R and R Surgical Institute v. Luminare Health Benefits, Inc.

CourtDistrict Court, C.D. California
DecidedDecember 10, 2024
Docket2:24-cv-08310
StatusUnknown

This text of R and R Surgical Institute v. Luminare Health Benefits, Inc. (R and R Surgical Institute v. Luminare Health Benefits, Inc.) is published on Counsel Stack Legal Research, covering District Court, C.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
R and R Surgical Institute v. Luminare Health Benefits, Inc., (C.D. Cal. 2024).

Opinion

CENTRAL DISTRICT OF CALIFORNIA

CIVIL MINUTES—GENERAL

Case No. CV 24-08310-MWF (AGRx) Date: December 10, 2024 Title: R and R Surgical Institute v. Luminare Health Benefits, Inc., et al Present: The Honorable MICHAEL W. FITZGERALD, U.S. District Judge

Deputy Clerk: Court Reporter: Rita Sanchez Amy Diaz

Attorneys Present for Plaintiff: Attorneys Present for Defendants: None Present None Present

Proceedings (In Chambers): ORDER RE: DEFENDANT’S MOTION TO DISMISS [12]; PLAINTIFF’S MOTION TO JOIN DEFENDANT AND FOR REMAND [15]

Before the Court are two motions: The first is Defendant Luminare Health Benefits, Inc.’s Motion to Dismiss (the “MTD”), filed on October 18, 2024. (Docket No. 12). Plaintiff R & R Surgical Institute filed an Opposition (“Opp. to MTD”) on November 15, 2024. (Docket No. 18). Defendant filed a Reply (“MTD Reply”) on November 26, 2024. (Docket No. 21). The second is Plaintiff’s Motion to Join Defendant and For Remand (the “MTR”), filed on October 28, 2024. (Docket No. 15). Defendant filed an Opposition (“Opp. to MTR”) on November 15, 2024. (Docket No. 17). Plaintiff filed a Reply (“MTR Reply”) on November 27, 2024. (Docket No. 22). The Court has read and considered the Motions and held a hearing on December 9, 2024. The Motion to Join Defendant and For Remand is GRANTED. Plaintiff shall file a First Amended Complaint no later than December 17, 2024. Upon the filing of the First Amended Complaint, the Court will issue a final Order remanding this action to the Superior Court of California for the County of Los Angeles. As such, the Motion to Dismiss is DENIED as moot. ______________________________________________________________________________ CENTRAL DISTRICT OF CALIFORNIA

Case No. CV 24-08310-MWF (AGRx) Date: December 10, 2024 Title: R and R Surgical Institute v. Luminare Health Benefits, Inc., et al I. BACKGROUND On August 28, 2024, Plaintiff commenced this action in Los Angeles County Superior Court. (Notice of Removal (“NOR”), Ex. 1 (Docket No. 1) (“Complaint”) at 7). Plaintiff, an unincorporated association, alleges that it rendered medical treatment to a member of a health plan and submitted a reimbursement claim to Defendant, who is a claims processor for various employer-sponsored health plans. (Id. ¶ 4). Defendant contends, and Plaintiff does not dispute, that the patient Plaintiff rendered services to is a member of the health plan sponsored and funded by Plasma Technology, Inc. (“PTI”), which is governed by the Employee Retirement Income Security Act of 1974 (“ERISA”). (MTD at 7). Defendant serves as a claims processor for PTI. (Id.). Defendant does not pay plan benefits from its own funds but instead, pays benefits using the healthcare plans’ funds. (Id. at 10). After Plaintiff submitted the reimbursement claim, Defendant issued an Evidence of Payment (“EOP”), agreeing to pay $235,306.22 with a prepaid credit card subject to a 5% merchant processing fee. (Complaint ¶ 2). To avoid the 5% merchant processing fee, Plaintiff requested Defendant issue payment in the form of a paper check. (Id. ¶ 2). After agreeing to do so, Defendant reduced the payment to $4,100.70 and issued an adjusted EOP. (Id.). Defendant claims that original EOP resulted from a clerical error and that it reduced the payment amount after the claim was reprocessed and adjusted accordingly. (Motion at 10). Plaintiff now seeks recovery of the remaining $231,205.52 included in the original EOP and prejudgment interest. (Complaint ¶ 3). Plaintiff brings the three following causes of action: (1) Account Stated; (2) Violation of California’s Unfair Competition Law (“UCL”), California Business & Professions Code §§ 17200, et seq.; and (3) Violation of California Penal Code sections 484 (Larceny), 487 (Grand Theft), and 496 (Receiving Stolen Property). (Complaint ¶¶ 10–28). On September 26, 2024, Defendant removed this action to federal district court on the basis of diversity jurisdiction, 28 U.S.C. § 1332. (NOR at 1). Plaintiff seeks to both join PTI as a defendant and to remand this action back to Los Angeles County ______________________________________________________________________________ CENTRAL DISTRICT OF CALIFORNIA

Case No. CV 24-08310-MWF (AGRx) Date: December 10, 2024 Title: R and R Surgical Institute v. Luminare Health Benefits, Inc., et al Superior Court because PTI is a non-diverse defendant. Defendant opposes remand and seeks to dismiss the case entirely. II. LEGAL STANDARDS A. Removal In general, “any civil action brought in a State court of which the district courts of the United States have original jurisdiction, may be removed by the defendant or the defendants, to the district court[.]” 28 U.S.C. § 1441(a). A removing defendant bears the burden of establishing that removal is proper. See Abrego Abrego v. The Dow Chem. Co., 443 F.3d 676, 684 (9th Cir. 2006) (per curiam) (noting the “longstanding, near-canonical rule that the burden on removal rests with the removing defendant”). If there is any doubt regarding the existence of subject matter jurisdiction, the court must resolve those doubts in favor of remanding the action to state court. See Gaus v. Miles, Inc., 980 F.2d 564, 566 (9th Cir. 1992) (“Federal jurisdiction must be rejected if there is any doubt as to the right of removal in the first instance.”). Indeed, “[i]f at any time before final judgment it appears that the district court lacks subject matter jurisdiction, the case shall be remanded.” 28 U.S.C. § 1447(c); see Kelton Arms Condo. Owners Ass’n, Inc. v. Homestead Ins. Co., 346 F.3d 1190, 1192 (9th Cir. 2003) (“Subject matter jurisdiction may not be waived, and, indeed, we have held that the district court must remand if it lacks jurisdiction.”). “The general rule, referred to as the ‘well-pleaded complaint rule,’ is that a civil action arises under federal law for purposes of § 1331 when a federal question appears on the face of the complaint.” City of Oakland v. BP PLC, 969 F.3d 895, 903 (9th Cir. 2020) (citing Caterpillar, 482 U.S. at 392). However, complete preemption is “an exception to the well-pleaded complaint rule.” Saldana v. Glenhaven Healthcare LLC, 27 F.4th 679, 686 (9th Cir. 2020) (citing City of Oakland, 969 F.3d at 905). Complete preemption applies if a well-pleaded complaint establishes a state-law cause of action but “requires resolution of a substantial question of federal law in dispute between the parties.” Franchise Tax Bd. of State of Cal. v. Construction Laborers Vacation Trust for Southern Cal. et al., 463 U.S. 1, 13 (1983); see also Caterpillar Inc. v. Williams, 482 U.S. 386, 393 (1987) (complete preemption is invoked when “the pre-emptive ______________________________________________________________________________ CENTRAL DISTRICT OF CALIFORNIA

Case No. CV 24-08310-MWF (AGRx) Date: December 10, 2024 Title: R and R Surgical Institute v.

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