Arnold Ex Rel. Arnold v. Blue Cross & Blue Shield of Texas, Inc.

973 F. Supp. 726, 1997 U.S. Dist. LEXIS 16953
CourtDistrict Court, S.D. Texas
DecidedApril 30, 1997
DocketCivil Action H-96-0346
StatusPublished
Cited by18 cases

This text of 973 F. Supp. 726 (Arnold Ex Rel. Arnold v. Blue Cross & Blue Shield of Texas, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Arnold Ex Rel. Arnold v. Blue Cross & Blue Shield of Texas, Inc., 973 F. Supp. 726, 1997 U.S. Dist. LEXIS 16953 (S.D. Tex. 1997).

Opinion

MEMORANDUM OPINION AND ORDER GRANTING REMAND

ATLAS, District Judge.

Plaintiff Rebecca Arnold (“Plaintiff’) originally brought this action against Blue Cross & Blue Shield of Texas, Inc. (“Blue Cross”) in state court alleging state statutory violations. Blue Cross removed the action to federal court, and Plaintiff moved to remand. In its Memorandum Opinion and Order of September 10, 1996, (“Order”) [Doe. #37], the Court denied Plaintiffs Motion to Remand [Doc. # 5] and granted the motion of the Office of Personnel Management (“OPM”) to Intervene as a Party Defendant [Doe. # 30]. Plaintiff was then permitted to amend her complaint to add a cause of action specifically addressed to OPM [Doc. #39], All three parties have since filed motions for summary judgment [Docs. # 48,49, and 61].

Upon further and more detailed consideration, the Court has determined that this case should in fact be remanded to state court. The Court’s earlier Memorandum Opinion and Order [Doc. #37], which denied Plaintiffs Motion to Remand and granted OPM’s Motion to Intervene, is therefore VACATED. Plaintiffs Motion to Remand [Doc. # 5] is hereby GRANTED. All Court orders issued following the Memorandum *729 Opinion and Order of September 10, 1996, are VACATED. The pending motions are DENIED AS MOOT.

I. PROCEDURAL BACKGROUND

Plaintiff Rebecca Arnold brought this action after her health insurance carrier, Defendant Blue Cross, denied her coverage for treatment of temporomandibular joint disorder (“TMJ”). Plaintiff is insured by Blue Cross because she is a dependent of her father, Phillip Arnold, a federal employee enrolled in the Blue Cross and Blue Shield Service Benefit Plan. Federal employees may elect to receive health insurance for themselves and their dependents by enrolling in plans, such as this one, which are established by contract between OPM, a federal agency, and health insurance carriers.

After diagnosing and treating Plaintiff for TMJ, her dentist, Dr. John E. Scott, submitted a claim for payment to Blue Cross. Blue Cross paid the bill in part but refused payment for the bulk of the claim. 1 Plaintiffs parents and Dr. Scott submitted a number of letters to Blue Cross and to OPM appealing the denial of coverage, but Blue Cross maintained its refusal to pay, and OPM affirmed the denial. See Petition, at 15-18. Apparently, Plaintiffs claim was originally rejected on the ground that her treatment was not medically necessary, see id. at 16, but the denial was ultimately justified on the ground that her treatment was simply not covered under her health insurance plan, see id. at 17-18. 2

Plaintiff sued Blue Cross in state court alleging two primary causes of action. First, she claims that Blue Cross’ failure to cover TMJ violates Article 21.53A of the Texas Insurance Code, which requires that every insurance policy issued in Texas that covers treatment of skeletal joints must also provide similar coverage for TMJ. 3 Second, she claims that Blue Cross’ description of its benefits, in its Service Plan brochure, appears to include coverage for TMJ, but since TMJ is not actually covered, Blue Cross’ description constitutes false advertising and a deceptive trade practice in violation of Article 21.21 of the Texas Insurance Code. 4

Blue Cross removed the action, claiming that this Court has federal question jurisdiction under 28 U.S.C. § 1441(b) because Plaintiffs state law claims are preempted by a federal statute, the Federal Employees Health Benefits Act (“FEHBA”), 5 U.S.C. § 8901 et seq. After Plaintiff moved for remand, Blue Cross attempted to amend its removal notice to allege that federal jurisdiction is also created by 28 U.S.C. § 1442(a)(1), the federal officer removal statute. The Court denied the Motion to Remand, finding that Plaintiffs claims turn on the construction of federal law and that there is a significant federal interest in this litigation. See Order, at 5-6. The Court did not address Blue Cross’ argument under 28 U.S.C. § 1442(a)(1), see Order, at 2 n. 1 (denying, as moot Blue Cross’ Motion to Amend its Notice of Remand), and also explicitly declined to rule at that time whether Plaintiffs claims were preempted by federal law, see id. at 11.

Upon further consideration, the Court has determined that Plaintiffs Motion to Re *730 mand should be granted. The next section explains why removal is not justified in this case under the well-pleaded complaint rule and examines Blue Cross’ argument that it is entitled to remove under 28 U.S.C. § 1442(a)(1).

II. FEDERAL REMOVAL JURISDICTION

A. The Well-Pleaded Complaint Rule

In its previous . Order, the Court ruled that the applicability of federal common law supported removal of this action. However, the mere fact that federal law may be involved or that there is a federal interest in the litigation is not sufficient to confer removal jurisdiction upon a federal court. The state courts are competent to interpret federal law as well as adjudicate cases that may involve a significant federal interest. See Chuska Energy Co. v. Mobil Exploration & Producing, North America Inc., 854 F.2d 727, 730 (5th Cir.1988).

Instead, in order to determine whether the case is removable, the Court must examine Plaintiffs claims under the well-pleaded complaint rule. See Louisville & Nashville Ry. Co. v. Mottley, 211 U.S. 149, 29 S.Ct. 42, 53 L.Ed. 126 (1908); Carpenter v. Wichita Falls Indep. Sch. Dist., 44 F.3d 362 (5th Cir.1995). It is well established that, under this rule, “federal jurisdiction exists only when a federal question is presented on the face of the plaintiffs properly pleaded complaint.” Caterpillar, Inc. v. Williams, 482 U.S. 386, 392, 107 S.Ct. 2425, 2429, 96 L.Ed.2d 318 (1987). 5 Unless the federal question appears on the face of Plaintiffs complaint, the case may not be removed even if a federal defense is inevitable.

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973 F. Supp. 726, 1997 U.S. Dist. LEXIS 16953, Counsel Stack Legal Research, https://law.counselstack.com/opinion/arnold-ex-rel-arnold-v-blue-cross-blue-shield-of-texas-inc-txsd-1997.