Lax v. APP of New Mexico ED, PLLC

CourtDistrict Court, D. New Mexico
DecidedOctober 5, 2020
Docket1:20-cv-00264
StatusUnknown

This text of Lax v. APP of New Mexico ED, PLLC (Lax v. APP of New Mexico ED, PLLC) is published on Counsel Stack Legal Research, covering District Court, D. New Mexico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lax v. APP of New Mexico ED, PLLC, (D.N.M. 2020).

Opinion

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEW MEXICO

BRIAN LAX, TRACEY BURON-HAHNLEIN, WERNER HAHNLEIN, and JEREMY HADER, on their own behalf and on behalf of all others similarly situated,

Plaintiffs,

v. CIV No. 20-264 SCY/JFR APP OF NEW MEXICO ED, PLLC, f/k/a ALIGNMD OF NEW MEXICO, PLLC, and LOVELACE HEALTH SYSTEM, LLC,

Defendants.

MEMORANDUM OPINION AND ORDER GRANTING PLAINTIFFS’ REQUEST FOR LIMITED DISCOVERY AND TAKING PLAINTIFFS’ MOTION TO REMAND UNDER ADVISEMENT

This case arises from alleged over-billing practices by Lovelace Health System, LLC (“Lovelace”) and APP of New Mexico ED, PLLC (“APP”). Plaintiffs are former patients who sought treatment at a Lovelace facility and allege they were overbilled by APP, a company that provides emergency room physician and nurse practitioner staffing for Lovelace facilities. Plaintiffs filed a class action complaint against Lovelace and APP in the New Mexico Second Judicial District Court on February 11, 2020. Doc. 1-1. On March 23, 2020, Defendant APP removed the action to federal court, citing diversity jurisdiction under the Class Action Fairness Act (“CAFA”). Doc. 1. Plaintiffs argue that the case should be remanded to state court because Defendants have failed to establish that greater than $5,000,000 is in controversy and because, even if it were, the “local controversy exception” mandates that this lawsuit remain in state court. Case precedent related to the amount in controversy weighs against Plaintiffs and the Court therefore rejects Plaintiffs’ argument that Defendants have not established a sufficient amount in controversy for purposes of CAFA jurisdiction. Further, the Court finds that Plaintiffs have not met their burden to establish the local controversy exception applies. Nonetheless, the Court will provide Plaintiffs the opportunity to conduct limited discovery on the question of class

citizenship. As a result, the Court takes Plaintiffs’ Motion to Remand under advisement. BACKGROUND Plaintiffs’ proposed class includes “all New Mexico residents who, beginning four years prior to the filing of this lawsuit, were billed by APP for amounts greater than the in-network amount permitted by their insurance provider for medical services provided at Lovelace facilities.” Id. ¶ 93. The Complaint brings claims for violations of the New Mexico Unfair Practices Act, conversion, willful breach of contract, unjust enrichment, and civil conspiracy. Doc. 1-1. In connection with Defendant APP’s removal to federal court, Defendant Lovelace has filed a consent to removal. Doc. 6. Before the Court presently is Plaintiffs’ Motion to Remand,

filed April 15, 2020 (Doc. 25) and fully briefed May 13, 2020 (Docs. 29, 30, 35). The Court held a hearing on this Motion on September 3, 2020. Doc. 38. Pursuant to 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73(b), the parties have consented to me serving as the presiding judge and entering final judgment. Docs. 9, 14, 15, 16. ANALYSIS The parties dispute two issues related to the CAFA: whether the amount in controversy is satisfied and whether the local exception applies. The Court will address each in turn. A. Amount in Controversy The CAFA grants federal courts subject matter jurisdiction over a class action when (1) “any member of a class of plaintiffs is a citizen of a State different from any defendant,” 28 U.S.C. § 1332(d)(2)(A); (2) the proposed class consists of at least 100 members, 28 U.S.C. § 1332(d)(5)(B); and (3) the amount in controversy exceeds 5 million dollars, excluding interest

and costs, 28 U.S.C. § 1332(d)(2). The parties do not dispute the existence of the first and second requirements: the class representatives are citizens of New Mexico while Defendant APP is a citizen of Tennessee and the proposed class is larger than 100 members. Doc. 25 at 2; Doc. 1 ¶¶ 2.01, 3.06 (Notice of Removal). The parties do, however, dispute whether the amount in controversy exceeds $5 million. To establish that the amount in controversy exceeds $5 million, “the claims of the individual class members shall be aggregated . . . .” 28 U.S.C. § 1332(d)(6). This amount is not “the amount the plaintiff[s] will recover, but rather an estimate of the amount that will be put at issue in the course of the litigation.” Frederick v. Hartford Underwriters Ins. Co., 683 F.3d 1242,

1245 (10th Cir. 2012) (citation omitted). Here, Plaintiffs request an unspecified amount of damages in their Complaint and challenge whether $5 million is at issue. As such, the removing defendant bears the burden to prove jurisdictional facts, by a preponderance of the evidence, that establish the amount in controversy exceeds $5 million. Id. at 1246. A defendant can make such a showing by contentions, interrogatories or admissions in state court; by calculation from the complaint’s allegations[;] by reference to the plaintiff’s information estimates or settlement demands[;] or by introducing evidence, in the form of affidavits from the defendant’s employees or experts, about how much it would cost to satisfy the plaintiff’s demands. Id. at 1247. Once a defendant meets its preponderance of the evidence burden, “remand is appropriate only if the plaintiff can establish that it is legally impossible to recover more than $5,000,000.” Id. Plaintiffs and Defendants disagree on the calculation to determine the amount of actual or compensatory damages at issue in this matter. In the Notice of Removal, Defendant APP offers

an affidavit executed by APP’s Senior Vice President Andrew McQueen which provides data related to “out-of-network patients” sent to collections: In 2016, APP sent approximately 3,500 out-of-network patients accounts to collections, averaging $940 per account, for emergency medical services rendered at Lovelace hospitals in New Mexico. In 2017, APP sent approximately 3,200 out- of-network patient accounts to collections, averaging $1,005 per account, for emergency medical services rendered at Lovelace hospitals in New Mexico. In 2018, APP sent approximately 4,200 out of network patient accounts to collections, averaging $1,047 per account, for emergency medical services rendered at Lovelace hospitals in New Mexico. The value of the out-of-network patient accounts sent to collections for emergency medical services rendered at Lovelace hospitals in New Mexico between 2016 and 2018 exceeded $5,000,000.

Doc. 1 at 8, ¶ 3.09. As Plaintiffs acknowledge, such calculation totals over $10 million. However, Plaintiffs assert that APP’s calculation does not meet the preponderance of evidence standard because it is overly broad compared to the class definition in three aspects. First, “Plaintiffs are not suing for total amounts billed. Plaintiffs are suing for amounts overbilled.” Doc. 25 at 3. For example, Plaintiffs explain that APP billed Plaintiff Brian Lax $1,484, but he only owed the in-network amount of $526.33. Id. He was therefore overbilled by $957.67. Id. at 4.

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Lax v. APP of New Mexico ED, PLLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lax-v-app-of-new-mexico-ed-pllc-nmd-2020.