Bruce F. Botsford v. Blue Cross and Blue Shield of Montana, Inc. Blue Cross and Blue Shield Association

314 F.3d 390, 2002 Cal. Daily Op. Serv. 12264, 2002 Daily Journal DAR 14468, 2002 U.S. App. LEXIS 26457, 2002 WL 31856602
CourtCourt of Appeals for the Ninth Circuit
DecidedDecember 23, 2002
Docket01-36019
StatusPublished
Cited by57 cases

This text of 314 F.3d 390 (Bruce F. Botsford v. Blue Cross and Blue Shield of Montana, Inc. Blue Cross and Blue Shield Association) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bruce F. Botsford v. Blue Cross and Blue Shield of Montana, Inc. Blue Cross and Blue Shield Association, 314 F.3d 390, 2002 Cal. Daily Op. Serv. 12264, 2002 Daily Journal DAR 14468, 2002 U.S. App. LEXIS 26457, 2002 WL 31856602 (9th Cir. 2002).

Opinion

OPINION

T.G. NELSON, Circuit Judge:

Defendants, Blue Cross and Blue Shield of Montana, Inc. (“Blue Cross”) appeal the district court’s dismissal of Bruce F. Bots-ford’s suit against them for lack of jurisdiction. Because we conclude that the Federal Employees Health Benefits Act 1 (FEHBA) completely preempts Botsford’s claim against Blue Cross, and that his claim thus arose under federal law, we reverse and remand.

I. BACKGROUND

After undergoing a $3,036.00 medical procedure and submitting the requisite paperwork to his FEHBA-covered health plan, Botsford received a reimbursement check for only $915.74 from Blue Cross. The physician who had performed Bots-ford’s procedure was a non-participating provider, and the plan would not pay his bill in full. Botsford paid his physician and did some research. Convinced that Blue Cross had not followed the method of determining reimbursement set forth in the brochure describing benefits that he had received, Botsford brought this suit.

Botsford filed six claims in federal court alleging various state common law causes of action, such as fraud, negligent misrepresentation, and breach of contract. He also alleged one state statutory claim. In that claim, Botsford alleged that Blue Cross had violated the Montana Unfair Trade Practices Act 2 by misrepresenting the policy regarding reimbursement of non-participating providers.

Eventually, Botsford moved to dismiss voluntarily and without prejudice all claims except the state-law fraud claim. The district court granted his motion. Then, Blue Cross moved to dismiss the fraud claim, asserting that FEHBA, and the regulations promulgated pursuant to it, preempted that claim. The court, at that point, questioned whether federal jurisdiction over the case existed.

The district court concluded that it lacked jurisdiction. The court reasoned that Botsford’s complaint was inherently a dispute over a contract, not a dispute involving a constitutional provision, federal law, or treaty. Although Blue Cross presented a federal defense, the court noted that a federal defense alone does not confer federal jurisdiction. Accordingly, the district court dismissed for lack of jurisdiction. Blue Cross appealed.

II. STANDARD OF REVIEW

We review the district court’s decision regarding the absence of subject matter jurisdiction de novo. 3 Similarly, we *393 review the district court’s determination of complete preemption de novo. 4

III. DISCUSSION

A federal defense to a state-law claim does not confer jurisdiction on a federal court. 5 Thus, a plaintiff may generally avoid federal jurisdiction through artful pleading of solely state-law claims. An exception to this general proposition exists, however. If federal law completely preempts a plaintiffs state-law claim, that plaintiff may not escape federal jurisdiction no matter how careful his or her pleading. “In such instances, any claim purportedly based on that preempted state law is considered, from its inception, a federal claim, and therefore arises under federal law.” 6

To preempt state-law causes of action completely, federal law must both: (1) conflict with state law (conflict preemption) and (2) provide remedies that displace state law remedies (displacement). 7 For the reasons set forth below, we conclude that FEHBA’s express preemption clause conflicts with the Montana statute in question, Montana Code Section 33-18-201(1). Moreover, FEHBA provides remedies that displace Montana state-law remedies.

A. ■ Conflict Preemption.

We conclude that Montana Code Section 33-18-201(1) conflicts with, and is therefore preempted by, FEHBA. Thus, Botsford’s claim satisfies the first prong of complete preemption: conflict preemption.

FEHBA contains an express preemption clause which reads as follows:

The terms of any contract under this chapter which relate to the nature, provision, or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans. 8

Originally, FEHBA’s preemption provision was narrower. It specified that only state and local laws and regulations that were “inconsistent with such contractual provisions” were preempted. 9 In 1998, however, after courts had rejected complete preemption based on the old clause, Congress amended FEHBA and adopted the preemption provision set forth above. 10 The new provision closely resembles ERISA’s express preemption provision, 11 and prece *394 dent interpreting the ERISA provision thus provides authority for eases involving the FEHBA provision. 12 Therefore, in our discussion of conflict preemption, except when we consider the different goals of the two statutes, we refer to ERISA and FEHBA cases interchangeably.

The interpretation of the broad preemption clauses contained in ERISA and FEHBA has evolved from a plain language interpretation in which the statutes would have preempted nearly everything, 13 to a more pragmatic interpretation in which courts seek to preserve the goals of Congress when it passed the statutes, while maintaining state control in traditional fields of state regulation. 14 In recent years, the Supreme Court has limited the broad language of the preemption clause, particularly the term “relates to.” A law “ ‘relates to’ an employee benefit plan, in the normal sense of the phrase, if it has a connection with or reference to such a plan.” 15 Each of these terms, “connection with” and “reference to,” has its own definition. 16 This case turns on the “connection with” prong, so we proceed to it now.

To determine whether Montana state law has a “connection with” Botsford’s FEHBA plan, we must “look both to the ‘objectives of the [FEHBA] statute as a guide to the scope of the state law that Congress understood would survive,’ as well as to the nature of the effect of the state law on[FEHBA] plans.” 17

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314 F.3d 390, 2002 Cal. Daily Op. Serv. 12264, 2002 Daily Journal DAR 14468, 2002 U.S. App. LEXIS 26457, 2002 WL 31856602, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bruce-f-botsford-v-blue-cross-and-blue-shield-of-montana-inc-blue-cross-ca9-2002.