Cruz v. Lovelace Health System, Inc.

District Court, D. New Mexico·Decided September 12, 2019·No. 1:18-cv-00974·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

ELDIE L. CRUZ, M.D.,

Plaintiff,

v. No: 1:18-cv-974-RB-SCY

LOVELACE HEALTH SYSTEM, INC., LOVELACE HEALTH SYSTEM, INC. dba LOVELACE MEDICAL GROUP, LOVELACE HEALTH SYSTEM, LOVELACE MEDICAL GROUP, AHS MANAGEMENT COMPANY, INC., AHS MANAGEMENT COMPANY, INC. dba ARDENT HEALTH SERVICES, AHS NEW MEXICO HOLDINGS, INC., AHS ALBUQUERQUE HOLDINGS, LLC, BHC MANAGEMENT SERVICES OF NEW MEXICO, LLC, ARDENT HEALTH SERVICES, INC., ARDENT HEALTH SERVICES, LLC, ARDENT HEALTH SERVICES, and RELIANCE STANDARD LIFE INSURANCE COMPANY,

Defendants.

MEMORANDUM OPINION AND ORDER Dr. Eldie Cruz (Plaintiff) filed for long-term disability (LTD) following a leave of absence from the hospital where he worked. He was eventually fired and lost his medical privileges. Plaintiff named 13 defendants in his suit, with most somehow connected to his employer through a web of corporate ownership. Having previously addressed several motions in two Memorandum Opinions and Orders (Opinions) (see Docs. 88; 90), the Court will now take up the Motion to Dismiss of AHS Management Company, Inc., AHS New Mexico Holdings, Inc.,1 AHS

1 Plaintiff cites D.N.M. LR-Civ. 10.2 to show how AHS’s Motion to Dismiss offers an unclear picture of the parties represented. (Doc. 41 at 2–3.) He states that because the motion’s title does not correspond to the parties listed in the first paragraph, the Court should deny. (Id. at 3.) While the title does exclude AHS New Mexico Holdings, Inc., the Court finds this to be harmless error, as the first paragraph and signature block make clear which parties sought relief. (Doc. 16 at 1.) Albuquerque Holdings, LLC, and AHS Medical Holdings, LLC2 (collectively AHS) (Doc. 16), as well as the Motion to Dismiss of BHC Management Services of New Mexico, LLC (BHC). (Doc. 12.) After evaluating Plaintiff’s claims and the complex business relationships at issue, the Court dismisses all claims against AHS and BHC for failure to state a claim. I. Background

The facts of this case were extensively recounted in Opinions filed on August 26, 2019 (Doc. 88) and September 3, 2019 (Doc. 90.) The Court will briefly repeat pertinent background information and include a few additional facts applicable to the current motions. Lovelace employed Plaintiff as a general surgeon.3 (Doc. 71 (Am. Compl.) ¶ 22.) Lovelace was the sponsor and “plan administrator” of an LTD plan. (Id. ¶ 23.) Reliance was the “claims administrator” of the LTD plan. (Id. ¶ 25.) Plaintiff received limited short-term disability payments in early 2016, (id. ¶ 36), but made an LTD benefits claim on March 1, 2016. (Id. ¶ 30.) Reliance, however, “denied Plaintiff’s claim for LTD Benefits.” (Id. ¶ 30.) After a failed appeal in February 2017, Reliance determined in September 2018 “that Plaintiff was entitled to three months of LTD

benefits to be paid by Lovelace based upon Reliance’s finding that Plaintiff met the policy definition of Totally Disabled.” (Id. ¶ 34.) But Lovelace did not pay any LTD benefits to Plaintiff. (Id.) Throughout this period, Plaintiff “repeatedly” asked Lovelace for ADA accommodation so that he could continue to work, but Lovelace failed to provide the requested accommodation. (Id.

2 The Court granted AHS Medical Holdings, LLC’s Motion to Dismiss the claims against non-entity Ardent Health Services in an earlier Opinion. (Doc. 88.) AHS Medical Holdings, LLC is not a named party in the case. Therefore, “AHS” Defendants throughout this Opinion refer collectively to AHS Management Company, Inc., AHS New Mexico Holdings, Inc., and AHS Albuquerque Holdings, LLC.

3 In his pleadings and briefing, Plaintiff refers to all the named defendants other than Reliance collectively as “Lovelace” or “the Lovelace Defendants.” (Doc. 71 (Am. Compl.) ¶¶ 15, 17, 18.) But in this Opinion, the Court will refer only to Plaintiff’s direct employer—Lovelace Health Systems, Inc.—as “Lovelace.” ¶¶ 38–39.) Lovelace “responded by demanding more and more information over a period of many months,” then informed Plaintiff on July 1, 2016, without notice, that he was fired. (Id. ¶ 39.) On February 27, 2018, “Lovelace notified Plaintiff that his medical privileges with Lovelace were being terminated . . . .” (Id. ¶ 41.) He filed a claim with the Equal Employment Opportunity Commission (EEOC) alleging that Lovelace violated the ADA by refusing his requests for

accommodation, and on October 15, 2018, received a right to sue letter from the EEOC. (Id. ¶ 42.) This Opinion takes on the residual issues remaining from the first two Opinions (Docs. 88; 90.) In its motion, the remaining AHS parties argue that the Court should dismiss Counts I–VII for failure to state a claim.4 (Doc. 16.) BHC also asks the Court to dismiss Counts I–VII. II. Legal Standard a. Failure to State a Claim A complaint must contain a “short and plain statement of the claim showing that the pleader is entitled to relief,” Fed. R. Civ. P. 8(a)(2), but it need not include “detailed factual allegations.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (citation omitted). A failure to adequately

plead permits district courts to dismiss a complaint for “failure to state a claim upon which relief may be granted.” Fed. R. Civ. P. 12(b)(6). To survive a motion to dismiss for failure to state a claim, the court, taking all allegations in the complaint as true, must evaluate whether the complaint contains “a plausible claim for relief.” Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009) (citation omitted). Though no probability requirement exists, the plausibility standard “asks for more than a sheer possibility that a defendant has acted unlawfully.” Id. at 678 (citation omitted). Dismissal becomes appropriate when it is “obvious” that there is no way to prevail using the pleaded facts.

4 AHS attempted to join Lovelace’s Motion to Dismiss the ADA claim, (Doc. 16 at 7 n.5), but in its September 3, 2019 Opinion, the Court limited joinder to Lovelace’s adoption of portions of Reliance’s Motion to Dismiss and BHC’s Motion to Dismiss, (Doc. 90 at 4–7.) Still, AHS addresses the ADA claim indirectly in its Motion to Dismiss. (Doc. 16 at 9–10.) See Brown v. Sherrod, 284 F. App’x 542, 543 (10th Cir. 2008); Hall v. Bellmon, 935 F.2d 1106, 1109 (10th Cir. 1991). b. ERISA Standards The Employee Retirement Income Security Act of 1978 (ERISA) permits employee participants or beneficiaries “to recover benefits due to him under the terms of his plan, to enforce

his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). Despite the lack of explicit statutory language defining which parties may be subject to suit, courts have coalesced around the idea that plan administrators are the primary defendants in ERISA suits. See Caffey v. Unum Life Ins. Co., 302 F.3d 576, 584 (6th Cir. 2002) (“It is well established that only plan administrators are liable for statutory penalties.”); Garren v. John Hancock Mut. Life Ins. Co., 114 F.3d 186, 187 (11th Cir.

Free access — add to your briefcase to read the full text and ask questions with AI

Cruz v. Lovelace Health System, Inc., (D.N.M. 2019).

Cruz v. Lovelace Health System, Inc. (Cruz v. Lovelace Health System, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

United States v. Nixon
418 U.S. 683 (Supreme Court, 1974)
Bell Atlantic Corp. v. Twombly
550 U.S. 544 (Supreme Court, 2007)
Ashcroft v. Iqbal
556 U.S. 662 (Supreme Court, 2009)
Sandoval v. Boulder Regional
388 F.3d 1312 (Tenth Circuit, 2004)
Florez v. Holly Corporation
154 F. App'x 707 (Tenth Circuit, 2005)
Brown v. Sherrod
284 F. App'x 542 (Tenth Circuit, 2008)
Cyr v. Reliance Standard Life Insurance
642 F.3d 1202 (Ninth Circuit, 2011)
Donald Law v. Ernst & Young, Etc.
956 F.2d 364 (First Circuit, 1992)
Rosalyn Caffey v. Unum Life Insurance Co.
302 F.3d 576 (Sixth Circuit, 2002)
Praseuth v. Newell-Rubbermaid, Inc.
219 F. Supp. 2d 1157 (D. Kansas, 2002)
Averhart v. US WEST Management Pension Plan
46 F.3d 1480 (Tenth Circuit, 1994)
United States v. Morris
287 F.3d 985 (Tenth Circuit, 2002)
Hall v. Bellmon
935 F.2d 1106 (Tenth Circuit, 1991)