HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY v. SPEECH & LANGUAGE CENTER, LLC

CourtDistrict Court, D. New Jersey
DecidedAugust 22, 2022
Docket3:22-cv-01748
StatusUnknown

This text of HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY v. SPEECH & LANGUAGE CENTER, LLC (HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY v. SPEECH & LANGUAGE CENTER, LLC) 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.

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HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY v. SPEECH & LANGUAGE CENTER, LLC, (D.N.J. 2022).

Opinion

NOT FOR PUBLICATION

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY, Plaintiff, wo . arp’ Civil Action No, 22-1748 (MAS) (DEA) ‘ MEMORANDUM OPINION SPEECH & LANGUAGE CENTER, LLC et al., Defendants.

SHIPP, District Judge This matter comes before the Court on Horizon Blue Cross Blue Shield of New Jersey’s (“Horizon Blue”) Motion to Remand. (ECF No. 12.) Defendants Chryssoula Arsenis (“Arsenis”) and Speech & Language Center, LLC (“Speech & Language,” and collectively, “Defendants”) opposed the Motion (ECF Nos. 16-19),! and Horizon Blue responded (ECF No. 20).? The Court has carefully considered the parties’ submissions and decides the matter without oral argument under Local Civil Rule 78.1. For the reasons below, the Court grants Horizon Blue’s Motion.

' Arsenis may proceed pro se in federal court. But Speech & Language, a corporation, may not. Rowland y. Cal. Men’s Colony, Unit I Men’s Advisory Council, 506 U.S. 194, 201-02 (1993) (“It has been the law for the better part of two centuries .. . that a corporation may appear in the federal □ courts only through licensed counsel.”). ? In April 2022, the Court swe sponte issued an Order to Show Cause as to why this case should not be remanded to state court for lack of subject matter jurisdiction and because removal was untimely. (ECF No. 8.) Arsenis responded. (ECF No. 13.)

L BACKGROUND This is a case about alleged healthcare fraud and an attempt to avoid the consequences of that fraud. In 2014, Horizon Blue sued Defendants in state court alleging that they engaged in a pattern of fraudulent billing for speech testing and therapy services. (See Notice of Removal *14-15, ECF No. 1.)° Arsenis is a speech pathologist who owned and operated Speech & Language in Warren, New Jersey. (/d. at *17-18.) Horizon Blue is an insurance provider that entered into an agreement with Arsenis in January 2007 to pay insurance claims submitted by Defendants for healthcare services to patients. U/d. at *21.) From at least 2009 through 2013, Defendants submitted numerous insurance claims to Horizon Blue and its affiliates to receive payment for speech therapy services it provided to various patients. (/d. at *22.) At some point, Horizon Blue realized that Defendants were submitting inflated or fraudulent bills that were impossible or implausible to perform (such as billing between 45 hours and 99 hours of services in one day) or that were for medically unnecessary services. (/d. at *27-28.) When Horizon Blue audited Defendants, the paperwork did not check out, either. Ud. at *28.) Worse yet, Horizon Blue’s investigation revealed that Defendants’ patients, many of whom were interviewed, undermined the accuracy of Defendants’ billing practices. Ud.) In all, Horizon Blue and its affiliates claim to have paid Defendants over $6.5 million in unentitled payments. (/d. at *29.) To recover for its losses, in 2014, Horizon Blue sued Defendants in state court, alleging that they violated the New Jersey Insurance Fraud Protection Act (“IFPA”), as well as other causes of action including fraud, breach of contract, unjust enrichment, and negligent misrepresentation. (fd. at *32-39.) After years of litigation, in August 2019, the parties agreed on settlement terms. See Horizon Blue Cross Blue Shield of N.J. v. Speech & Language Ctr., LLC, No. 19-1353, 2020

? Page numbers preceded by an asterisk refer to the page number atop the ECF header.

WL 7383560, at *2 (N.J. Super. Ct. App. Div. Dec. 16, 2020). But before the ink on the settlement agreement was dry, Arsenis refused to execute the documents or make her obligatory payments. Id. Horizon Blue moved the state court to enforce its rights, which the court granted. (Lee Cert., Ex. B, ECF No. 12-6.) After an appeal, on January 27, 2022, the state court ruled in favor of Horizon Blue to enforce its settlement rights. (Lee Cert., Ex. A, ECF No. 12-5.) Not ready to give up the fight, Arsenis removed the action to federal court on March 29, 2022. (Notice of Removal (citing 28 U.S.C. §§ 1331, 1441, 1446(d)).) The nearly decade-long state court action thus arrived before this Court. Given the seemingly improper removal, the Court issued an Order to Show Cause. (See OTSC, ECF No. 8.) Horizon Blue moved for remand, as well, claiming the matter is neither properly before the Court nor timely removed. (PI.’s Mot. to Remand, ECF No. 12.) After the parties submitted a series of briefing and exhibits (ECF Nos. 13, 16-20), Horizon Blue’s Motion is now before the Court. IL. LEGAL STANDARD For a federal court to hear a case, it must have diversity or federal question jurisdiction over the issue. See 28 U.S.C. §§ 1331, 1332; In re Morrissey, 717 F.2d 100, 102 (3d Cir. 1983) (“United States district courts are courts of limited jurisdiction and Congress, as allowed by the Constitution, must expressly grant them the power and authority to hear and decide cases.’’), The federal removal statute, 28 U.S.C. § 1441, states that unless “otherwise expressly provided by Act of Congress, any civil action brought in a [s]tate court of which the district courts of the United States have original jurisdiction, may be removed . . . to the district court of the United States for the district and division embracing the place where such action is pending.” 28 U.S.C. § 1441(a). A plaintiff can move to remand a case removed to a federal court where the court lacks subject matter jurisdiction. fd. § 1447(c).

The removal statute “is to be strictly construed against removal” to honor Congressional intent. Samuel-Basset v. Kia Motors Am., Inc., 357 F.3d 392, 396 (3d Cir. 2004); Abels v. State Farm Fire & Cas. Co., 770 F.2d 26, 29 (3d Cir. 1985) (“Because lack of jurisdiction would make any decree in the case void and the continuation of the litigation in federal court futile, the removal statute should be strictly construed and all doubts should be resolved in favor of remand.”). Thus, a district court has the authority to remand a case that was removed to federal court if “at any time before final judgment it appears the district court lacks subject matter jurisdiction... .” 28 U.S.C. § 1447(c). To defeat a motion to remand, a defendant bears the burden of demonstrating the federal court’s jurisdiction. Abels, 770 F.2d at 29. Il. DISCUSSION Horizon Blue launches a dual-fronted attack on the removal of this case, contending that the Court lacks subject matter jurisdiction and removal was untimely. The Court considers each removal defect in turn. A. The Court Lacks Subject Matter Jurisdiction Federal courts are courts of limited jurisdiction. G. W. v. Ringwood Bad. of Educ., 28 F.4th 465, 468 (3d Cir. 2022). To invoke subject matter jurisdiction on removal, a defendant must demonstrate that the case falls within the Court’s diversity jurisdiction or federal question jurisdiction. See 28 U.S.C.

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HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY v. SPEECH & LANGUAGE CENTER, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/horizon-blue-cross-blue-shield-of-new-jersey-v-speech-language-center-njd-2022.