Connecticut State Dental Ass'n v. Anthem Health Plans, Inc.

591 F.3d 1337, 48 Employee Benefits Cas. (BNA) 1674, 2009 U.S. App. LEXIS 28773, 2009 WL 5126236
Court of Appeals for the Eleventh Circuit·Decided December 30, 2009·No. 08-15268, 08-15277·Published·Cited by 247 cases

Opinion

QUIST, District Judge:

These consolidated appeals require us to decide whether § 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), completely preempts one or more of Plaintiffs’ state law claims, thus providing a *1342 basis for federal question jurisdiction. Plaintiffs, Martin J. Rutt (“Rutt”) D.D.S., Michael Egan (“Egan”), D.D.S., and Connect State Dental Association (“CSDA”), filed separate complaints in Connecticut state court, and Defendant, Anthem Health Plans, Inc. (“Anthem”), removed the cases on the basis of ERISA preemption. The district court denied Plaintiffs’ motions to remand. For the following reasons, we conclude that ERISA completely preempts at least some portions of Rutt and Egan’s state law claims but does not preempt CSDA’s state law claim. We also conclude that the district court abused its discretion in denying Rutt and Egan’s motion to vacate or amend the judgment. Therefore, we affirm in part and reverse in part the order denying Plaintiffs’ motions to remand, reverse the order denying Rutt and Egan’s motion to vacate or amend, and remand.

I. BACKGROUND

Rutt and Egan are dentists who practice in Connecticut. CSDA is a membership organization comprised of Connecticut dentists, including Rutt and Egan. Anthem offers and administers managed health and dental plans to employers and employer groups which provide coverage to employees and their eligible dependents. Many of these plans are “employee welfare benefit plans” governed by ERISA. See 29 U.S.C. § 1002(1).

Rutt and Egan participate in Anthem’s network of dentists who provide services to individuals enrolled in Anthem’s plans. They became participating dentists by entering into contracts with Anthem (“Provider Agreement”), pursuant to which they agreed to provide professional services in exchange for compensation in “the amount specified in the Comprehensive Schedule of Professional Services, or the Usual, Customary and Reasonable allowable determination.” 1

On April 15, 2002, Rutt and Egan filed a five-count class action complaint against Anthem in Connecticut state court, alleging claims for breach of contract, breach of the duty of good faith and fair dealing, violation of the Connecticut Unfair Trade Practices Act (“CUTPA”), negligent misrepresentation, and unjust enrichment. The crux of the allegations was that Anthem employed a number of practices, such as “improper downcoding” and “improper bundling,” as a means of underpaying participating dentists for services they performed. CSDA also sued Anthem in state court, alleging in a single count that Anthem violated the CUTPA. The factual allegations mirrored those in Rutt and Egan’s complaint.

Anthem removed the cases to the United States District Court for the District of Connecticut on the basis that Plaintiffs’ state law claims are completely preempted by ERISA. Plaintiffs filed motions to remand, but before the motions were decided, the cases were transferred by the Joint Judicial Panel on Multi-District Litigation as “tag along” cases in the multi-district litigation titled In re: Managed Care, pending in the Southern District of Florida. The Florida federal district court eventually denied Plaintiffs’ motions to remand in brief orders, citing only its previous decision on a motion to remand in another case as the basis for denying Plaintiffs’ motions. 2

The district court stayed Plaintiffs’ tag-along cases from August 2003 to April *1343 2008, while it addressed the cases and matters on the main track. Prior to the stay, Anthem filed motions to dismiss, and Plaintiffs filed responses. The district court never ruled on these motions. Instead, twice it denied the motions without prejudice but directed Anthem to refile them. Anthem refiled its motions as instructed in November 2007 and again in April 2008. Plaintiffs responded to the November 2007 motions but, due to an error of counsel, failed to respond to the April 2008 motions. The district court thus granted Anthem’s motions based on Plaintiffs’ failure to respond. Plaintiffs then moved to vacate or amend the orders granting Anthem’s motions, but the district court denied the motions, concluding that Plaintiffs had not shown excusable neglect. Plaintiffs timely appealed.

II. STANDARDS OF REVIEW

We review de novo denials of motions to remand as well as preemption determinations. Henderson v. Wash. Nat’l Ins. Co., 454 F.3d 1278, 1281 (11th Cir.2006); Anderson v. H & R Block, Inc., 287 F.3d 1038, 1041 (11th Cir.2002). “We have jurisdiction to consider denial of a motion to remand upon the entry of a final order,” which occurred in this case on June 6, 2008, when the district court granted Anthem’s motions to dismiss. Bailey v. Janssen Pharmaceutica, Inc., 536 F.3d 1202, 1205 (11th Cir.2008).

We review the district court’s denial of the motions to vacate or amend judgment for an abuse of discretion. Lockard v. Equifax, Inc., 163 F.3d 1259, 1267 (11th Cir.1998).

III. MOTION TO REMAND

On a motion to remand, the removing party bears the burden of showing the existence of federal subject matter jurisdiction. Pacheco de Perez v. AT&T Co., 139 F.3d 1368, 1373 (11th Cir.1998). The test ordinarily applied for determining whether a claim arises under federal law is whether a federal question appears on the face of the plaintiffs well-pleaded complaint. Louisville & Nashville R.R. v. Mottley, 211 U.S. 149, 152, 29 S.Ct. 42, 43, 53 L.Ed. 126 (1908). “As a general rule, a case arises under federal law only if it is federal law that creates the cause of action.” Diaz v. Sheppard, 85 F.3d 1502, 1505 (11th Cir.1996) (citing Franchise Tax Bd. v. Constr. Laborers Vacation Trust, 463 U.S. 1, 8-10, 103 S.Ct. 2841, 2846, 77 L.Ed.2d 420 (1983)). Because Plaintiffs’ complaints allege only state law claims, there is no jurisdiction under the well-pleaded complaint rule.

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Connecticut State Dental Ass'n v. Anthem Health Plans, Inc., 591 F.3d 1337, 48 Employee Benefits Cas. (BNA) 1674, 2009 U.S. App. LEXIS 28773, 2009 WL 5126236 (11th Cir. 2009).

591 F.3d 1337 (Connecticut State Dental Ass'n v. Anthem Health Plans, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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