Milby v. MCMC LLC

Filing 13

MEMORANDUM OPINION AND ORDER signed by Senior Judge Charles R. Simpson, III on 2/9/2016, DENYING 6 Plaintiff's Motion to Remand. Awarding Plaintiff attorney fees and costs is unwarranted. cc: Counsel(RLK)

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF KENTUCKY
AT LOUISVILLE
PLAINTIFF

SAMANTHA MILBY

v.

CIVIL ACTION NO. 3:15-cv-00814-CRS

MCMC LLC

DEFENDANT

MEMORANDUM OPINION AND ORDER
Plaintiff Samantha Milby brought this action in Jefferson Circuit Court in Louisville,
Kentucky, against Defendant MCMC LLC (“MCMC”). MCMC removed the action to this
Court. Milby now moves for remand and seeks attorney fees and costs. For the reasons below,
the Court will deny Milby’s motion.
Removal to federal court is proper for “any civil action brought in a State court of which
the district courts of the United States have original jurisdiction.” 28 U.S.C. § 1441(a). This
Court has original jurisdiction over cases “arising under the … laws … of the United States.” 28
U.S.C. § 1331. In determining whether a particular case arises under federal law, the Court
determines whether a federal question necessarily appears in the plaintiff’s complaint. Aetna
Health Inc. v. Davila, 542 U.S. 200, 207 (2004). “[W]hen a federal statute wholly displaces the
state-law cause of action through complete pre-emption,” the state law claim can be removed.
Beneficial Nat. Bank v. Anderson, 539 U.S. 1, 8, (2003). “When the federal statute completely
pre-empts the state-law cause of action, a claim which comes within the scope of that cause of
action, even if pleaded in terms of state law, is in reality based on federal law.” Id. In particular,
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ERISA “converts an ordinary state common law complaint into one stating a federal claim for
purposes of the well-pleaded complaint rule.” Davila, 542 U.S. 200, 209 (2004) (quoting Metro.
Life Ins. Co. v. Taylor, 481 U.S. 58, 65 (1987)).
Removability is not apparent on the face of Milby’s complaint. Indeed, Milby’s
complaint reads as an attempt to evade federal jurisdiction. See, e.g., Compl. ¶ 2, ECF No. 1-1
(“Plaintiff’s claims arise solely under the laws of the Commonwealth of Kentucky. Plaintiff does
not assert any claim arising under federal law.”). Just as the proclamation that windmills are
giants does not alter the structure’s actual nature, Milbly’s persistent recital that these claims are
grounded solely in state law cannot vanquish the evident federal jurisdiction.
In her complaint, Milby asserted state law claims against MCMC alleging it issued a
medical opinion concerning Milby without a license to practice medicine in the Commonwealth
as required under KRS § 311.560. MCMC rendered the medical opinion in reviewing Milby’s
claim for Employee Retirement Income Security Act (“ERISA”) benefits. Milby claims that the
medical opinion led to the denial of her claim. Milby does not dispute that the medical review
occurred for ERISA plan benefit determination purposes.
Congress enacted ERISA to “protect … the interests of participants in employee benefit
plans and their beneficiaries … by establishing standards of conduct, responsibility, and
obligation for fiduciaries” and to “provid[e] for appropriate remedies, sanctions, and ready
access to the Federal courts.” 29 U.S.C. § 1001(b). “The purpose of ERISA is to provide a
uniform regulatory regime over employee benefit plans.” Aetna Health Inc. v. Davila, 542 U.S.
200, 208 (2004). To achieve this uniformity, ERISA includes expansive preemption provisions,
see 29 U.S.C. § 1144, intended to safeguard employee benefit plans as “exclusively a federal

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concern.” Davila, 542 U.S. at 208 (internal quotation and citation omitted); see also Sherfel v.
Newson, 768 F.3d 561, 564 (6th Cir. 2014) (“ERISA is a statute unique in its preemptive
effect.”).
ERISA “supersede[s] any and all State laws insofar as they may … relate to any
[covered] employee benefit plan.” 29 U.S.C. §1144(a). “[A]ny state-law cause of action that
duplicates, supplements, or supplants the ERISA civil enforcement remedy conflicts with the
clear congressional intent to make the ERISA remedy exclusive and is therefore pre-empted.”
Davila, 542 U.S. at 209. “As long as ERISA exclusively regulates the activity (deciding whether
to award benefits), ERISA prevents the distinct state law tort scheme from superimposing an
extra layer of regulation on top of the ERISA-regulated plan benefit determination.” Hutchison v.
Fifth Third Bancorp., 469 F.3d 583, 588 (6th Cir. 2006).
A claim is within the scope of Section 1132(a)(1)(B) – ERISA’s civil enforcement
remedy – for preemption purposes if: “(1) the plaintiff complains about the denial of benefits to
which he is entitled ‘only because of the terms of an ERISA-regulated employee benefit plan’;
and (2) the plaintiff does not allege the violation of any ‘legal duty (state or federal) independent
of ERISA or the plan terms[.]’” Gardner v. Heartland Indus. Partners, 715 F.3d 609, 613 (6th
Cir. 2013) (quoting Davila, 542 U.S. at 210).
This Court and other courts within this circuit have ruled on cases with similar facts. See,
e.g., Hogan v. Jacobson, No. 3:12CV-820 (W.D. Ky. Sept. 26, 2013) (finding ERISA completely
preempted plaintiff’s state law claim under KRS § 311.560 because the defendant nurses were
only involved in denying Hogan’s benefits “to the extent that they were each asked to review
[the plaintiff’s] file when she appealed the initial denial of benefits”). Similarly, the Court finds

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here that Milby’s challenge to MCMC practitioners’ medical qualifications are subsumed within
Milby’s ERISA claim for wrongful denial of benefits.
Milby argues that when MCMC issued a medical opinion neither it nor its agent was
licensed in the Commonwealth to practice medicine. Milby’s ERISA plan insurer relied on this
plan in denying her benefits. In seeking damages related to a medical professional’s medical
review for ERISA plan benefit determination, a plaintiff must seek damages under ERISA. See
Hogan, No. 3:12CV-820. Otherwise, a state enforcement mechanism supplants Congress’
uniform enforcement system. Indeed, Milby already has a pending suit against the insurer for
wrongful denial of benefits. See Milby v. Liberty Life Assurance Co. of Boston, Case No. 3:12cv-487-CRS, (W.D. Ky. Apr. 30, 2015). Milby’s suit against MCMC arises only because of her
ERISA benefit claim review. Milby does not allege a violation of any legal duty beyond the
scope of the ERISA plan and the review of her benefit claim.
As the Court will deny Milby’s motion to remand, awarding Milby attorney fees and
costs is unwarranted.
The Court DENIES Plaintiff Samantha Milby’s motion to remand (DN 6).
IT IS SO ORDERED.

February 9, 2016

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