Skipper v. CareFirst Blue Choice

CourtCourt of Special Appeals of Maryland
DecidedMarch 3, 2025
Docket2479/23
StatusPublished

This text of Skipper v. CareFirst Blue Choice (Skipper v. CareFirst Blue Choice) is published on Counsel Stack Legal Research, covering Court of Special Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Skipper v. CareFirst Blue Choice, (Md. Ct. App. 2025).

Opinion

Matthew Skipper, et al. v. CareFirst BlueChoice, Inc., No. 2479, September Term, 2023. Opinion by Hotten, J.

PRE-JUDGMENT INTEREST – EFFECT OF DEFENDANT’S PRE-TRIAL TENDER OF COMPENSATORY RELIEF

A defendant’s tender of compensatory monetary relief to a plaintiff following the filing of a complaint does not automatically render moot whatever claim the plaintiff may have for pre-judgment interest.

CIVIL PROCEDURE – CLASS ACTIONS – CERTIFICATION OF CLASS ACTION – MOOTNESS

In an action filed as a class action, the defendant’s tender of individual damages to the prospective class representative shortly after a complaint was filed does not require denial of certification of the case as a class action on the ground that the prospective class representative’s individual claim has been rendered moot. Tender of individual relief to the putative class representative does not moot a class action if that plaintiff has not been afforded a reasonable opportunity to seek class certification, including any necessary discovery. Circuit Court for Prince George’s County Case No.: C-16-CV-23-001420 REPORTED

IN THE APPELLATE COURT

OF MARYLAND

No. 2479

September Term, 2023

______________________________________

MATTHEW SKIPPER, ET AL.

v.

CAREFIRST BLUECHOICE, INC. ______________________________________

Nazarian, Leahy, Hotten, Michele D. (Senior Judge, Specially Assigned),

JJ. ______________________________________

Opinion by Hotten, J. ______________________________________

Filed: March 3, 2025

Pursuant to the Maryland Uniform Electronic Legal *Tang, Rosalyn, J., and Albright, Anne, J., did Materials Act (§§ 10-1601 et seq. of the State not participate in the Court’s decision to Government Article) this document is authentic. designate this opinion for publication pursuant 2025.03.03 to Md. Rule 8-605.1. '00'05- 18:04:56 Gregory Hilton, Clerk Appellants, Matthew and Jamie Skipper, appeal the grant by the Circuit Court for

Prince George’s County of a motion to dismiss in favor of appellee, CareFirst BlueChoice,

Inc. The Skippers present three questions for this Court’s review, 1 which we have

consolidated and rephrased, as follows:

1. Where the principal amount of an insurance claim is paid years after the date it was due, but before the date a judgment issues, is the delay in payment a sufficient injury, on its own, to support standing?

For the reasons that follow, we reverse the circuit court’s grant of the motion to dismiss

and remand for further proceedings consistent with this opinion. 2

BACKGROUND

The Skippers are a married couple residing in Bowie, Maryland. In 2010, following

a diagnosis of female infertility, the Skippers sought fertility treatment from the GW

Medical Faculty Associates Fertility & IVF Center (“GW-MFA”). At the time, they had a

health insurance policy through Aetna.

From 2012 to 2015, the Skippers made several attempts at intrauterine insemination,

followed by several egg retrieval cycles and several attempted fresh embryo transfers.

These initial retrieval and fresh transfer cycles were all unsuccessful, but were covered

under the Skippers’ Aetna policy. In 2015, the Skippers’ physician determined that

1 The Skippers presented the following questions on appeal: 1. Does loss of use of funds constitute an injury for purposes of standing? 2. Is an unpaid principal necessary for pre-judgment interest? 3. Does late payment of an insurance reimbursement constitute complete relief for failure to cover the service at the outset? 2 Since we reverse the grant of the motion to dismiss, the circuit court’s subsequent denial of the Skippers’ motion to alter or amend the judgment is rendered moot. pregnancy was extremely unlikely to result from a fresh embryo transfer and advised that

the Skippers should create and freeze embryos for transfer. 3

At some point in 2016, the Skippers switched their coverage from Aetna and

obtained a new health insurance policy with CareFirst. However, there was a period in

between coverage under the two policies where the Skippers were uninsured. 4 During the

period between the end of their coverage through Aetna and before their coverage through

CareFirst, the Skippers created and froze four embryos from a fresh egg retrieval. Soon

thereafter, the Skippers transferred two of the frozen embryos, resulting in a successful

pregnancy. Since these procedures occurred at a time when the Skippers were uninsured,

they were paid for out of pocket by the Skippers.

Mr. Skipper, as the subscriber and primary insured, entered into an Individual

Enrollment Agreement (“IEA”) with CareFirst, effective January 1, 2018. Ms. Skipper was

also covered under the policy as a dependent spouse. The IEA provides for coverage of

3 Egg freezing, also known as oocyte cryopreservation, is a process in which a woman’s eggs (oocytes) are extracted, frozen, and stored to preserve reproductive potential in women of reproductive age. What is Egg Freezing?, UCLA Health, https://www.uclahealth.org/medical-services/obgyn/fertility/egg-freezing. Women choose to undergo egg freezing for a variety of reasons, such as waiting to find the right partner or because of a medical treatment or health condition that can affect fertility. The total cost of the process generally covers medication, ultrasounds, bloodwork, the egg retrieval procedure, the egg freezing process, and annual frozen egg storage fees. Whether any of the treatment is covered by insurance varies depending on the insurance plan. Pardis Hosseinzadeh, M.D., M.S.C., Freezing Eggs: Preserving Fertility for the Future, Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/wellness-and- prevention/freezing-eggs-preserving-fertility-for-the-future. 4 It is not clear from the record why or when exactly the Skippers switched their health insurance coverage from Aetna, nor is it clear how long the Skippers were uninsured before coverage under their CareFirst policy became effective. However, it is clear that the Skippers were insured by CareFirst during the events at issue in the case at bar. 2 “Medically Necessary, non-Experimental/Investigational artificial insemination,

intrauterine insemination and in-vitro fertilization.” The IEA goes on to state that benefits

are limited to “Assisted reproductive technologies as described and limited below,” with

one of those limitations being for “Ovum transplants and gamete intra-fallopian tube

transfer, zygote intra-fallopian transfer, or cryogenic or other preservation techniques used

in these or similar procedures.”

On July 2, 2018, the Skippers’ physician contacted CareFirst to request coverage

for IVF treatment using the remaining frozen embryos. The next day, CareFirst denied

coverage for the embryo thawing, reasoning that it was “not a covered benefit/service,” but

otherwise approved coverage for the embryo transfer. The Skippers received this prior

authorization from CareFirst on September 7, 2018. Despite the denial of coverage, the

Skippers proceeded with the IVF process, jointly paying $900 of their marital funds out of

pocket to cover the cost of embryo thawing on October 2, 2018.

Nearly two years later, the Skippers appealed CareFirst’s denial of coverage in a

letter dated June 12, 2020. CareFirst denied the appeal in a letter dated July 9, 2020,

explaining that an appeal must be submitted within 180 days of the adverse benefit

determination. Since the Skippers’ appeal was received on June 16, 2020, more than 180

days after the July 2, 2018 denial, CareFirst determined that it could not consider the

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Skipper v. CareFirst Blue Choice, Counsel Stack Legal Research, https://law.counselstack.com/opinion/skipper-v-carefirst-blue-choice-mdctspecapp-2025.