FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP v. BLUE CROSS BLUE SHIELD OF MINNESOTA

CourtDistrict Court, D. New Jersey
DecidedDecember 23, 2020
Docket2:17-cv-12025
StatusUnknown

This text of FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP v. BLUE CROSS BLUE SHIELD OF MINNESOTA (FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP v. BLUE CROSS BLUE SHIELD OF MINNESOTA) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP v. BLUE CROSS BLUE SHIELD OF MINNESOTA, (D.N.J. 2020).

Opinion

Not for Publication UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP, Plaintiff, Civil Action No. 17-12025 (ES) (JAD) v. OPINION BLUE CROSS BLUE SHIELD OF MINNESOTA, et al., Defendants.

Salas, District Judge Before the Court is the motion of Defendants Blue Cross Blue Shield of Minnesota (“BCBSM”) and The Travelers Companies, Inc.1 (“Travelers”) (collectively, “Defendants”) motion to dismiss Plaintiff Femino-Ducey-Queler Orthopedic Group’s (“Plaintiff”) Complaint. (D.E. No. 13). The Court also ordered the parties to show cause why this action should not be remanded to New Jersey State Court for lack of subject-matter jurisdiction. (D.E. No. 26). Having considered the parties’ submissions, the Court decides this matter without oral argument. See Fed. R. Civ. P. 78(b); L. Civ. R. 78.1(b). As set forth below, the Court finds that it has subject-matter jurisdiction pursuant to 28 U.S.C. § 1332 and will permit jurisdictional discovery. I. Background Plaintiff is a New Jersey company providing healthcare services. (D.E. No. 1-1 (“Compl.”) ¶ 1). On July 26, 2016, Plaintiff, through its employee or contractor, Frank Femino, M.D.,

1 The Travelers Companies, Inc. was improperly pleaded as The Travelers Insurance Company. (See D.E. No. 8 at 2). conducted surgical services on L.Z.; L.Z. had sustained a left foot open fracture dislocation and went to the emergency room at Clara Maass Medical Center. (Id. ¶ 17). L.Z. had a self-insured employee health insurance plan through her employer, Travelers; the plan was administered by Defendants. (Id. ¶¶ 5 & 16). Plaintiff is a non-participating, or out-of-network, provider as to the

plan. (Id. ¶ 15). Dr. Femino determined that urgent surgery was necessary, and the hospital, “as part of the normal business practice,” received authorization for the surgery. (Id. ¶¶ 17 & 21). After Dr. Femino performed the surgery, Plaintiff billed Defendants “for the primary surgeon charges” of $68,470, which represented the “normal and reasonable charges” for the “complex procedures performed.” (Id. ¶¶ 20 & 22). Defendants paid Plaintiff $8,904.18. (Id. ¶ 23). Plaintiff brought an action against Defendants in the Superior Court of New Jersey, Essex County, for claims of breach of contract, promissory estoppel, account stated, fraudulent inducement, and violation of New Jersey regulations governing payment for emergency services rendered by an out-of-network provider. (See generally id.). On November 16, 2017, Defendants removed the case to this Court based on diversity and federal question jurisdiction. (D.E. No. 1-1

¶ 15). Plaintiff filed a motion to remand, arguing that the removal was improper because the Court lacked subject-matter jurisdiction under 29 U.S.C. § 1331. (See D.E. No. 5). Defendants filed an opposition, arguing that while Defendants disagreed with Plaintiff regarding the Court’s federal question jurisdiction, it is undisputed that the Court had jurisdiction based on the parties’ diversity of citizenship. (D.E. No. 8). Soon thereafter, Plaintiff withdrew its motion to remand. (D.E. No. 9). Defendants subsequently filed a motion to dismiss, arguing that (i) the Employee Retirement Income Security Act, 29 U.S.C. § 1001, et seq. (“ERISA”) preempts all of Plaintiff’s state claims; (ii) Plaintiff cannot establish personal jurisdiction over Defendants; and (iii) Plaintiff fails to state a claim under Federal Rule of Civil Procedure 12(b)(6). (See generally D.E. No. 13- 1 (“Def. Mov. Br.”)). Plaintiff filed opposition (D.E. No. 19 (“Pl. Opp. Br.”), to which Defendants relied (D.E. No. 21 (“Def. Reply Br.”)). On July 23, 2019, given the Court’s “ongoing obligation to ensure that it may properly exercise subject-matter jurisdiction before proceeding to hear a

dispute,” the Court ordered the parties to show cause why the action should not be remanded to state court (D.E. No. 26 (“Order to Show Cause” or “OTSC”) at 6), to which Defendants and Plaintiff responded (D.E. No. 28 (“Def. OTSC Br.”) & D.E. No. 32 (“Pl. OTSC Br.”)). II. Discussion A. Subject-Matter Jurisdiction The two most common bases for federal subject-matter jurisdiction are (i) federal questions, which are “all civil actions arising under the Constitution, laws, or treaties of the United States”; and (ii) diversity of citizenship, when parties are of diverse citizenship and the amount in controversy exceeds $75,000. 28 U.S.C §§ 1331 & 1332. The Court is satisfied that it has subject- matter jurisdiction under 28 U.S.C. § 1332.

In its Order to Show Cause, the Court pointed out that the Complaint seeks compensatory damages in the amount of $59,565.82; punitive damages in the amount of §100,000 based on claims of fraudulent inducement; and attorney’s fees, costs, and interests. (OTSC ¶ 10; Compl. ¶¶ 32, 36, 41, 48 & 54). The Court noted that, where, as here, “a claim for punitive damages represents the bulk of the amount in controversy and is vital for the exercise of diversity jurisdiction, it should be given close scrutiny.” (Id. ¶ 11). The Court further noted that “[a] request for punitive damages does not support diversity jurisdiction when that request is ‘patently frivolous’ and ‘without foundation’” under New Jersey law. (Id. ¶ 12 (quoting Quinones- Velazquez v. Maroulis, 677 F. App’x 801, 804 (3d Cir. 2017)). Because “punitive damages are not available under New Jersey law unless it can be proven that the defendant acted maliciously or with willful and wanton misconduct,” and because “the Complaint contains no allegations that Defendants’ actions were accompanied by malice or inexcusable recklessness,” the Court was “wary that Plaintiff’s punitive damages request cannot reasonably justify the exercise of diversity

jurisdiction here.” (Id. ¶ 14). In response, Defendants argue that, to plead a right to punitive damages under New Jersey law based on fraudulent inducement, “a plaintiff may allege malice, intent, knowledge and other conditions of mind a person generally.” (Def. OTSC Br. at 3 (citing N.J. Court Rule 4:5-8(a)2)). Because the Complaint “alleges that [D]efendants never intended to pay a promised amount,” which, according to Defendants, is sufficient under New Jersey law to support a fraudulent inducement claim. (Def. OTSC Br. at 3). Plaintiff, on the other hand, states generally that it “acknowledges that the Complaint as pleaded—in light of those concerns expressed by the Court in the Order [to Show Cause]—does not make it sufficiently likely that Plaintiff could successfully recover the punitive damages requested.” (Pl. OTSC Br. at 2). In addition, Plaintiff states that it

“wishes to withdraw the entirety of its [fraudulent inducement claim] including its request for $100,000 punitive damages.” (Id.). Plaintiff argues that, because “whether federal jurisdiction ever attached in this matter is an open [question]” as evidenced by the Court’s Order to Show Cause, upon abandonment of its claim for punitive damages, the amount in controversy required for the Court’s diversity jurisdiction was never met. (Id. at 2–3). The Court disagrees. Pursuant to 28 U.S.C.

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FEMINO-DUCEY-QUELER ORTHOPEDIC GROUP v. BLUE CROSS BLUE SHIELD OF MINNESOTA, Counsel Stack Legal Research, https://law.counselstack.com/opinion/femino-ducey-queler-orthopedic-group-v-blue-cross-blue-shield-of-minnesota-njd-2020.