HealthNow New York, Inc. v. New York

739 F. Supp. 2d 286, 49 Employee Benefits Cas. (BNA) 2449, 2010 U.S. Dist. LEXIS 95124, 2010 WL 3607619
CourtDistrict Court, W.D. New York
DecidedSeptember 13, 2010
Docket1:10-cr-00345
StatusPublished
Cited by3 cases

This text of 739 F. Supp. 2d 286 (HealthNow New York, Inc. v. New York) is published on Counsel Stack Legal Research, covering District Court, W.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
HealthNow New York, Inc. v. New York, 739 F. Supp. 2d 286, 49 Employee Benefits Cas. (BNA) 2449, 2010 U.S. Dist. LEXIS 95124, 2010 WL 3607619 (W.D.N.Y. 2010).

Opinion

DECISION AND ORDER

WILLIAM M. SKRETNY, Chief Judge.

I. INTRODUCTION

Plaintiff HealthNow New York Inc. (“HealthNow”) brings this action pursuant *290 to Article I of the United States Constitution, 29 U.S.C. § 1001 et seq., and 42 U.S.C. § 1983, seeking declaratory and injunctive relief from the State of New York and Andrew M. Cuomo, in his official capacity as New York State Attorney General.

Presently before this Court is Plaintiffs Motion for a Preliminary and Permanent Injunction and for Summary Judgment. 1 Also before this Court are Defendants’ Motion to Dismiss Plaintiffs complaint 2 and Cross Motion for Summary Judgment. 3 For the reasons discussed below, Defendants’ Motion to Dismiss is granted and Plaintiffs motion and Defendants’ Cross Motion for Summary Judgment are denied as moot.

II. BACKGROUND

A. Facts

In adjudicating Defendants’ Motion to Dismiss, this Court assumes the truth of the following factual allegations contained in Plaintiffs complaint. See Hosp. Bldg. Co. v. Trs. of Rex Hosp., 425 U.S. 738, 740, 96 S.Ct. 1848, 1850, 48 L.Ed.2d 338 (1976); see also Hamilton Chapter of Alpha Delta Phi, Inc. v. Hamilton Coll., 128 F.3d 59, 62-63 (2d Cir.1997).

Plaintiff HealthNow is a non-profit health services corporation licensed in New York State. (Complaint, Docket No. 1. ¶ 8.) Nearly all of Plaintiffs business involves Employee Retirement Security Act (“ERISA”) benefit plans. (Id. at ¶ 3.) Pursuant to contracts governing the relationship between the employee-benefit plan and its members, Plaintiff pays for covered medical expenses incurred by plan members. (Id.) Plaintiffs contracts include subrogation and reimbursement provisions, through which Plaintiff pursues recovery of medical expenses paid to injured plan members. (Id.)

An addition to Article 5 of the New York State General Obligations Law (the “Anti-Subrogation Law”) provides that after a plaintiff and a tortfeasor settle certain tort actions — including personal injury, medical malpractice, and wrongful death actions — a benefit provider, such as HealthNow, that paid for health care services and other losses incurred by the plaintiff no longer has reimbursement or subrogation rights to recovery of those costs from the plaintiff or tortfeasor. (Id. at ¶ 2.)

The New York State legislature enacted the Anti-Subrogation Law on November 12, 2009. (Id. at ¶ 32.) The General Obli *291 gations Law was amended by the addition of section 5-335, which establishes the “[ljimitation of non-statutory reimbursement and subrogation claims in personal injury and wrongful death actions” and specifically provides that

[w]hen a plaintiff settles with one or more defendants in an action for personal injuries, medical, dental, or podiatric malpractice, or wrongful death, it shall be conclusively presumed that the settlement does not include any compensation for the cost of health care services, loss of earnings or other economic loss to the extent those losses or expenses have been or are obligated to be paid or reimbursed by a benefit provider, except for those payments as to which there is a statutory right of reimbursement. By entering into any such settlement, a plaintiff shall not be deemed to have taken an action in derogation of any nonstatutory right of any benefit provider that paid or is obligated to pay those losses or expenses; nor shall a plaintiffs entry into such settlement constitute a violation of any contract between the plaintiff and such benefit provider.

(Id. at ¶ 31) (citing N.Y. Gen. Oblig. Law § 5-335(a) (McKinney 2009)). 4

Plaintiff asserts that it has subrogation and reimbursement rights in more than 1,300 outstanding claims representing nearly $14,000,000 in potential recovery, which the Anti-Subrogation Law now prevents Plaintiff from enforcing. (Complaint, ¶ 6.)

B. Procedural History

Plaintiff commenced this action on April 26, 2010, by filing a complaint in the United States District Court for the Western District of New York. (Docket No. 1.) Plaintiff alleges that the Anti-Subrogation Law is preempted by ERISA; applies only to contractual subrogation and reimbursement rights and not equitable subrogation rights; and violates the Due Process and Contracts clauses of the United States Constitution.

On June 2, 2010, Plaintiff filed its Motion for Preliminary and Permanent Injunction and for Summary Judgment pursuant to Rules 56 and 65 of the Federal Rules of Civil Procedure. (Docket No. 7.) Plaintiff seeks a declaratory judgment to declare the Anti-Subrogation Law invalid and an injunction to enjoin its enforcement.

Defendants filed a Motion to Dismiss Plaintiffs complaint pursuant to Rules 12(b)(1) and 12(b)(6) of the Federal Rules of Civil Procedure on June 11, 2010 (Docket No. 11), and a Cross Motion for Summary Judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure on June 23, 2010 (Docket No. 18). In the Motion to Dismiss, Defendants assert that because the Eleventh Amendment to the United States Constitution bars suit against the State of New York and the Ex parte Young exception to Eleventh Amendment immunity does not apply to the Attorney General, no ease or controversy exists involving either of the two defendants, and this Court therefore lacks jurisdiction. In the Cross Motion, Defendants repeat these arguments and further argue that Plaintiff has not satisfied the requirements necessary for injunctive relief and that the AntiSubrogation Law is neither preempted by ERISA nor violative of the United States Constitution.

The New York State Trial Lawyers Association sought and was granted amicus *292 curiae status and submitted amicus briefing in this case. This Court heard oral argument on these motions on August 31, 2010, and took the matters under advisement at that time.

III. DISCUSSION

A. Legal Standards

1. Rule 12(b)(1)

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Bluebook (online)
739 F. Supp. 2d 286, 49 Employee Benefits Cas. (BNA) 2449, 2010 U.S. Dist. LEXIS 95124, 2010 WL 3607619, Counsel Stack Legal Research, https://law.counselstack.com/opinion/healthnow-new-york-inc-v-new-york-nywd-2010.