R. et al v. Regence Blue Cross Blue Shield of Utah

Filing 36

MEMORANDUM DECISION AND ORDER granting 20 Plaintiffs' Motion to Conduct Discovery. Signed by Magistrate Judge Paul M. Warner on 1/9/2020. (jds)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF UTAH, CENTRAL DIVISION

RANDALL R, ALISA R., and KARA R.,
MEMORANDUM DECISION AND
ORDER

Plaintiffs,
v.

Case No. 2:18-cv-00381-DB-PMW
REGENCE BLUE CROSS SHIELD OF
UTAH,

District Judge Dee Benson
Chief Magistrate Judge Paul M. Warner

Defendant.

District Judge Dee Benson referred this case to Chief Magistrate Judge Paul M. Warner
pursuant to 28 U.S.C. § 636(b)(1)(A). 1 Before the court is Plaintiffs’ Motion to Conduct
Discovery. 2 The court has carefully reviewed the written memoranda submitted by the parties.
Pursuant to Civil Rule 7-1(f) of the Rules of Practice for the United States District Court for the
District of Utah, the court has concluded that oral argument is not necessary and will determine
the motion on the basis of the written memoranda. See DUCivR 7-1(f). For the following
reasons, Plaintiffs’ motion is granted.
BACKGROUND
Plaintiffs Randall R. and Alisa R. (“Plaintiffs”) are participants in a self-funded
employee welfare benefits plan subject to the Employee Retirement Income Security Act

1

See Docket Nos. 3 and 8.

2

See Docket No. 20.

(“ERISA”). See 29 U.S.C. § 2001 et seq. Plaintiff Kara R. (“K.R.”) is the child of Randall R.
and Alisa R., and a beneficiary of the health plan. K.R. received inpatient residential treatment
at Youth Care for mental health and substance abuse related issues at various periods
throughout 2014 and 2015.
Defendant Regence Blue Cross Blue Shield of Utah (“Defendant”), the insurer and
claims administrator, denied payment for K.R.’s treatment at Youth Care from May 22, 2015
forward on the basis that K.R.’s condition did not meet Defendant’s necessity criteria for
continued stay at the chemical dependence residential level of care at Youth Care.
Having exhausted the appeals process, Plaintiffs filed suit against Defendant asserting a
claim for benefits under ERISA, see 29 U.S.C. § 1132(a)(1)(B), and a claim for violation of the
Mental Health Parity and Addition Equity Act (“Parity Act”), see 29 U.S.C. § 1132(a)(3), for
mental health and substance abuse benefits.
In the instant motion, Plaintiffs move the court for permission to conduct discovery
regarding the Parity Act claim. Defendant oppose discovery of this claim arguing they
anticipate filing a motion for judgment on the pleadings as they believe the claim is “deficient
on its face.” 3 Defendant asserts the Parity Act claim “is nothing more than a re-packaged §
1132(a)(1)(B) claim for benefits” and discovery is typically not allowed in ERISA benefit
claims. 4 In response, Plaintiffs assert the discovery is necessary to properly evaluate the Parity

3

Docket No. 26 at 2.

4

Id.

2

Act claim. Plaintiffs also filed a motion for leave to file a second amended complaint to state the
Parity Act claims more clearly, which the court granted on December 12, 2019. 5
DISCUSSION
The motion before the court relates to discovery. “The district court has broad discretion
over the control of discovery, and [the Tenth Circuit] will not set aside discovery rulings absent
an abuse of that discretion.” Sec. & Exch. Comm’n v. Merrill Scott & Assocs., Ltd., 600
F.3d1262, 1271 (10th Cir. 2010) (quotations and citations omitted).
Rule 26(b)(1) provides:
Parties may obtain discovery regarding any nonprivileged matter
that is relevant to any party’s claim or defense and proportional to
the needs of the case, considering the importance of the issues at
stake in the action, the amount in controversy, the parties’ relative
access to relevant information, the parties’ resources, the
importance of the discovery in resolving the issues, and whether
the burden or expense of the proposed discovery outweighs its
likely benefit. Information within this scope of discovery need
not be admissible in evidence to be discoverable.
Fed. R. Civ. P. 26(b)(1). While discovery is generally not necessary for ERISA claims, see
Murphy v. Deloitte & Touche Group Ins. Plan, 619 F.3d 1151, 1162-63 (10th Cir. 2010), “the
nature of Parity Act claims is that they generally require further discovery to evaluate whether
there is a disparity between the availability of treatments for mental health and substance abuse
disorders and treatment for medical/surgical conditions.” Robert L. v. Cigna Health & Life Ins.
Co., No. 2:18-CV-976 RJS DBP, 2019 WL 6220062, at *2 (D. Utah Nov. 21, 2019).

5

See Docket No. 32.

3

Here, Plaintiffs are legally entitled to conduct discovery on their Parity Act claim. For
these types of claims, discovery is essential to allow Plaintiffs to learn and compare processes,
strategies, evidentiary standards, and other factors Defendant used to show whether mental
health and substance abuse benefits were discerningly limited. Defendant cannot avoid
discovery simply because it anticipates filing a motion for judgment on the pleadings.
Moreover, the court granted Plaintiffs’ motion to amend complaint wherein Plaintiffs
distinguish the Parity Act claim from the ERISA benefits claim more clearly. Accordingly,
Plaintiffs’ motion is granted. Plaintiffs may conduct discovery as to the Parity Act claim only.
In regard to the ERISA benefits claim, Plaintiffs shall not attempt to obtain indirectly what they
cannot obtain directly. See, e.g., Murphy v. Deloitte & Touche Grp. Ins. Plan, 619 F.3d 1151,
1157 (10th Cir. 2010) (stating extra-record discovery is generally not permitted for claims that
seek judicial review of ERISA plan administrator’s decisions).
CONCLUSION AND ORDER
Based on the foregoing, Plaintiffs’ Motion to Conduct Discovery 6 is GRANTED as
detailed above.
IT IS SO ORDERED.
DATED this 9th day of January, 2020.
BY THE COURT:

_____________________________
Paul M. Warner
Chief United States Magistrate Judge
6

See Docket No. 20.

4