct occurring only after the Effective Date of the releases in the
Shane and Love Litigation and thus fell outside the scope of the injunctions. The
District Court agreed with the defendants and dismissed the complaint. The
plaintiffs appealed from the District Court’s order, and both sides presented
arguments essentially identical to the ones made below.11
II.
We are here faced with the question of whether the complaint seeking
declaratory relief on the scope of the consent decrees issued in the Shane and Love
settlements made out a claim for which declaratory relief could be granted under
Rule 12(b)(6).
We review de novo orders granting a motion to dismiss for failure to state a
claim upon which relief can be granted under Federal Rule of Civil Procedure
12(b)(6). Michel v. NYP Holdings, Inc., 816 F.3d 686, 694 (11th Cir. 2016).
11

During the course of the appeal, we called for supplemental briefing to confirm that the
District Court had jurisdiction over this suit. In their supplemental briefs, the parties addressed
the scope of the declaratory judgment procedures created by the Declaratory Judgment Act, 28
U.S.C. § 2201. Those arguments provide the basis of this opinion.
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When ruling on a Rule 12(b)(6) motion, the allegations in the complaint are
accepted as true and construed in the light most favorable to the plaintiff, id., yet
the plaintiff must plead “enough facts to state a claim to relief that is plausible on
its face.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570, 127 S. Ct. 1955,
1974, 167 L. Ed. 2d 929 (2007). We may affirm a Rule 12(b)(6) dismissal on any
basis supported by the record. Jaffke v. Dunham, 352 U.S. 280, 281, 77 S. Ct. 307,
308, 1 L. Ed. 2d 314 (1957); Michel, 816 F.3d at 694.
I would conclude that the Declaratory Judgment Act does not permit a court
to grant declaratory relief regarding the scope of an injunction and that any
complaint seeking such a remedy does not state a claim on which relief can be
granted. In enacting the Declaratory Judgment Act, Congress intended to create a
remedy that is coextensive with—not in derogation of—remedies traditionally
available at law and equity. At least under these circumstances, I must conclude
that this implies an intended distinction between remedies and enforcement
mechanisms for an already-granted remedy. This distinction is implied because
using a declaratory judgment to plumb the scope of an injunction rather than
bearing the risk of being held in contempt would allow the declaratory judgment to
undermine the injunction as a remedy. Injunctions definitionally and as a matter of
sound jurisprudential policy rely on the maintenance of the traditional enforcement
mechanism of the court’s inherent civil contempt power. Injunctions are carefully
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crafted with this enforcement mechanism in mind and thus ensure respect for the
rule of law as resting upon the integrity of the judicial process. Therefore, a
declaratory judgment cannot issue on the scope of an injunction such as this one.
This discussion will proceed in three parts. The first is a brief discussion of
statutory interpretation principles. The second is an application of these principles
to the Declaratory Judgment Act, which by necessity includes a discussion of the
injunction as an independent remedy in relation to the Act. The third is an analysis
of the complaint below under the Declaratory Judgment Act and Rule 12(b)(6).

A.
Statutes in the United States “must be construed in the light of Congress’
intent.” Federal Election Comm’n v. NRA Political Victory Fund, 513 U.S. 88,
102, 115 S. Ct. 537, 545, 130 L. Ed. 2d 439 (1994). This intent is divined primarily
from the statute’s language itself read according to the ordinary meaning of the
words employed. Lawson v. FMR LLC, 134 S. Ct. 1158, 1165, 188 L. Ed. 2d 158
(2014). We also employ prudential cannons to ensure that we do not overrun
congressional intent and threaten the stability of our legal system. One such
cannon is that we assume that Congress is familiar with the background of
common law, draws upon common law concepts, and only abrogates common law
when and to the extent it clearly express intent to do so. See, e.g., Ibrandtsen Co.
v. Johnson, 343 U.S. 779, 783, 72 S. Ct. 1011, 1014–15, 96 L. Ed. 1294 (1952)
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(“Statutes which invade the common law . . . are to be read with a presumption
favoring the retention of long-established and familiar principles, except when a
statutory purpose to the contrary is evident”); Shaw v. Merchants’ Nat’l Bank, 101
U.S. 557, 565, 25 L. Ed. 892 (1879) (“No statute is to be construed as altering the
common law, farther than its words import. It is not to be construed as making any
innovation upon the common law which it does not fairly express.”); United States
v. Bellard, 674 F.2d 330, 335 (5th Cir. 1982) (“Changes in or abrogation of the
common law must be clearly and plainly expressed by the legislature; even where
such an intention is explicit, the scope of the common law will be constrained no
further than the fair import of the statute’s language requires.” (citations omitted)).

B.
The Declaratory Judgment Act, 28 U.S.C. § 2201, allows a court “[i]n a case
of actual controversy within its jurisdiction” and “upon the filing of an appropriate
pleading, [to] declare the rights and other legal relations of any interested party
seeking such declaration, whether or not further relief is or could be sought.” The
statute was intentionally written so broadly as to create an optional remedy coextensive with those remedies traditionally available at law or equity. Fed. R. Civ.
P. 57 Advisory Committee Note. Hence, Federal Rule of Civil Procedure 57

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provides that “[t]he existence of another adequate remedy does not preclude a
declaratory judgment that is otherwise appropriate.”
The most commonly cited limitation on the Declaratory Judgment Act is one
that is both constitutional in nature and apparent on the statute’s face—that the
court must have subject-matter jurisdiction over the underlying claim. E.g. United
Public Workers of Am. v. Mitchell, 330 U.S. 75, 89, 67 S. Ct. 556, 564, 91 L. Ed.
754 (1947). Yet when considering the terms of the statute and the background of
common law and equitable remedies to which Congress added the declaratory
judgment, an additional—if subtle—limitation emerges that was no less clearly
intended by Congress. In noting that the declaratory judgment “shall have the
force and effect of a final judgment or decree” available “whether or not further
relief is or could be sought,” 28 U.S.C. § 2201, Congress plainly intended that the
declaratory judgment serve as a primary remedy available for any underlying cause
of action, see Fed. R. Civ. P. 57 (“The existence of another adequate remedy does
not preclude a declaratory judgment . . . .”); Fed. R. Civ. P. 57 Advisory
Committee Note; 10B Charles Allen Wright et al., Federal Practice and Procedure
§ 2751 (4th ed. 2016) (noting that “[t]he remedy made available by the Declaratory
Judgment Act and Rule 57” is designed to serve the same role as a “coercive
remedy” only before coercion is necessary). Cf. Black’s Law Dictionary 1485
(10th ed. 2014) (defining “remedy” as “[t]he means of enforcing a right or
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preventing or redressing a wrong; legal or equitable relief.”). Designed as a
remedy, therefore, it is crucial to mark that there is nothing in the statute that
suggests that a declaratory judgment may also be used as an enforcement
mechanism for a different remedy already granted in a suit. See 28 U.S.C. § 2201.
This otherwise fine distinction takes on significantly greater force when
considering Congress’s clearly expressed intent that the declaratory judgment
supplement—not supplant—remedies traditionally available at law or equity, Fed.
R. Civ. P. 57 Advisory Committee Note, along with the prudential assumption that
Congress only alters common law through clear expression of intent to do so, e.g.
Shaw, 101 U.S. at 565.
One such traditional remedy is the injunction: a powerful equitable remedy
that is defined by and whose strength primarily derives from its enforcement
mechanisms. The Supreme Court itself defines the injunction as “an equitable
decree compelling obedience under the threat of contempt” under Federal Rule of
Civil Procedure 65(d). International Longshoremen Ass’n v. Philadelphia Marine
Trade Ass’n, 389 U.S. 64, 75, 88 S. Ct. 201, 209, 19 L. Ed. 2d 236 (1967). We
have repeatedly emphasized this link between injunctions and contempt, reminding
litigants on numerous occasions that an injunction is enforceable through the trial
court’s civil contempt power. 12 Mama Mia’s Trattoria, Inc. v. Original Brooklyn

12

In fact, we have spelled this out in great detail:
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Water Bagel Co., 768 F.3d 1320, 1324–25 (11th Cir. 2014); Alderwoods Grp. v.
Garcia, 682 F.3d 958, 966–68 (11th Cir. 2012); Faught v. American Home Shield
Corp., 660 F.3d 1289, 1293 (11th Cir. 2011); Thomas v. Blue Cross & Blue Shield
Ass’n, 594 F.3d 823, 828–29 (11th Cir. 2010); Reynolds v. Roberts, 207 F.3d 1288,
1298 (11th Cir. 2000); In re Grand Jury Proceedings, 142 F.3d 1416, 1424 (11th
Cir. 1998); Wyatt v. Rogers, 92 F.3d 1074, 1078 n.8 (11th Cir. 1996); Newman v.
Alabama, 683 F.2d 1312, 1318–19 (11th Cir. 1982). In fact, the basic procedure
for enforcing an injunction remains essentially unchanged since the days of
Blackstone. See 3 William Blackstone, Commentaries *453 (“the performance of
[the final decree of the chancery court] is enforced (if necessary) by commitment
of the person, or sequestration of the party’s estate.”). The reason that the
contempt power is so integral to the injunction as a remedy is that it relieves courts
from merely “hoping for compliance” with its order, and instead allows them to

If the plaintiff (the party obtaining the writ) believes that the defendant (the
enjoined party) is failing to comply with the decree’s mandate, the plaintiff moves
the court to issue an order to show cause why the defendant should not be
adjudged in civil contempt and sanctioned. The plaintiff's motion cites the
injunctive provision at issue and alleges that the defendant has refused to obey its
mandate. If satisfied that the plaintiff's motion states a case of non-compliance,
the court orders the defendant to show cause why he should not be held in
contempt and schedules a hearing for that purpose. At the hearing, if the plaintiff
proves what he has alleged in his motion for an order to show cause, the court
hears from the defendant. At the end of the day, the court determines whether the
defendant has complied with the injunctive provision at issue and, if not, the
sanction(s) necessary to ensure compliance.
Reynolds v. Roberts, 207 F.3d 1288, 1298 (11th Cir. 2000) (citations omitted).
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enforce the order through a fine13 or conditional jail term. Hutto v. Finney, 437
U.S. 678, 690, 98 S. Ct. 2565, 2573, 57 L. Ed. 2d 522 (1978). Accordingly, we
have rejected past attempts to circumvent “equity’s time-honored contempt
procedure” through alternative means of seeking compliance with an injunction.
Newman, 683 F.2d at 1318–19.
The dramatic strength of contempt proceedings as the enforcement
mechanism of injunctions is supported by the underlying equitable process. The
injunction “is not a remedy which issues as a matter of course.” City of
Harrisonville v. W.S. Dickey Clay Mfg. Co., 289 U.S. 334, 337–38, 53 S. Ct. 602,
603, 77 L. Ed. 1208 (1933). Indeed, injunctions are only issued following the
court’s careful consideration and balancing of the parties’ competing conveniences
and injuries, and are not used “‘to restrain an act the injurious consequences of
which are merely trifling.’” Weinberger v. Romero-Barcelo, 456 U.S. 305, 311–
12, 102 S. Ct. 1798, 1803, 72 L. Ed. 2d 91 (1982) (quoting Consolidated Canal
Co. v. Mesa Canal Co., 177 U.S. 296, 302, 20 S. Ct. 628, 630, 44 L. Ed. 777
(1900)). Courts are obligated to be highly circumspect throughout this process to
ensure that “injunctive relief ‘is drafted in light of what the court believes will be
the future course of events,’” so that its order is not used to serve injustice.
13

Among the financial penalties courts may use to enforce their injunctions is the
“remedial fine, which compensates the party who won the injunction for the effects of his
opponent’s noncompliance.” Hutto v. Finney, 437 U.S. 678, 690, 98 S. Ct. 2565, 2573, 57 L. Ed.
2d 522 (1978).
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Salazar v. Buono, 559 U.S. 700, 714–15, 130 S. Ct. 1803, 1816, 176 L. Ed. 2d 634
(2010) (quoting Charles Allen Wright et al., Federal Practice & Procedure § 2961
(2d ed. 1995)). Naturally, therefore, injunctions are generally hotly contested in
litigation, see Weinberger, 456 U.S. at 312, 102 S. Ct. at 1803, or negotiated in
settlement, Larry Kramer, Consent Decrees and the Rights of Third Parties, 87
Mich. L. Rev. 321, 325–26, so that the court will properly account for the parties’
various interests, Weinberger, 456 U.S. at 312, 102 S. Ct. at 1803. Given the
importance of the interests that injunctions are meant to protect, the elaborate
decision-making process leading to their issuance, and the heavy involvement of
the parties in their construction, it is not only logical but sound policy that
injunctions have such a potent enforcement mechanism as contempt proceedings.
The longstanding doctrinal requirement of enforcing injunctions through
contempt proceedings also supports the judiciary as an institution by inspiring
respect for the rule of law as resting on the integrity of the judicial process. The
threat of contempt proceedings inspires respect for the rule of law by serving as a
strong incentive to interpret the mandate of the court in the best of faiths and to
therefore treat the judiciary with the reverence that is its main source of strength.
See Hecht Co. v. Bowles, 321 U.S. 321, 329, 64 S. Ct. 587, 592, 88 L. Ed. 754
(1944) (“The historic injunctive process was designed to deter”). Cf. Hutto, 437
U.S. at 690–91, 98 S. Ct. at 2573–74 (discussing the “effective enforcement
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weapons” courts have for enforcing injunctions through their contempt powers so
that they need not merely “hop[e] for compliance”). The parties can rest assured
that the court took the parties’ interests—through litigation or settlement—and the
public into consideration and did not behave arbitrarily even though one or both of
the parties might be unhappy with the content of the injunction. See Salazar, 559
U.S. at 714–15, 130 S. Ct. at 1816; Weinberger, 456 U.S. at 311–12, 102 S. Ct. at
1803. Indeed, knowing the process that underpins injunctions and the show-cause
risk they bear if their actions incite another party to move the court to institute
contempt proceedings, the parties have every reason to stick to the straight and
narrow of the court’s order. Furthermore, by relying on their inherent contempt
power to enforce injunctions, courts remain faithful to their core competency,
which guarantees the integrity of the judicial process. See Newman 683 F.2d at
1319–20 (holding that a district court cannot forego a contempt proceeding in
favor of enforcing its injunction by making the required action directly for the
enjoined party). Thus, the linkage between the injunction and its enforcement
mechanism extends to the very foundation of our legal system.
To interpret the Declaratory Judgment Act as extending to the interpretation
of an already-issued injunction effectively undermines the efficacy of the
injunction as a remedy while simultaneously eroding the integrity of the judiciary.
The injunction is definitionally enforced by contempt, International Longshoremen
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Ass’n, 389 U.S. at 75, 88 S. Ct. at 209, and to instead allow parties to test the
waters anytime they think a contemplated action might be prohibited would
irreparably degrade its extraordinary and equitable nature. Parties would no longer
treat injunctions as deeply considered mandates to which they must solemnly
conform their conduct, but rather as pesky roadblocks to surmount via ceaseless
declaratory judgment actions. District courts would have less concern with
crafting a considered and balanced order knowing that regardless of the outcome
the litigants would soon be back in court fussing over the details. Permanent
injunctions would no longer mark the end of a suit, but would instead inaugurate a
whole new saga of litigation since an enjoined party’s actions no longer have to be
weighed against the hazard of contempt punishment. Thus, to treat the declaratory
judgment not as an alternative remedy but rather as an alternative to the
enforcement mechanism of an already-issued injunction is to reduce the efficacy of
the injunction as a remedy and, in the process, to diminish the integrity of the
courts charged with issuing and enforcing them.
This is emphatically not what Congress intended when it passed the
Declaratory Judgment Act. Congress intended to create a remedy to supplement—
not supplant—the remedies traditionally available at law and equity. See 28
U.S.C. § 2201; Fed. R. Civ. P. 57 Advisory Committee Note. To allow the
declaratory judgment to serve not just as a remedy but as an alternative to the
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longstanding enforcement mechanism of the injunction is to effectively supplant
the injunction as a remedy. Although I am sure that many litigants might wish to
use a declaratory judgment action like this one in a good faith attempt to comply
with a court order, Congress designed this statute carefully so that it would
contribute to the good functioning of the judiciary and its great and unbroken
practices. Therefore, I would conclude that the Declaratory Judgment Act does not
extend to circumstances such as these.

C.
In this case, the District Court correctly dismissed the plaintiff doctors’
complaint. Though the District Court ably analyzed the release incorporated by the
injunctions, it did not need to reach that question, and I would thus affirm its ruling
based on the record and my analysis of the Declaratory Judgment Act. See Michel,
816 F.3d at 694. That statute provides an alternative remedy for a cause of action,
not an alternative enforcement mechanism for the injunction, see 28 U.S.C. § 2201,
whose strength as a remedy relies on enforcement through the court’s contempt
power, e.g., Hutto, 437 U.S. at 690–91, 98 S. Ct. at 2573–74; Newman, 683 F.2d
at 1318–19. By seeking a declaratory judgment on the scope of the consent
decrees issued in the Shane and Love Litigation, the doctors have not stated a claim
for which declaratory relief is available under the terms of the statute. Therefore,

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in no way have they “state[d] a claim to relief that is plausible on its face.”
Twombly, 550 U.S. at 570, 127 S. Ct. at 1974.

III.
In conclusion, I would affirm the District Court’s dismissal of the plaintiff
doctors’ complaint for failure to state a claim under Rule 12(b)(6) because a
declaratory judgment action is not the appropriate action for determining the scope
of an injunction.

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GILMAN, Circuit Judge, concurring.
I write separately because I respectfully disagree with my learned colleague
Judge Tjoflat, whose concurring opinion questions the propriety of using a
declaratory-judgment action as a means of determining the scope of the settlement
agreements in this case. His assertion that “[a]llowing a declaratory judgment to
issue for these purposes would significantly defang the injunction as a remedy,
which would work a serious harm on the rule of law and the integrity of the
judiciary” (Tjoflat Op. at 1) finds no support in the text of the Declaratory
Judgment Act, the caselaw of this or any other circuit, or in the teachings of the
Supreme Court.
To begin with, at no time in the course of the proceedings below did the
plaintiffs, the defendants, or the district court question the propriety of using a
declaratory-judgment action as the proper vehicle for declaring the plaintiffs’
rights vis-à-vis the settlement agreements. This is an issue raised sua sponte by
Judge Tjoflat. Yet the Declaratory Judgment Act, through which the plaintiffs
brought their action, expressly enables the district court to “declare the rights . . . of
any interested party seeking such declaration.” 28 U.S.C. § 2201(a).
The Supreme Court, moreover, has endorsed the use of a declaratoryjudgment action under similar circumstances.

See, e.g., MedImmune, Inc. v.

Genentech, Inc., 549 U.S. 118, 137 (2007) (holding “that petitioner was not
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required, insofar as Article III is concerned, to break or terminate its 1997 license
agreement before seeking a declaratory judgment in federal court that the
underlying patent is invalid, unenforceable, or not infringed”); see also Abbott
Labs. v. Gardner, 387 U.S. 136, 152 (1967) (noting “that it was the very purpose
of the Declaratory Judgment Act to ameliorate” the plaintiff’s dilemma of having
to choose between abandoning his rights or risking prosecution), abrogated on
other grounds by Califano v. Sanders, 430 U.S. 99, 105 (1977).
In a similar vein, this court and its sister circuits have noted that declaratoryjudgment actions are an appropriate means of determining the scope of a
settlement agreement or consent decree. See Thomas v. Blue Cross & Blue Shield
Ass’n, 594 F.3d 823, 830–31 (11th Cir. 2010) (implying that the plaintiff should
have filed a complaint for a declaratory judgment to determine whether his claims
were released by the settlement agreement); City of El Paso v. El Paso Entm’t,
Inc., 382 F. App’x 361, 364–65 (5th Cir. 2010) (holding that the district court acted
properly in “declar[ing] the rights of the parties pursuant to” a settlement
agreement and permanent injunction by way of a declaratory-judgment action);
Peter Bay Homeowners Ass’n, Inc. v. Stillman, 294 F.3d 524, 533 (3d Cir. 2002)
(holding that “[c]learly, the District Court had jurisdiction to interpret the meaning
and scope of the various obligations” imposed by an earlier court order by way of a
declaratory-judgment action).
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The only jurists who appear vexed by the use of the declaratory-judgment
action in this or a similar setting are Judge Tjoflat, in his concurring opinion in this
case, and Justice Clarence Thomas, who was the sole dissenter in MedImmune.
MedImmune, 549 U.S. at 137 (Thomas, J., dissenting) (arguing that Article III
requires that a “patent licensee . . . must breach its license prior to challenging the
validity of the underlying patent pursuant to the Declaratory Judgment Act”). To
the contrary, the authorities that I have cited comport with the common-sense idea
that the courts should not force parties to be cited for contempt in order to ascertain
the scope of a consent decree. Id. at 129. Declaratory-judgment actions, after all,
are designed to avoid such dilemmas. Id.
Nor do I see any basis for concern over subject-matter jurisdiction in this
case. That the plaintiffs sought to join the Conway action in Alabama was enough
to make the question before the district court “a substantial controversy, between
parties having adverse legal interests, of sufficient immediacy and reality to
warrant the issuance of a declaratory judgment.” See Maryland Cas. Co. v. Pac.
Coal & Oil Co., 312 U.S. 270, 273 (1941). Contrary to Judge Tjoflat’s concerns,
Article III’s case-or-controversy requirement will ensure that any sustainable
declaratory-judgment action will be based on a material dispute rather than a mere
“fussing over the details.” (Tjoflat Op. at 15) That test has been clearly met in the
present case.
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Judge Tjoflat, however, gravely warns that “[p]arties would no longer treat
injunctions as deeply considered mandates to which they must solemnly conform
their conduct, but rather as pesky roadblocks to surmount via ceaseless
declaratory-judgment actions.” (Tjoflat Op. at 15) But he cites no authority for
these fears, and I would draw just the opposite conclusion. That the plaintiffs in
the case before us sought a declaration of their alleged rights rather than risk being
cited for contempt strikes me as showing a very deep respect for the injunction
issued by the district court. In sum, I believe that the use of the Declaratory
Judgment Act was a completely appropriate procedure in the present case.

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