United Behavioral Health v. United States District Court for the Northern District of California, Sa

CourtCourt of Appeals for the Ninth Circuit
DecidedSeptember 4, 2024
Docket24-242
StatusUnpublished

This text of United Behavioral Health v. United States District Court for the Northern District of California, Sa (United Behavioral Health v. United States District Court for the Northern District of California, Sa) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United Behavioral Health v. United States District Court for the Northern District of California, Sa, (9th Cir. 2024).

Opinion

NOT FOR PUBLICATION FILED SEP 4 2024 UNITED STATES COURT OF APPEALS MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED BEHAVIORAL HEALTH, No. 24-242 Petitioner-Defendant, v. D.C. Nos. 3:14-cv-02346-JCS, 3:14-cv-5337 UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF CALIFORNIA, MEMORANDUM* Respondent,

DAVID WIT and GARY ALEXANDER, et al., Real-Parties-In-Interest-Plaintiffs.

Petition for Writ of Mandamus

Submitted September 4, 2024**

Before: CHRISTEN and FORREST, Circuit Judges, and ANELLO,*** District Judge.

* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). *** The Honorable Michael M. Anello, United States District Judge for the Southern District of California, sitting by designation. 1 Defendant United Behavioral Health (UBH) petitions for a writ of mandamus,

contending that the district court misunderstood this court’s mandate regarding

plaintiffs’ denial of benefits claim that was issued after our decision in Wit v. United

Behav. Health (Wit III), 79 F.4th 1068 (9th Cir. 2023). We grant the petition and

direct the district court to enter judgment for UBH on this claim.

1.

A writ of mandamus is a remedy reserved for “extraordinary situations.” Kerr

v. U.S. Dist. Ct., 426 U.S. 394, 402 (1976). Three criteria must be met for this remedy

to issue: (1) the right to the writ must be clear and indisputable, (2) no other adequate

means, such as an appeal, may exist to obtain the relief desired, and (3) in exercising

discretion, we must be “satisfied that the writ is appropriate under the

circumstances.” Cheney v. U.S. Dist. Ct., 542 U.S. 367, 380–81 (2004).

Mandamus is the appropriate remedy when district courts vary from our

mandate. Vizcaino v. U.S. Dist. Ct., 173 F.3d 713, 719 (9th Cir. 1999); see also

Vendo Co. v. Lektro-Vend Corp., 434 U.S. 425, 427 (1978); United States v. Cote,

51 F.3d 178, 181 (9th Cir. 1995). When “execut[ing] the terms of a mandate,” district

courts can reconsider “any issue not expressly or impliedly disposed of on appeal.”

S.F. Herring Ass’n v. U.S. Dep’t of Interior, 946 F.3d 564, 574 (9th Cir. 2019)

(citations omitted); see also United States v. Kellington, 217 F.3d 1084, 1092 (9th

2 Cir. 2000); Mendez-Gutierrez v. Gonzales, 444 F.3d 1168, 1172 (9th Cir. 2006). “In

determining which matters fall within the compass of a mandate, ‘[d]istrict courts

must implement both the letter and the spirit of the mandate, taking into account the

appellate court’s opinion and the circumstances it embraces.’” Creech v. Tewalt, 84

F.4th 777, 787 (9th Cir. 2023) (quoting Vizcaino, 173 F.3d at 719).

We review a district court’s adherence to our mandate de novo. Pit River Tribe

v. U.S. Forest Serv., 615 F.3d 1069, 1080 (9th Cir. 2010) (citing Kellington, 217

F.3d at 1092).

2.

Because UBH did not appeal the district court’s resolution of plaintiffs’ state-

mandate claims, see Wit III, 79 F.4th at 1086, we addressed two claims in our

decisions: a denial of benefits claim and a fiduciary duty claim.

Starting with the denial of benefits claim, in Wit III, we held that the district

court erred in certifying this claim for class treatment. Plaintiffs did not limit their

proposed classes to members who were denied a full and fair review of their claims,

nor did they establish that such a common showing was possible because the classes

were also not limited to claimants whose claims were denied based only on UBH’s

challenged Guidelines. Id. at 1086, 1089.

3 On the merits of the denial of benefits claim, in an earlier decision we

explained that “the [Plans’] GASC1 precondition mandates that a treatment be

consistent with GASC as a starting point.” Wit v. United Behav. Health (Wit II), 58

F.4th 1080, 1097 (9th Cir. 2023), vacated and superseded by Wit III, 79 F.4th 1068.

And we elaborated that the GASC precondition “does not compel UBH to cover all

treatment that is consistent with GASC” because “other Plan provisions . . . still

exclude certain treatments even if they are consistent with GASC.” Id. In subsequent

filings interpreting Wit II, the parties disputed whether the district court mistakenly

understood that the Plans were obliged to cover services simply because they were

consistent with GASC.

In Wit III, we clarified that although the district court’s findings, conclusions,

and orders were inconsistent on this point, viewed as a whole, the record included

statements reflecting the district court’s recognition that the various Plans allowed

claims to be excluded even if the services provided were consistent with GASC. Wit

III, 79 F.4th at 1086–88. It was in this context that we held: “[T]o the extent the

district court interpreted the Plans to require coverage for all care consistent with

GASC, the court erred.” Id. at 1088. And we reversed both “the district court’s

1 GASC stands for “generally accepted standards of care.” 4 certification of the denial of benefits classes” and “the judgment on Plaintiffs’ denial

of benefits claim” without remand. Id. at 1089.

Our reasoning on the merits of the denial of benefit claim also applied to the

fiduciary duty claim, id. at 1088 n.7, and we reversed the district court’s judgment

on that claim as well “to the extent [it] [wa]s based on the district court’s erroneous

interpretation of the Plans,” id. at 1089. But because it was unclear whether the

entirety of the fiduciary duty claim was based on misinterpretation of the Plans’

GASC precondition, we remanded for the district court to identify any surviving

aspect of that claim and, if some part of that claim did survive under our reasoning,

“to answer the threshold question of whether Plaintiffs’ fiduciary duty claim is

subject to the exhaustion requirement.” Id. at 1090.

3.

In its thorough analysis of the spirit of our mandate, the district court lost the

letter. Vizcaino, 173 F.3d at 719.

Wit III established that the errors in the class certification order related to the

denial of benefits claim also infected the merits and remedy determinations related

to that same claim. 79 F.4th at 1086. And in “revers[ing] the district court’s judgment

that UBH wrongfully denied benefits to the named Plaintiffs to the extent the district

court concluded the Plans require coverage for all care consistent with GASC,” we

5 held that requiring “coverage for all care consistent with GASC” was a

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Related

Vendo Co. v. Lektro-Vend Corp.
434 U.S. 425 (Supreme Court, 1978)
General Atomic Co. v. Felter
436 U.S. 493 (Supreme Court, 1978)
Pit River Tribe v. United States Forest Service
615 F.3d 1069 (Ninth Circuit, 2010)
United States v. Daniel F. Kellington
217 F.3d 1084 (Ninth Circuit, 2000)
United States v. Ronald Thrasher
483 F.3d 977 (Ninth Circuit, 2007)
San Francisco Herring Ass'n v. Usdoi
946 F.3d 564 (Ninth Circuit, 2019)
David Wit v. United Behavioral Health
58 F.4th 1080 (Ninth Circuit, 2023)
Thomas Creech v. Josh Tewalt
84 F.4th 777 (Ninth Circuit, 2023)

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United Behavioral Health v. United States District Court for the Northern District of California, Sa, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-behavioral-health-v-united-states-district-court-for-the-northern-ca9-2024.