Hackert v. Cigna Health and Life Insurance Company et al

Filing 21

ORDER signed by District Judge Kimberly J. Mueller on 1/11/2016 ORDERING that the 14 findings and recommendations are ADOPTED IN FULL. Plaintiff's 6 motion for remand is DENIED. Plaintiff's 7 motion to dismiss defendants' counterclaims is DENIED. (Zignago, K.)

1
2
3
4
5
6
7
8

UNITED STATES DISTRICT COURT

9

FOR THE EASTERN DISTRICT OF CALIFORNIA

10
11

JOHN HACKERT,

12
13
14
15
16

No. 2:15-cv-1248 KJM CKD PS

Plaintiff,
v.

ORDER

CIGNA HEALTH AND LIFE
INSURANCE COMPANY, et al.,
Defendants.

17
18

This matter was referred to the assigned United States Magistrate Judge under

19

Local Rule 302(c)(21). On September 3, 2015, the Magistrate Judge filed findings and

20

recommendations on plaintiff John Hackert’s motions to dismiss and remand, recommending

21

both motions be denied. ECF No. 14. The findings and recommendations were served on the

22

parties and gave notice that any objections were to be filed within fourteen days.

23

Hackert filed timely objections. See Objections, ECF No. 15. He argues the

24

Magistrate Judge incorrectly determined he sought reimbursement from defendant Cigna Health

25

and Life Insurance Company as an assignee of rights under the Employee Retirement Income

26

Security Act (ERISA). Id. at 4–7. He also objects to the Magistrate Judge’s conclusion that this

27

court has subject matter jurisdiction over a certain subset of his claims. Id. at 7. Cigna responded

28

to Hackert’s objections, arguing the Magistrate Judge correctly found Hackert sought
1

1

reimbursement as an assignee and arguing this court has supplemental jurisdiction over any state-

2

law claims in the complaint. Response, ECF No. 16.

3

In accordance with the provisions of 28 U.S.C. § 636(b)(1)(C) and Local Rule 304,

4

this court has conducted a de novo review of this case. Having reviewed the file, the court finds

5

the findings and recommendations to be supported by the record and by the proper analysis. The

6

court writes separately here only to address Hackert’s objections.

7

I.

8
9

RELEVANT LEGAL STANDARDS
A defendant may remove an action originally filed in state court if the federal

court would have original subject matter jurisdiction over that action. 28 U.S.C. § 1441; Moore-

10

Thomas v. Alaska Airlines, Inc., 553 F.3d 1241, 1243 (9th Cir. 2009). Federal courts have

11

original subject matter jurisdiction over any action arising under the laws of the United States.

12

28 U.S.C. § 1331; Moore-Thomas, 553 F.3d at 1243. “[I]f a federal cause of action completely

13

preempts a state cause of action any complaint that comes within the scope of the federal cause of

14

action necessarily ‘arises under’ federal law.” Franchise Tax Bd. of State of Cal. v. Constr.

15

Laborers Vacation Trust for S. Cal., 463 U.S. 1, 24 (1983). As relevant to this case, ERISA

16

completely preempts a plaintiff’s state-law claims if both (1) at some point in time, he could have

17

brought that claim under ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), and (2) the

18

defendant’s actions implicate no other independent legal duty. Aetna Health Inc. v. Davila, 542

19

U.S. 200, 210 (2004); Marin Gen. Hosp. v. Modesto & Empire Traction Co., 581 F.3d 941, 946

20

(9th Cir. 2009).

21

A plaintiff may contest removal in a motion to remand. Moore-Thomas, 553 F.3d

22

at 1244. In response to such a motion, the defendant bears the burden to show removal was

23

proper. Id. The court may consider evidence extrinsic to the pleadings if necessary to resolve

24

relevant factual disputes concerning jurisdiction. See, e.g., Land v. Dollar, 330 U.S. 731, 735 n. 4

25

(1947) (“[W]hen a question of the District Court’s jurisdiction is raised . . . the court may inquire

26

. . . into the facts as they exist); Valdez v. Allstate Ins. Co., 372 F.3d 1115, 1117 (9th Cir. 2004)

27

(allowing consideration of “summary-judgment-type evidence”).

28
2

1
2

II.

DISCUSSION
A.

3

Assignment of Rights
A healthcare provider has standing to bring an ERISA action against an insurance

4

fund, and ERISA completely preempts a related state law claim, when the provider sues as the

5

assignee of a patient’s rights to benefits under an ERISA plan. See, e.g., Hobbs v. Blue Cross

6

Blue Shield of Ala., 276 F.3d 1236, 1241 (11th Cir. 2001); The Meadows v. Employers Health

7

Ins., 47 F.3d 1006, 1008 (9th Cir. 1995). Given this authority, the Magistrate Judge found

8

removal was proper because Hackert had sought reimbursement for medical services provided to

9

his patients as their assignee. Findings & Recommendations at 2. The Magistrate Judge relied on

10

the declaration of Cheri Baron, a Cigna claims service analyst, who averred that Hackert had

11

submitted claims for benefits under an assignment of rights. See Baron Decl. ¶ 5, ECF No. 12-1;

12

id. Ex. A, at 9.1

13

As noted above, Hackert objects to this finding and argues he is not an assignee of

14

any patient’s rights. See Objections at 4. He cites the declaration he submitted in support of the

15

motion to remand, averring he is “not a fiduciary, beneficiary, or assignee of any beneficiary of

16

any CIGNA patient vis-à-vis ERISA.” Hackert Decl. ¶ 3, ECF No. 6. He explains he has no

17

“assignment of benefits on file for any CIGNA patient, written or otherwise.” Id. ¶ 4. Perhaps in

18

anticipation of the very response Cigna gave in its opposition to his motion, he explains further:

19

“Although the claim submission protocols of my former or current billing services may

20

potentially suggest that there was assignment of benefits, no actual assignment of benefits exists

21

for any of the claims I have submitted to CIGNA through the agency of a billing service, or

22

otherwise.” Id. ¶ 6.

23

On the other hand, Hackert also acknowledges he could not bring a claim against

24

Cigna here unless he had either negotiated an agreement to do so or filed a claim on his patients’

25

behalf. Objections at 6. He explains, “The claims in question were . . . filed on behalf of the

26

patients to whom the benefits were owed” because “the average patient, if billed directly by the

27
28

1

To avoid confusion, the pages cited are those printed on the top right corner by the
CM/ECF system.
3

1

provider, would most likely feel incapable of submitting a claim to an insurance entity like

2

CIGNA.” Id.

3

In sum, the evidence shows Hackert submitted claims on his patients’ behalf, his

4

billing system suggested his patients had assigned him their right to do so, and Cigna’s records

5

show those claims were submitted under an assignment of rights. Hackert’s bare averment that

6

he is not an assignee and has no assignment agreement “on file” does not counterbalance these

7

facts. In light of this evidence, Cigna has carried its burden to show Hackert submitted claims as

8

his patients’ assignee and would have standing to bring an ERISA action, and the removal was

9

proper. In a similar case, another district court concluded similarly. See Spring E.R., LLC v.

10

Aetna Life Ins. Co., No. 09-2001, 2010 WL 598748, at *3–4 (S.D. Tex. Feb. 17, 2010).

11

B.

12

Supplemental Jurisdiction
Hackert objects that the Magistrate Judge tacitly and improperly lumped together

13

(1) the claims Cigna argues were preempted by ERISA and (2) other claims involving a Health

14

Maintenance Organization (HMO), for which he claims an independent California statutory

15

remedy exists. See Objections at 7. Assuming without deciding that the court would lack

16

independent subject matter jurisdiction over these HMO-related claims, because all Hackert’s

17

claims arise within the same factual circumstances, this court has supplemental jurisdiction over

18

them. See 28 U.S.C. § 1367(a) (“[I]n any civil action of which the district courts have original

19

jurisdiction, the district courts shall have supplemental jurisdiction over all other claims that are

20

so related to claims in the action within such original jurisdiction that they form part of the same

21

case or controversy under Article III of the United States Constitution.”).

22

III.

CONCLUSION

23

1. The findings and recommendations filed September 3, 2015 are adopted in full;

24

2. Plaintiff’s motion for remand, ECF No. 6, is denied; and

25

3. Plaintiff’s motion to dismiss defendants’ counterclaims, ECF No. 7, is denied.

26

IT IS SO ORDERED.

27

DATED: January 11, 2016.

28
4 UNITED STATES DISTRICT JUDGE