Access Mediquip, L.L.C. v. Unitedhealthcare Insurance

Fifth Circuit

Access Mediquip, L.L.C. v. Unitedhealthcare Insurance

698 F.3d 229, 54 Employee Benefits Cas. (BNA) 1003, 2012 WL 4747260, 2012 U.S. App. LEXIS 20809

CourtCourt of Appeals for the Fifth Circuit

DecidedOctober 5, 2012

Docket10-20868

StatusPublished

Cited by49 cases

This text of 698 F.3d 229 (Access Mediquip, L.L.C. v. Unitedhealthcare Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Access Mediquip, L.L.C. v. Unitedhealthcare Insurance, 698 F.3d 229, 54 Employee Benefits Cas. (BNA) 1003, 2012 WL 4747260, 2012 U.S. App. LEXIS 20809 (5th Cir. 2012).

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Opinions

PER CURIAM:

The court took en banc this case, which raises questions about the scope of liability of an ERISA plan administrator and fiduciary for allegedly misrepresenting a plan beneficiary’s coverage in its advice to a provider of health devices. The vacated panel opinion relied primarily on this court’s decisions in Transitional Hosp. v. Blue Cross & Blue Shield of Texas, Inc., 164 F.3d 952 (5th Cir.1999), and Memorial Hosp. Sys. v. Northbrook Life Ins. Co., 904 F.2d 236 (5th Cir.1990), in reaching the conclusion that three of the provider’s state law claims, for negligent misrepresentation, promissory estoppel and violations of the Texas Insurance Code, were not preempted by ERISA.¹

The panel itself rejected, albeit without citing, this court’s decision in Cypress Fairbanks Med. Ctr., Inc. v. Pan-American Life Ins. Co., 110 F.3d 280 (5th Cir.1997). Further, UnitedHealtheare, the plan administrator, contended in its petition for rehearing en banc that Transitional and Northbrook, and consequently the panel’s decision, are in tension with the court’s prior opinions in Hermann Hosp. v. MEBA Med. & Benefits Plan, 845 F.2d 1286 (5th Cir.1988) (“Hermann I”), and Hermann Hosp. v. MEBA Med. & Benefits Plan, 959 F.2d 569 (5th Cir.1992) (“Hermann II”).

Having reconsidered this case en banc, we reinstate the panel opinion and overrule, to the extent inconsistent with its reasoning, the court’s opinions in Cypress Fairbanks, Hermann I and Hermann II.

The judgment of the district court is REVERSED and the case REMANDED for further proceedings consistent herewith.

REVERSED and REMANDED.

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PER CURIAM:

The court took en banc this case, which raises questions about the scope of liability of an ERISA plan administrator and fiduciary for allegedly misrepresenting a plan beneficiary’s coverage in its advice to a provider of health devices. The vacated panel opinion relied primarily on this court’s decisions in Transitional Hosp. v. Blue Cross & Blue Shield of Texas, Inc., 164 F.3d 952 (5th Cir.1999), and Memorial Hosp. Sys. v. Northbrook Life Ins. Co., 904 F.2d 236 (5th Cir.1990), in reaching the conclusion that three of the provider’s state law claims, for negligent misrepresentation, promissory estoppel and violations of the Texas Insurance Code, were not preempted by ERISA.¹

The panel itself rejected, albeit without citing, this court’s decision in Cypress Fairbanks Med. Ctr., Inc. v. Pan-American Life Ins. Co., 110 F.3d 280 (5th Cir.1997). Further, UnitedHealtheare, the plan administrator, contended in its petition for rehearing en banc that Transitional and Northbrook, and consequently the panel’s decision, are in tension with the court’s prior opinions in Hermann Hosp. v. MEBA Med. & Benefits Plan, 845 F.2d 1286 (5th Cir.1988) (“Hermann I”), and Hermann Hosp. v. MEBA Med. & Benefits Plan, 959 F.2d 569 (5th Cir.1992) (“Hermann II”).

Having reconsidered this case en banc, we reinstate the panel opinion and overrule, to the extent inconsistent with its reasoning, the court’s opinions in Cypress Fairbanks, Hermann I and Hermann II.

The judgment of the district court is REVERSED and the case REMANDED for further proceedings consistent herewith.

REVERSED and REMANDED.

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Bluebook (online)

698 F.3d 229, 54 Employee Benefits Cas. (BNA) 1003, 2012 WL 4747260, 2012 U.S. App. LEXIS 20809, Counsel Stack Legal Research, https://law.counselstack.com/opinion/access-mediquip-llc-v-unitedhealthcare-insurance-ca5-2012.

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