Marin General Hospital v. Modesto & Empire Traction Co.

581 F.3d 941, 47 Employee Benefits Cas. (BNA) 2310, 2009 U.S. App. LEXIS 20161, 2009 WL 2882832
CourtCourt of Appeals for the Ninth Circuit
DecidedSeptember 10, 2009
Docket07-16518
StatusPublished
Cited by260 cases

This text of 581 F.3d 941 (Marin General Hospital v. Modesto & Empire Traction Co.) 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
Marin General Hospital v. Modesto & Empire Traction Co., 581 F.3d 941, 47 Employee Benefits Cas. (BNA) 2310, 2009 U.S. App. LEXIS 20161, 2009 WL 2882832 (9th Cir. 2009).

Opinion

WILLIAM A. FLETCHER, Circuit Judge:

We consider in this case whether § 502(a)(1)(B) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), completely preempts a state-law action for breach of contract, negligent misrepresentation, quantum meruit and estoppel. Because the state-law claims could not be pursued under § 502(a)(1)(B), and because they rely on legal duties that are independent from duties under any benefit plan established under ERISA, we hold that they are not completely preempted. Because the claims are not completely preempted under § 502(a)(1)(B), there is no federal question subject matter jurisdiction in federal court. Removal from state court was therefore improper.

I. Background

According to its complaint, Marin General Hospital (“the Hospital”) telephoned the Medical Benefits Administrators of MD, Inc., (“MBAMD”) on April 8, 2004, to confirm that a prospective patient had health insurance through an ERISA plan provided by his employer, Modesto & Empire Traction Co. (“Modesto”). MBAMD was the administrator of Modesto’s plan. According to the complaint, MBAMD orally verified the patient’s coverage, authorized treatment, and agreed to cover 90% of the patient’s medical expenses at the Hospital.

Between April 19 and April 24, 2004, the Hospital performed a lumbar fusion procedure on the patient. The Hospital then submitted a bill to MBAMD for $178,926.54. MBAMD paid the Hospital $46,655.54 and stated in a letter that the Hospital was not entitled to further payment. The Hospital sent MBAMD a letter stating that “[p]er your contract this claim should be paid at 90% of total charges.” *944 MBAMD denied that it had such a contract with the Hospital and refused to make additional payment.

On December 8, 2006, the Hospital filed suit in California state court against Modesto, MBAMD, and MB AMD’s CEO and Chairman Ronald Wilson (collectively “defendants”) for breach of an implied contract, breach of an oral contract, negligent misrepresentation, quantum meruit, and estoppel. Defendants removed the suit to federal district court on the ground that ERISA completely preempted the Hospital’s claims. The Hospital moved to remand to state court, arguing that it alleged only state-law claims in its complaint, and that these claims were not completely preempted under ERISA. Defendants moved to dismiss, arguing that ERISA preempted the Hospital’s state-law claims and that the Hospital failed to allege any cognizable claims under ERISA.

The court denied the Hospital’s motion to remand and dismissed its complaint. The court concluded that the Hospital’s only remedy was under § 502(a)(1)(B), a subsection of ERISA’s civil remedy provision for plan participants and beneficiaries, and that the Hospital’s complaint failed to sufficiently allege a cause of action under that subsection. The court granted the Hospital leave to amend. The Hospital’s amended complaint, like its first complaint, alleged only state-law claims. The Hospital again moved for remand to state court, and defendants moved to dismiss. The court dismissed without leave to amend and entered judgment in favor of defendants. The Hospital timely appealed.

II. Standard of Review

The question in this case is whether the Hospital’s state-law claims are completely preempted under § 502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a)(1)(B), and thus whether the case was properly removed from state to federal court. Removal was proper only if the Hospital’s claims are completely pre-empted. The existence of subject matter jurisdiction is a question of law that we review de novo. Nike, Inc. v. Comercial Iberica de Exclusivas Deportivas, S.A., 20 F.3d 987, 990 (9th Cir.1994). The burden of establishing federal subject matter jurisdiction falls on the party invoking removal. Toumajian v. Frailey, 135 F.3d 648, 652 (9th Cir.1998).

III. Discussion

Defendants removed the Hospital’s state court action to federal court based on federal question jurisdiction. 28 U.S.C. §§ 1331(a), 1441(a). Generally speaking, “[a] cause of action arises under federal law only when the plaintiffs well-pleaded complaint raises issues of federal law.” Hansen v. Blue Cross of Cal., 891 F.2d 1384, 1386 (9th Cir.1989). “The well-pleaded complaint rule is the basic principle marking the boundaries of the federal question jurisdiction of the federal district courts.” Metro. Life Ins. Co. v. Taylor, 481 U.S. 58, 63, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987) (internal quotation marks omitted). The Hospital’s complaint asserts only state-law causes of action, and defendants’ preemption defense would appear in its answer if it ever filed one. But defendants argue that the Hospital’s suit comes within the exception to the well-pleaded complaint rule for state-law causes of action that are completely preempted by § 502(a) of ERISA. We agree with defendants that there is an exception to the well-pleaded complaint rule for state-law causes of action that are completely preempted by § 502(a). However, for the reasons that follow, we disagree with defendants’ contention that the Hospital’s causes of action are completely preempted.

A. Complete Preemption under ERISA

The parties in this case have not clearly understood the difference between com *945 píete preemption under ERISA § 502(a), 29 U.S.C. § 1132(a), and conflict preemption under ERISA § 514(a), 29 U.S.C. § 1144(a). We take this opportunity to make clear the difference between the two kinds of preemption, and to make clear the different jurisdictional consequences that result from these two kinds of preemption.

Complete preemption under § 502(a) is “really a jurisdictional rather than a preemption doctrine, [as it] confers exclusive federal jurisdiction in certain instances where Congress intended the scope of a federal law to be so broad as to entirely replace any state-law claim.” Franciscan Skemp Healthcare, Inc. v. Cent. States Joint Bd. Health & Welfare Trust Fund, 538 F.3d 594, 596 (7th Cir. 2008). The Supreme Court first articulated, indeed created, the doctrine of complete preemption under § 502(a) of ERISA as a basis for federal question removal jurisdiction under 28 U.S.C.

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581 F.3d 941, 47 Employee Benefits Cas. (BNA) 2310, 2009 U.S. App. LEXIS 20161, 2009 WL 2882832, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marin-general-hospital-v-modesto-empire-traction-co-ca9-2009.