E. v. Deseret Mutual Benefit Administrators

CourtDistrict Court, D. Utah
DecidedJune 20, 2023
Docket2:20-cv-00707
StatusUnknown

This text of E. v. Deseret Mutual Benefit Administrators (E. v. Deseret Mutual Benefit Administrators) is published on Counsel Stack Legal Research, covering District Court, D. Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
E. v. Deseret Mutual Benefit Administrators, (D. Utah 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH, CENTRAL DIVISION

L.E., MEMORANDUM DECISION AND ORDER Plaintiff, Case No. 2:20-cv-00707-RJS-DBP v. Chief District Judge Robert J. Shelby DESERET MUTUAL BENEFIT ADMINISTRATORS, Chief Magistrate Judge Dustin B. Pead

Defendant.

This case arises under the Employee Retirement Income Security Act of 1974 (ERISA). Plaintiff L.E. alleges Defendant Deseret Mutual Benefit Administrators (DMBA) violated ERISA by denying coverage for her outpatient psychotherapy sessions. Now before the court are the parties’ cross-Motions for Summary Judgment and L.E.’s Motion to Supplement the Administrative Record.1 For the reasons stated below, DMBA’s Motion for Summary Judgment is GRANTED in part and DENIED in part, L.E.’s Motion to Supplement the Administrative Record is DENIED, and L.E.’s Motion for Summary Judgment is DENIED in part and REMANDED in part. BACKGROUND AND PROCEDURAL HISTORY L.E. was a participant in the Deseret Premier Plan (under the Deseret Healthcare Employee Welfare Benefits Plan) when she received psychotherapy from a licensed clinical psychologist, Dr. Katie Burton (also known as Dr. Kate Yoder), for post-traumatic stress disorder and dissociative identity disorder.2 In January 2020, the Plan Administrator, DMBA,

1 Dkt. 36, L.E.’s Motion for Summary Judgment; Dkt. 35, DMBA’s Motion for Summary Judgment; Dkt. 55, L.E.’s Motion and Memorandum to Supplement the Joint Administrative Record. 2 See Dkt. 36 at 6–7; see also Dkt. 32, Administrative Record (AR) [SEALED] at 16. started denying coverage for some of L.E.’s outpatient psychotherapy sessions, leading her to accrue out-of-pocket costs she argues should have been covered by the Plan.3 The Plan fully covers mental health outpatient evaluation, therapy, and medication management after the patient’s copayment,4 with some notable exceptions. For example, the

Plan excludes coverage for certain “[m]ental or emotional conditions without manifest psychiatric disorder . . . or non-specific conditions,” and “[c]ounseling.”5 In denying coverage for L.E.’s psychotherapy sessions, however, DMBA did not reference specific provisions of the Plan or otherwise explain the reason for the denial beyond cursory statements of non-coverage.6 During the relevant period, L.E. avers $64,405.10 was covered by the Plan, while she was left with out-of-pocket charges of $33,749.90.7 And she “continues to receive treatment which [she contends] should be covered by the Plan.”8 The Plan and the summary plan description (together, the Plan Documents)9 outline the process for appealing DMBA’s denial of benefits. Notably, the Plan Documents require

3 See Dkt. 36 at 11, 19–23. 4 Id. at 9 (citing AR at 226). 5 Id. at 9–10 (citing AR at 226, 243, 1147, 1198). 6 Most of the denials stated: “THE ABOVE SERVICE IS NOT COVERED. Expenses which do not meet the definition of eligible charges are denied.” See AR at 6, 7, 11, 30, 31, 35, 36, 111, 115. Other denials provided: “THESE SERVICES ARE NOT COVERED BY THE PLAN.” See id. at 1, 2, 12, 13, 18, 29. 7 Dkt. 30, Second Amended Complaint ¶¶ 25–27. 8 Id. ¶ 28. 9 See AR at 200–15 (Summary Plan Description: General Information), 216–45 (Summary Plan Description: Deseret Premier Plan), 246–57 (Definitions), 258–73 (General Information), 1142–67 (Plan). participants to “exhaust[] all administrative remedies” before filing a civil action.10 In the context of both pre- and post-service claims, the Plan contemplates two levels of appeal: (1) an initial review of the denial with DMBA’s Claims Management Review team; and (2) a second appeal with the Claims Review Committee.11 The Plan Documents clarify that either the

participant or a “duly authorized representative” of the participant may file an appeal under the Plan.12 However, the appeal must be submitted “in writing within [twelve] months from the date” of the adverse benefit decision.13 On May 8, 2020, DMBA received a seven-page letter from L.E.’s counsel, Marcie E. Schaap, seeking an initial review of the denials for L.E.’s psychotherapy sessions.14 In the letter, counsel argued that DMBA’s “reduction in benefits [was] unjustified and create[d] an unfair financial burden for [L.E.]”15 She requested, among other things, further explanations from DMBA regarding the denial of benefits and the specific criteria used to assess L.E.’s claims.16 DMBA responded to the letter a week later, on May 19, 2020, noticing the “request for a first-level review of benefits for services,” while also alerting L.E.’s counsel that she did not

10 See Dkt. 35 at 6 (citing AR at 211); see also AR at 1243 (“The claims procedures set forth in Section 5.2 must be exhausted prior to any Participant, any Spouse, any other Dependent or any other person bringing an action under this Plan.”). L.E. contends this is a “legal conclusion,” as opposed to a statement of undisputed material fact, and points out that “ERISA does not contain an exhaustion requirement and the court’s application of the exhaustion requirement is subject to the court’s discretion and contains several exceptions.” Dkt. 37, L.E.’s Opposition to DMBA’s Motion for Summary Judgment at 3 (citing McGraw v. Prudential Ins. Co. of Am., 137 F.3d 1253, 11263 (10th Cir. 1998)). For background purposes, the court agrees with DMBA that the Plan Documents require an exhaustion of administrative remedies. 11 See Dkt. 35 at 6 (citing AR at 213, 274, 1235–36); Dkt. 37 at 3. 12 See AR at 1232, see also id. at 213, 271, 274. 13 Id. at 212, 245, 270. 14 Dkt. 35 at 6–7 (citing AR at 466–72); see also AR at 19–25. 15 AR at 20, 467. 16 Id. at 20, 23–24, 467, 470–71. “meet the plan criteria for an authorized representative to act on the patient’s behalf.”17 To satisfy the plan criteria, DMBA stated that L.E. would need to do the following: • Provide a written statement approving the authorized representative to act on the patient’s behalf. • The written statement must include the specific service dates (if post-service), description of treatment or service, and claim or preauthorization numbers for which the representative is authorized to act. • The written statement must include the patient’s signature in support of the authorization, witnessed by a notary public, dated on or after the date of the initial adverse benefit determination.18 DMBA explained that its decision was “unrelated to any [Health Insurance Portability and Accountability Act (HIPAA)] authorizations previously granted.”19 DMBA further cautioned that it would “direct all information and notification about that claim to the personal representative authorized to act on the patient’s behalf” only after these procedures were followed.20 Finally, DMBA stated that counsel or L.E. could find the “provision(s) to authorize a personal representative” in the summary plan description under “Claims Review and Appeal Procedures.”21 On May 27, 2020, L.E. responded by providing DMBA with a signed form on DMBA letterhead entitled “Authorization to Use and/or Disclose Protected Health Information (PHI).”22 The form authorized DMBA to “use and disclose [L.E.’s] PHI” to her counsel, including

17 See Dkt. 35 at 6–7 (citing AR at 27–28). 18 AR at 27. 19 Id. 20 Id. 21 Id. at 28. The relevant parts of the summary plan description explain that the participant, or “someone [they] name to act for [them] as [their] authorized representative, may file an appeal.” The summary plan description then directs participants to “[c]ontact DMBA’s appeals coordinator . . . for information about how to authorize another person to represent [them].” Id. at 213, 271; see also id. at 46, 274 (reflecting the same guidance on DMBA’s standard appeal form and “Understanding Your Explanation of Benefits” document, respectively). 22 See Dkt.

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