Goncalves Ex Rel. Goncalves v. Rady Children's Hospital San Diego

865 F.3d 1237, 2017 WL 3273868, 2017 U.S. App. LEXIS 14149
CourtCourt of Appeals for the Ninth Circuit
DecidedAugust 2, 2017
Docket15-55010
StatusPublished
Cited by126 cases

This text of 865 F.3d 1237 (Goncalves Ex Rel. Goncalves v. Rady Children's Hospital San Diego) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Goncalves Ex Rel. Goncalves v. Rady Children's Hospital San Diego, 865 F.3d 1237, 2017 WL 3273868, 2017 U.S. App. LEXIS 14149 (9th Cir. 2017).

Opinions

Dissent by Judge WARDLAW

[1242]*1242OPINION

BELL, Senior District Judge:

OPINION

Blue Cross Blue Shield of Massachusetts, Anthem Blue Cross Blue Shield of New Hampshire, and Blue Cross of California (collectively, “the Blues”) asserted a lien against Lucas Goncalves’s putative future settlement proceeds in an ongoing medical negligence action in California Superior Court to satisfy a subrogation clause in a Federal Employee Health Benefit Act (“FEHBA”) health insurance plan that the Blues administer. When Goncalves asked the Superior Court to expunge the lien, the Blues removed the action to federal court under the federal officer removal statute. See 28 U.S.C. § 1442(a)(1). The district court held that the probate exception precluded federal court jurisdiction and remanded the action back to state court.

The sole issue on appeal is whether Gon-calves’s motion to expunge the Blues’ sub-rogation hen is properly in state or federal court. We have jurisdiction to review the remand order under 28 U.S.C. § 1447(d), see Cabalce v. Thomas E. Blanchard & Assocs., Inc., 797 F.3d 720, 727 n.1 (9th Cir. 2015), and, holding that the action was properly in federal court, we reverse.

I

Shortly after he was born in' October 2007, Lucas Goncalves was transferred to Rady Children’s Hospital of San Diego. While receiving treatment at Rady Children’s Hospital, Goncalves suffered internal injuries from alleged medical negligence.

Goncalves was covered by his father’s FEHBA health insurance plan administered by the Blues on behalf of the U.S. Office of Personnel Management (“OPM”). Pursuant to the plan’s coverage, the Blues paid $459,483.57 for Goncalves’s medical treatment in connection with his alleged negligently afflicted injuries from Rady Children’s Hospital. The plan has a subro-gation clause,1 allowing the Blues to recover from Goncalves any monies he receives to reimburse the Blues for any benefits paid under the plan. In relevant part, the plan states:

(a) The [Blues’] subrogation rights, procedures and policies, including recovery rights, shall be in accordance with the provisions of the agreed upon brochure text .... [The Blues], in [their] discretion, shall have the right to file suit in federal court to enforce those rights.
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(c) ... The obligation of the [Blues] to recover amounts through subrogation is limited to making a reasonable effort to seek recovery of amounts to which it is entitled to recover in cases which are brought to [their] attention. ...
(d) The [Blues] may also recover directly from [Goncalves] all amounts received by [Goncalves] by suit, settlement, or otherwise from any third party or its insurer ... for benefits which ■ have been paid under this contract.
(e) [Goncalves] shall take such action, furnish such information and assistance, and execute such papers as the [Blues] or [their] representatives believe[] are necessary to facilitate enforcement of [their] rights, and shall take no action which would prejudice the interests of the [Blues] to subrogation.
(f) ... [A]ll Participating Plans shall subrogate under a single, nation-wide policy to ensure equitable and consistent [1243]*1243treatment for all Members under the contract.

In February 2011, Goncalves, through a guardien ad litem, filed a state-court action alleging medical malpractice against Rady Children’s Hospital and other defendants. In November 2013, the Blues placed a lien of $459,483.57 on any funds Goncalves receives from the suit to recover earlier benefits paid by the Blues under the plan. In April 2014, the California Superior Court approved a settlement between Goncalves and the non-Rady Children’s Hospital defendants, leaving Rady Children’s Hospital as the sole defendant. Sometime in June 2014, Goncalves and Rady Children’s Hospital entered into a settlement agreement; because Goncalves is a minor, the California Probate Code requires the Superior Court’s approval of any settlement. See, e.g., Cal. Prob. Code §§ 3500(b), 3600; Schultz v. Harney, 27 Cal.App.4th 1611, 33 Cal.Rptr.2d 276, 278 (1994).

In July 2014, Goncalves filed a motion in state court to expunge the Blues’ lien on the ground that the Blues’ “claims of lien are subject to the anti-subrogation provision ... and are therefore unenforceable” because “FEBHA [sic] does not preempt state anti-subrogation laws.” The Blues removed this action under the federal officer removal statute, 28 U.S.C. § 1442(a)(1), to the U.S. District Court for the Southern District of California. Goncalves asked the district court to remand the case to state court on, inter alia, two grounds: (1) the Blues could not remove the case under § 1442(a)(1) and (2), even if removal was otherwise proper, the probate exception barred federal jurisdiction. The district court held that the Blues had acted pursuant to a federal officer’s direction and could remove the ease pursuant to § 1442(a)(1). The district court, however, agreed with Goncalves that any exercise of federal jurisdiction would interfere with the probate proceedings in California. The district court remanded the case back to state court.

The Blues filed this appeal, arguing that the district court erred because the probate exception did not bar federal jurisdiction. In response, Goncalves continues to argue that the probate exception bars federal jurisdiction, but argues alternatively that even if it does not, the action was not properly removed under § 1442(a)(1). We ordered supplemental briefing as to whether the prior exclusive jurisdiction doctrine barred federal court jurisdiction; the Blues contend that it does not, and Goncalves contends that it does.

II

We address first whether the Blues properly removed the action to federal court under 28 U.S.C. § 1442(a)(1). We then address whether either the probate exception or the prior exclusive jurisdiction doctrine bars the exercise of federal jurisdiction.

A. The Action Is Removable Under the Federal Officer Removal Statute

The federal officer removal statute provides, in relevant part:

(a) A civil action ... that is commenced in a State court and that is against or directed to [the following] may be removed by them to the district court of the United States for the district and division embracing the place wherein it is pending:
(1) The United States or any agency thereof or any officer (or any person acting under that officer) of the United States or of any agency thereof, in an official or individual capacity, for or relating to any act under color of such office ....

28 U.S.C. § 1442 (emphasis added). The statute defines a “civil action” to “include

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Bluebook (online)
865 F.3d 1237, 2017 WL 3273868, 2017 U.S. App. LEXIS 14149, Counsel Stack Legal Research, https://law.counselstack.com/opinion/goncalves-ex-rel-goncalves-v-rady-childrens-hospital-san-diego-ca9-2017.