FHMC v. BLUE CROSS

CourtCourt of Appeals of Arizona
DecidedJune 22, 2026
Docket1 CA-CV 25-0735
StatusUnpublished
AuthorMichael S. Catlett

This text of FHMC v. BLUE CROSS (FHMC v. BLUE CROSS) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
FHMC v. BLUE CROSS, (Ark. Ct. App. 2026).

Opinion

NOTICE: NOT FOR OFFICIAL PUBLICATION. UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

IN THE ARIZONA COURT OF APPEALS DIVISION ONE

FHMC, LLC et al., Plaintiffs/Appellants,

v.

BLUE CROSS AND BLUE SHIELD OF ARIZONA, INC, Defendant/Appellee.

No. 1 CA-CV 25-0735 FILED 06-22-2026

Appeal from the Superior Court in Maricopa County No. CV2024-021225 The Honorable Dewain D. Fox, Judge

AFFIRMED

COUNSEL

Fountain Hills Medical Center, Fountain Hills By Grover C. Peters Counsel for Plaintiff/Appellant

Papetti Samuels Weiss McKirgan LLP, Scottsdale By Randall S. Papetti, Lauren Ann Crawford Counsel for Defendant/Appellee FHMC, et al. BLUE CROSS Decision of the Court

MEMORANDUM DECISION

Presiding Judge Michael S. Catlett delivered the decision of the Court, in which Judge Angela K. Paton and Judge Jennifer M. Perkins joined.

C A T L E T T, Judge:

¶1 This appeal involves a dispute between an out-of-network health care provider and an insurer of health care plans and policies about reimbursement for emergency care services. The health care providers, FHMC, LLC and FHMC Clinic, LLC (together “FHMC”), appeal the superior court’s judgment dismissing their complaint for failing to state a claim against the insurer, Blue Cross and Blue Shield of Arizona, Inc. (“Blue Cross”). Because the superior court correctly entered judgment dismissing FHMC’s claims, we affirm.

FACTS AND PROCEDURAL HISTORY

¶2 On appeal from a dismissal for failure to state a claim, we presume the well-pleaded factual allegations are true and “indulge all reasonable inferences from those facts, but mere conclusory statements are insufficient.” Coleman v. City of Mesa, 230 Ariz. 352, 356 ¶ 9 (2012).

¶3 Blue Cross insures health care plans and policies. FHMC provides health care through a medical clinic and emergency care facility in Fountain Hills, Arizona. FHMC is an out-of-network (“OON”) provider because it has no contract with Blue Cross setting reimbursement rates or otherwise governing payment for services provided to patients with Blue Cross insurance plans (“the insureds”). During all relevant times, FHMC provided emergency care services to the insureds as an OON provider.

¶4 In return for treatment, FHMC required all patients, including the insureds, to execute several forms regarding payment. In one form, the insureds confirmed they are “financially responsible” for services rendered. The same form states that if the insureds receive a reimbursement check from Blue Cross for such services, the funds are “legally due to” FHMC.

¶5 Another form, the “Conditions of Admission and Consent to Medical Treatment,” includes an “Assignment of Insurance Benefits/Promise to Pay” (“Assignment”) authorizing Blue Cross to pay

2 FHMC, et al. BLUE CROSS Decision of the Court

FHMC directly and purporting to assign certain insurance rights and benefits to FHMC. The Assignment provides:

I ASSIGN TO [FHMC] all of my rights and benefits under existing policies of insurance providing coverage and payment for any expenses incurred as a result of services and treatment rendered by [FHMC]. I authorize direct payment to [FHMC] of any insurance benefits otherwise payable to or on behalf of myself.

The insureds also granted FHMC “power of attorney . . . expressly limited to those [powers] reasonably required to collect any payments or benefits[.]”

¶6 Pursuant to these forms, FHMC submitted claims to Blue Cross for reimbursement for emergency care services. For some time, Blue Cross sent reimbursements directly to FHMC for an unknown number of claims. But for seventy-one claims, Blue Cross instead sent reimbursement checks directly to the insureds, totaling an estimated $467,084.70 (“Pre-NSA Claims”). FHMC has unsuccessfully tried to collect from these insureds.

¶7 After the federal No Surprises Act (“NSA”) became effective in January 2022, FHMC alleges Blue Cross “dramatically decreased” its reimbursement rates for emergency care services. See 42 U.S.C. § 300gg-111 et seq., Pub. L. No. 116-260, 134 Stat. 2758 (2020). According to FHMC, Blue Cross violated the NSA by: (1) failing to timely process claims; (2) issuing insufficient initial payments and denials without explanation; (3) refusing to participate in open negotiations or agree on appropriate reimbursement amounts; (4) submitting improper calculations for arbitration; and (5) failing to pay or underpaying awards (“Post-NSA Claims”). As a result, FHMC contends Blue Cross withheld “millions of dollars[.]”

¶8 FHMC sued Blue Cross under the NSA in federal district court, but that court dismissed the action for failure to state a claim. FHMC then sued Blue Cross in superior court, asserting eleven claims under Arizona law.

¶9 Blue Cross moved to dismiss FHMC’s complaint for failing to state a claim. After briefing and argument, the superior court dismissed FHMC’s complaint in full. As to the Pre-NSA Claims, the court concluded that because FHMC was an OON provider, Blue Cross was not contractually obligated to send reimbursements directly to FHMC. The court also reasoned that the insureds could not pursue the Pre-NSA Claims against Blue Cross, so FHMC also could not.

3 FHMC, et al. BLUE CROSS Decision of the Court

¶10 The court dismissed the Post-NSA Claims based on conflict preemption, concluding FHMC’s state-law claims “st[ood] as an obstacle to the accomplishment and execution” of the NSA. Because the court dismissed the Post-NSA Claims on preemption grounds, it did not consider Blue Cross’s alternative arguments that FHMC’s claims fail under state law.

¶11 FHMC timely appealed. We have jurisdiction. A.R.S. §§ 12- 2101(A)(1), 12-120.21(A)(1).

DISCUSSION

¶12 For the most part, the superior court concluded that the NSA preempts FHMC’s state law claims. So in large part, the court did not decide whether FHMC stated any valid claim under state law. And on appeal, the parties focus their arguments on federal preemption.

¶13 “[P]ursuant to the Supremacy Clause, U.S. Const. art. VI, cl. 2, when a state law clearly conflicts with federal. . . law, the state law must yield[.]” In re Marriage of Quijada and Dominguez, 257 Ariz. 432, 437 ¶ 20 (2024). “We presume that federal lawmakers do not ‘cavalierly preempt’ state law because ‘the States are independent sovereigns in our federal system,’ and have historically ‘had great latitude’ to protect ‘the lives, limbs, health, comfort, and quiet’ of their citizens.” Varela v. FCA US LLC, 252 Ariz. 451, 459 ¶ 13 (2022) (citations omitted). Our supreme court has cautioned against concluding that “state law is preempted not by what is expressed in federal law, but rather by what may be implied by federal law.” Id. at 460 ¶¶ 15–16. “[I]n our system of federalism, we do not start with federal law and apply it unless the legislature manifests a contrary intent; rather, we presume that state law prevails[.]” Roberts v. State, 253 Ariz. 259, 266 ¶ 21 (2022).

¶14 What does this mean here? It means we conduct our analysis in a different order than the superior court. We start with the question whether FHMC stated any valid claim under state law. Only if FHMC did so, do we analyze whether any valid claim is preempted under federal law. This approach is consistent with how Arizona courts proceed when a defendant argues federal preemption and failure to state a claim under state law. It also jives with federalism and avoiding constitutional issues when possible. See Conklin v. Medtronic, Inc., 245 Ariz.

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FHMC v. BLUE CROSS, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fhmc-v-blue-cross-arizctapp-2026.