Shannon Jacks v. Meridian Resource Company

701 F.3d 1224, 2012 WL 6554554
CourtCourt of Appeals for the Eighth Circuit
DecidedDecember 17, 2012
Docket11-3037
StatusPublished
Cited by99 cases

This text of 701 F.3d 1224 (Shannon Jacks v. Meridian Resource Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shannon Jacks v. Meridian Resource Company, 701 F.3d 1224, 2012 WL 6554554 (8th Cir. 2012).

Opinion

BEAM, Circuit Judge.

Meridian Resource Company and Blue Cross Blue Shield-Kansas City (hereinafter BCBS-KC collectively) appeal the district court’s remand based upon the local controversy exception to the Class Action Fairness Act (CAFA), its determination that federal common law was not contemplated in this action, and its decision that BCBS-KC could not remove this matter under the federal officer removal statute. We vacate the district court’s judgment and remand the case for further consideration consistent with this opinion.

I. BACKGROUND

The Federal Employees Health Benefits Act of 1959 1 (FEHBA) establishes a comprehensive program of health insurance for federal employees and charges the United States Office of Personnel Management (OPM) with negotiating contracts with private insurance carriers to provide an array of health-care plans. Empire Healthchoice Assurance, Inc. v. McVeigh, 547 U.S. 677, 682, 126 S.Ct. 2121, 165 L.Ed.2d 131 (2006). “Largest of the plans for which OPM has contracted, annually since 1960, is the Blue Cross Blue Shield Service Benefit Plan (Plan), administered by local Blue Cross Blue Shield companies [such as BCBS-KC].” Id. Appellant BCBS-KC administers the Plan in Missouri. FEHBA provides that the government pays about 75% of health-plan premiums and the enrollee pays for the rest. 5 U.S.C. § 8906(b). Premiums thus shared are deposited in a special Treasury Fund, from which carriers draw to pay for covered benefits. Id. § 8909(a). Meridian Resource Company is a vendor, based in Wisconsin, that provides subrogation and reimbursement services for BCBS-KC, as well as many other BCBS Plan administrators in other locales.

FEHBA requires that contracts between OPM and carriers “contain a detailed statement of benefits offered,” including “such máximums, limitations, exclusions, and other definitions of ben *1228 efits as [OPM] considers necessary or desirable,” and allows OPM to “prescribe reasonable minimum standards for health benefits plans [and carriers].” 5 U.S.C. § 8902(d), (e). Concerning reimbursement and subrogation, matters FEHBA itself does not address, the Plan’s Statement of Benefits reads in part:

If another person or entity ... causes you to suffer an injury or illness, and if we pay benefits for that injury or illness, you must agree to [the following]: All recoveries you obtain (whether by lawsuit, settlement, or otherwise), no matter how described or designated, must be used to reimburse us in full for benefits we paid. Our share of any recovery extends only to the amount of benefits we have paid or will pay to you or, if applicable, to your heirs, administrators, successors, or assignees.

If the insured does not voluntarily reimburse under these terms, the Plan requires the carrier to make a “reasonable effort to seek recovery of amounts ... it is entitled to recover in cases ... brought to its attention,” and gives the carrier discretion to file suit in federal court to enforce its rights. “Pursuant to the OPM-BCBSA [Blue Cross Blue Shield Association] master contract, reimbursements obtained by the carrier must be returned to the Treasury Fund.” Empire, 547 U.S. at 685, 126 S.Ct. 2121.

In 2007, Shannon Jacks, a Missouri resident, was in a motor vehicle accident and received benefits from BCBS-KC for her injuries. Jacks subsequently asserted a personal injury claim against the third-party tortfeasor, reached a settlement, and recovered funds for her injuries. BCBSKC asserted a lien on Jacks’ third-party award in an amount equal to the amount BCBS-KC had paid on her behalf for the injuries she sustained in the accident. Jacks sued BCBS-KC in Jackson County, Missouri, on behalf of herself and others similarly situated alleging Missouri state law violations. Missouri has laws prohibiting subrogation.

The crux of this suit challenges the application, in Missouri, of the provision in the Plan administered by BCBS-KC that requires a Plan enrollee who receives benefits in connection with any injury in addition to compensation from a third party must reimburse BCBS-KC the amount of benefits paid. Given the state’s anti-subrogation laws, Jacks contends that BCBSKC is unable to recover its reimbursement lien in Missouri.

BCBS-KC removed the action to federal district court, citing three grounds in support: (1) CAFA, 28 U.S.C. § 1382(d); (2) 28 U.S.C. § 1441 federal question jurisdiction on the ground that Jacks’ claims “turn on the construction of federal common law and otherwise raise substantial issues of federal law;” and (3) 28 U.S.C. § 1442(a)(1), the federal officer removal statute. Jacks moved to remand the matter to state court, and the district court granted the motion. BCBS-KC appealed. The bases for Jacks’ motion and the district court’s remand are discussed in turn below, as appropriate, in juxtaposition with our analyses. The sole question on appeal concerns where this action will be adjudicated as between the available state and federal courts.

II. DISCUSSION

A. Jurisdiction on Appeal

The parties first dispute whether this court has jurisdiction to hear all of the issues presented by this appeal. 2 Jacks *1229 concedes that jurisdiction lies to review the district court’s remand under the local controversy exception of CAFA, but without citation to supporting authority, claims that this panel lacks jurisdiction to address the remainder of the district court’s order. The basis on which Jacks grounds this latter argument is wholly unclear. BCBSKC simply counters that because this is an appeal from a final order under § 1291, this court has jurisdiction over the entire order. Neither argument carries the day but jurisdiction lies nonetheless.

Section 1447(d) generally provides that “[a]n order remanding a case to the State court from which it 'was removed is not reviewable on appeal or otherwise.” Despite this broadly worded prohibition, the Supreme Court has held that § 1447(d) only bars appellate review of a district court’s remand order that is “based on a ground specified in [28 U.S.C.] § 1447(c).” Carlsbad Tech., Inc. v. HIF Bio, Inc., 556 U.S. 635, 638, 129 S.Ct. 1862, 173 L.Ed.2d 843 (2009). This means that “remand orders based on a procedural defect or lack of subject matter jurisdiction are unreviewable.” Carlson v. Arrowhead Concrete Works, Inc., 445 F.3d 1046

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Bluebook (online)
701 F.3d 1224, 2012 WL 6554554, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shannon-jacks-v-meridian-resource-company-ca8-2012.