New Mexico Top Organics - Ultra Health, Inc. v. Blue Cross and Blue Shield of New Mexico

CourtDistrict Court, D. New Mexico
DecidedJanuary 24, 2024
Docket1:22-cv-00546
StatusUnknown

This text of New Mexico Top Organics - Ultra Health, Inc. v. Blue Cross and Blue Shield of New Mexico (New Mexico Top Organics - Ultra Health, Inc. v. Blue Cross and Blue Shield of New Mexico) 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
New Mexico Top Organics - Ultra Health, Inc. v. Blue Cross and Blue Shield of New Mexico, (D.N.M. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

NEW MEXICO TOP ORGANICS—ULTRA HEALTH, INC., and JACOB R. CANDELARIA, TOMAS LORENZO VALENCIA, BRYCE BRYANT-FLYNN, MATIAS TRUJILLO, as father and guardian of MT, a minor, ERICA ROWLAND, and ARIEL McDOUGAL, on behalf of themselves and all others similarly situated,

Plaintiffs,

v. 1:22-cv-00546-MV-LF

BLUE CROSS AND BLUE SHIELD OF NEW MEXICO, TRUE HEALTH NEW MEXICO, INC., CIGNA HEALTH AND LIFE INSURANCE COMPANY, MOLINA HEALTHCARE OF NEW MEXICO, INC., PRESBYTERIAN HEALTH PLAN, INC., PRESBYTERIAN INSURANCE COMPANY, INC., and WESTERN SKY COMMUNITY CARE, INC.,

Defendants.

PROPOSED FINDINGS AND RECOMMENDED DISPOSITION

THIS MATTER comes before the Court on Plaintiffs New Mexico Top Organics—Ultra Health, Inc., Jacob R. Candelaria, Matias Trujillo, Erica Rowland, and Ariel McDougal’s Motion to Remand, filed August 21, 2022, and their Second Motion to Remand or Alternatively Motion for Leave to Conduct Discovery to Determine Subject Matter Jurisdiction, filed on November 11, 2022. Docs. 24, 40. It also comes before the Court on Defendants Blue Cross and Blue Shield of New Mexico (“BCBSNM”), Presbyterian Health Plan, Inc. and Western Sky Community Care, Inc.’s Motion to Disregard New Evidence and Arguments in Plaintiffs’ Reply in Support of Remand, or in the Alternative, for Leave to File a Surreply, filed on October 26, 2022. Doc.39. The Honorable Martha Vazquez, Senior United States District Judge, referred all three motions to me “to conduct hearings, 1f warranted, including evidentiary hearings, and to perform any legal analysis required to recommend to the District Court an ultimate disposition.” Docs. 54, 55. The Court held a hearing on the motions on October 25, 2023. Doc. Having read the motions and considered the relevant law, and having heard the argument of counsel, I recommend that the Court DENY all three motions. I. Background Facts and Procedural Posture On June 10, 2022, Plaintiffs and two additional named plaintiff-representatives, Tomas Lorenzo Valencia and Bryce Preston Bryant-Flynn (collectively, the “Original Plaintiffs”), filed a class action complaint for damages and declaratory judgment (the “Original Complaint’) against Defendants and four additional health plans and health insurance issuers (the “Original Defendants”)! in state court, seeking damages and declaratory relief that would compel health plans and health insurance issuers in New Mexico to pay for the cost of cannabis distributed under the Lynn and Erin Compassionate Use Act, N.M. STAT. ANN. 1978 § 26-2B-1 et seq. (“LECUA”). See Doc. 1-1 (Original Complaint). On July 22, 2022, five of the Original Defendants timely removed the case to this Court, asserting three separate bases for the Court’s original jurisdiction. Doc. 1. First, the Original Defendants asserted that the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), completely preempted the claims of at least two Original Plaintiffs, Valencia and Bryant-Flynn, who obtain health care coverage through their

—_—__—_!_———-# ' The additional “Original Defendants” are True Health New Mexico, Inc. (“True Health”), Cigna Health and Life Insurance Company (“Cigna”), Molina Healthcare of New Mexico, Inc., and Presbyterian Insurance Company, Inc.

private employers, giving rise to federal question jurisdiction. See Doc. 1 4-8. Second, the Original Defendants asserted that this Court has original jurisdiction under the Class Action Fairness Act (“CAFA”), 28 U.S.C. § 1332(d), because (1) the proposed class has more than 100 members, (2) “the parties are minimally diverse,” and (3) the amount in controversy exceeds $5,000,000. See Doc. 1 at 8-12. Third, the Original Defendants asserted that the Court has jurisdiction under 28 U.S.C. § 1331 because the Original Complaint necessarily raised substantial federal questions, including whether health plans operating under a joint state and federal government program relying primarily on federal funding can be compelled to violate federal law. See Doc. 1 at 12-18. The Original Defendants further asserted that the Court has supplemental jurisdiction over any claims not subject to the Court’s original jurisdiction because “they form part of the same case or controversy.” Jd. at 19-20. On August 19, 2022, before any of the Original Defendants answered the Original Complaint, Plaintiffs filed their First Amended Complaint (“FAC”). Doc. 22. Two days later, Plaintiffs filed their first Motion to Remand, arguing that the FAC does not state any claim under ERISA and therefore is not subject to complete preemption, that CAFA does not apply because the FAC raises an entirely local controversy, and that because the FAC does not state a federal cause of action, there is no federal-question jurisdiction. Doc. 24. Defendants responded that the Court has original jurisdiction under CAFA, and that Plaintiffs had failed to meet their burden of proving that the Court should abstain from exercising that jurisdiction under the local controversy exception. Doc. 31 at 15—25.?_ They also argue that both the Original Complaint

—_!/HsH__—_!_1—-# ? When citing to Doc. 31, the Court cites to the CM/ECF document number and page in the CM/ECF heading rather than to the document’s page numbers at the bottom of each page.

and the FAC raise substantial issues of federal law. Id. at 25–35. Lastly, they argue that the Court should exercise supplemental jurisdiction over all claims in the FAC in part because the Court had original jurisdiction over the Original Complaint due to complete ERISA preemption, and Plaintiffs should not be permitted to amend away federal jurisdiction once a case is properly removed. Id. at 36–38. In reply, Plaintiffs argue that (1) defining the class as qualified patients

under LECUA establishes that at least two thirds of the class are New Mexico citizens; (2) all Defendants are significant Defendants, and BCBSNM—the one remaining non-citizen defendant—is really a New Mexico defendant; (3) the purported federal questions are only affirmative defenses and no element of Plaintiffs’ claims rely on a violation or interpretation of federal law; and (4) there is no reason for the Court to exercise supplemental jurisdiction because no ERISA claim remains. See Doc. 37 at 1. Plaintiffs also request an opportunity to conduct limited discovery if the Court is not satisfied that they have satisfied the first or second prong of the local controversy exception to CAFA. See id. at 6–7, 11. In response to Plaintiffs’ reply, Defendants filed their Motion to Disregard New Evidence

and Arguments in Plaintiffs’ Reply in Support of Remand, or in the Alternative, for Leave to File a Surreply. Doc. 39. Plaintiffs opposed Defendants’ motion, and Defendants filed a reply in support of their motion. Docs. 41, 44. On November 8, 2022, Plaintiffs filed a Second Motion to Remand or Alternatively Motion for Leave to Conduct Discovery to Determine Subject Matter Jurisdiction. Doc. 40. In their motion, Plaintiffs argue that BCBSNM is a New Mexico citizen—or at least they should be able to conduct limited discovery on that question—and therefore there is not minimal diversity between the Plaintiffs and the remaining Defendants under CAFA. Id. Thus, they argue, the Court lacks subject matter jurisdiction. See id. In response, Defendants argue that BCBSNM is 4 just a division of Health Care Service Corporation (“HCSC”), a citizen of Illinois, and that Plaintiffs intended to sue HCSC. Doc. 43 at 12-16.2>

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Isaiah Evans v. Walter Industries
449 F.3d 1159 (Eleventh Circuit, 2006)
Metropolitan Life Insurance v. Taylor
481 U.S. 58 (Supreme Court, 1987)
Aetna Health Inc. v. Davila
542 U.S. 200 (Supreme Court, 2004)
Rockwell International Corp. v. United States
549 U.S. 457 (Supreme Court, 2007)
In Re Burlington Northern Santa Fe Railway Co.
606 F.3d 379 (Seventh Circuit, 2010)
McPhail v. Deere & Co.
529 F.3d 947 (Tenth Circuit, 2008)
Coffey v. Freeport McMoran Copper & Gold
581 F.3d 1240 (Tenth Circuit, 2009)
C. L. Whitelock v. Delbert Leatherman
460 F.2d 507 (Tenth Circuit, 1972)
Pfeiffer v. Hartford Fire Insurance Company
929 F.2d 1484 (Tenth Circuit, 1991)
Gonzales v. Raich
545 U.S. 1 (Supreme Court, 2005)
Gilmore v. Weatherford
694 F.3d 1160 (Tenth Circuit, 2012)
Dutcher v. Matheson
733 F.3d 980 (Tenth Circuit, 2013)
Kaufman v. Allstate New Jersey Insurance
561 F.3d 144 (Third Circuit, 2009)
In Re Sprint Nextel Corp.
593 F.3d 669 (Seventh Circuit, 2010)
Jose Mondragon v. Capital One Auto Finance
736 F.3d 880 (Ninth Circuit, 2013)

Cite This Page — Counsel Stack

Bluebook (online)
New Mexico Top Organics - Ultra Health, Inc. v. Blue Cross and Blue Shield of New Mexico, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-mexico-top-organics-ultra-health-inc-v-blue-cross-and-blue-shield-nmd-2024.