Pacificare of Oklahoma, Inc. v. Burrage

59 F.3d 151, 1995 WL 406638
CourtCourt of Appeals for the Tenth Circuit
DecidedJuly 11, 1995
DocketNo. 95-5064
StatusPublished
Cited by20 cases

This text of 59 F.3d 151 (Pacificare of Oklahoma, Inc. v. Burrage) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pacificare of Oklahoma, Inc. v. Burrage, 59 F.3d 151, 1995 WL 406638 (10th Cir. 1995).

Opinion

STEPHEN. H. ANDERSON, Circuit Judge.

This matter concerns a malpractice action originally filed in state court. Pacificare of Oklahoma, Inc., a health maintenance organization (HMO) and one of the named defendants, removed the action to federal court, stating the state law claims are preempted by the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1144(a). The district court concluded that ERISA preempts only one of plaintiffs three claims. The court dismissed the preempted claim and remanded the other two claims to state court, pursuant to 28 U.S.C. § 1367(c)(3).1

Pacificare seeks a writ of mandamus directing the district court judge to rescind his order remanding the two claims to state court and to decide that those claims are preempted by ERISA. Pacificare argues mandamus should issue because mandamus may be the only method by which this court will be able to review these important issues of ERISA preemption. The remanded claims allege that Pacificare is (1) vicariously hable for the medical malpractice of Dr. Goen, a Pacificare primary care physician and alleged agent of Pacificare, and (2) vicariously and directly hable for loss of consortium for the wrongful death that resulted from Dr. Goen’s malpractice.

The district court’s remand order is reviewable. Although remand orders under 28 U.S.C. § 1447(e), (d), are not generally reviewable, the district court did not remand pursuant to these sections. The district court had federal question jurisdiction over the claim it found preempted by ERISA and had supplemental jurisdiction over the remaining claims, pursuant to 28 U.S.C. § 1367(a). The district court made a discretionary decision under § 1367(c)(3) not to exercise supplemental jurisdiction over the remaining claims. “A remand based on a [153]*153district court’s perceived discretion is not” treated as a remand under § 1447(e). Albertson’s, Inc. v. Carrigan, 982 F.2d 1478, 1480 (10th Cir.1993). Therefore, this court has authority to review the remand order. Id.

Review by mandamus also is appropriate. “[B]ecause an order remanding a removed action does not represent a final judgment reviewable by appeal, ‘[t]he remedy in such a case is by mandamus to compel action, and not by writ of error to review what has been done.’ ” Id. (quoting Thermtron Prods., Inc. v. Hermansdorfer, 423 U.S. 336, 352-53, 96 S.Ct. 584, 593-94, 46 L.Ed.2d 542 (1976)) (further quotation and citation omitted) (alterations in original).

Mandamus may be used “to compel a district court to exercise its jurisdiction when it has a duty to do so.” Id. Mandamus “will issue only in those exceptional cases where the inferior court has acted wholly without jurisdiction or so clearly abused its discretion as to constitute a judicial usurpation of power.” Kaiser Steel Corp. v. Frates (In re Kaiser Steel Corp.), 911 F.2d 380, 387 (10th Cir.1990). The party seeking the writ must show that the right to the writ is “clear and indisputable.” Id. (citation omitted). This court looks to the following noneonclusive guidelines to determine whether to grant the writ:

“First, the party seeking the writ has no other adequate means to secure the relief desired. Second, the petitioning party will be damaged or prejudiced in a way not correctable on appeal. Third, the district court’s order constitutes an abuse of discretion____ Fourth, the district court’s order represents an often repeated error and manifests a persistent disregard of federal rules. Fifth, the district court’s order raises new and important problems or issues of law of the first impression.”

Id. (quoting Dalton v. United States (In re Dalton), 733 F.2d 710, 717 (10th Cir.1984), cert. dismissed, 469 U.S. 1185, 105 S.Ct. 947, 83 L.Ed.2d 959 (1985)) (alteration in original).

Malpractice Claim

There is no question that the district court’s order raises an issue of first impression. No circuit has decided whether ERISA preempts a claim that an HMO is vicariously liable for alleged malpractice of one of its physicians, and the district courts are divided on the issue.2 As one district court observed, “the split among courts exemplifies the difficulty [of] this preemption issue.” Haas v. Group Health Plan, Inc., 875 F.Supp. 544, 547 (S.D.Ill.1994); see also Kearney v. U.S. Healthcare, Inc., 859 F.Supp. 182, 185 (E.D.Pa.1994) (stating it is evident that “reasonable and capable people may differ” over this question of preemption). We conclude that the district court correctly decided that ERISA does not preempt the medical malpractice claim.

This court reviews de novo the district court’s determination that ERISA preempts a state law claim. Airparts Co. v. Custom Benefit Servs. of Austin, Inc., 28 F.3d 1062, 1064 (10th Cir.1994). ERISA preempts state laws that “relate to” employee benefit plans. 29 U.S.C. § 1144(a). There is no dispute here that the medical malpractice claim is based on state law and that Pacificare’s plan is an employee benefit [154]*154plan. The issue is whether the medical malpractice claim “relates to” the Pacificare plan.

“A law ‘relates to’ an employee benefit plan, in the normal sense of the phrase, if it has a connection with or reference to such a plan.” Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96-97 (1983). “ ‘There is no simple test for determining when a law “relates to” a plan.’” Airparts Co., 28 F.3d at 1064 (quoting National Elevator Indus., Inc. v. Calhoon, 957 F.2d 1555, 1558 (10th Cir.), cert. denied, — U.S. -, 113 S.Ct. 406, 121 L.Ed.2d 331 (1992)). This court has identified the following four categories of laws which relate to an employee benefit plan:

“First, laws that regulate the type of benefits or terms of ERISA plans. Second, laws that create reporting, disclosure, funding, or vesting requirements for ERISA plans. Third, laws that provide rules for the calculation of the amount of benefits to be paid under ERISA plans. Fourth, laws and common-law rules that provide remedies for misconduct growing out of the administration of the ERISA plan.”

Id. at 1064-65 (quoting National Elevator, 957 F.2d at 1558-59) (further quotation omitted).

Plaintiff, who was asked to respond to the mandamus petition as the real party in interest, argues that the malpractice claim is not preempted because it is a law of general application which does not affect the structure, administration, or benefits provided by the plan.

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

Related

Lind v. Aetna Health, Inc.
466 F.3d 1195 (Tenth Circuit, 2006)
Villazon v. Prudential Health Care Plan, Inc.
843 So. 2d 842 (Supreme Court of Florida, 2003)
Hinterlong v. Baldwin
Appellate Court of Illinois, 1999
Thurkill v. the Menninger Clinic, Inc.
72 F. Supp. 2d 1232 (D. Kansas, 1999)
Thompson v. Gencare Health Systems, Inc.
49 F. Supp. 2d 1145 (E.D. Missouri, 1999)
Herrera v. Lovelace Health Systems, Inc.
35 F. Supp. 2d 1327 (D. New Mexico, 1999)
Negron v. Patel
6 F. Supp. 2d 366 (E.D. Pennsylvania, 1998)
Long v. Great West Life & Annuity Insurance Co.
957 P.2d 823 (Wyoming Supreme Court, 1998)
Dykema Ex Rel. Estate of Dykema v. King
959 F. Supp. 736 (D. South Carolina, 1997)
United States v. Roberts
88 F.3d 872 (Tenth Circuit, 1996)
Jass v. Prudential Health Care Plan, Inc.
88 F.3d 1482 (Seventh Circuit, 1996)
Prihoda v. Shpritz
914 F. Supp. 113 (D. Maryland, 1996)
Pacificare of Oklahoma, Inc. v. Burrage
59 F.3d 151 (Tenth Circuit, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
59 F.3d 151, 1995 WL 406638, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pacificare-of-oklahoma-inc-v-burrage-ca10-1995.