Wagoner v. First Fleet Incorporated

CourtDistrict Court, D. Arizona
DecidedAugust 9, 2022
Docket2:22-cv-00990
StatusUnknown

This text of Wagoner v. First Fleet Incorporated (Wagoner v. First Fleet Incorporated) is published on Counsel Stack Legal Research, covering District Court, D. Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wagoner v. First Fleet Incorporated, (D. Ariz. 2022).

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

9 Gary L. Wagoner, No. CV-22-00990-PHX-JAT

10 Plaintiff, ORDER

11 v.

12 First Fleet Incorporated,

13 Defendant. 14 15 16 Pending before the Court is Defendant First Fleet, Inc.’s (“First Fleet”) Motion to 17 Dismiss (Doc. 6), and Plaintiff Dr. Gary Wagoner’s (“Plaintiff”) Response to Motion to 18 Dismiss and Motion for Default (Doc. 9). Also pending before the Court is Defendant’s 19 Reply in Support of Its Motion to Dismiss and in Opposition to Plaintiff’s Motion for 20 Default (Doc. 11), and Defendant’s Motion to Strike (Doc. 13). The Court now rules on 21 the motions. 22 I. BACKGROUND 23 Plaintiff is a chiropractor based in Scottsdale, Arizona, and is the designated 24 representative for patient Jeffrey Cagle. (Doc. 1-3 at 5–6). Plaintiff provided medical care 25 to Mr. Cagle on October 10, 2019. (Id. at 6). Mr. Cagle signed an assignment of benefits 26 contract to allow Plaintiff to collect payment from Mr. Cagle’s employee health benefits 27 plan through First Fleet, Inc., an insurance company affiliated with Blue Cross Blue Shield 28 of Tennessee (BCBST). (Id. at 6, 18). Both parties agree that Mr. Cagle’s plan is regulated 1 by the Employee Retirement Income Security Act (ERISA). (Doc. 9 at 1; Doc. 6 at 2). 2 After he provided anesthesiology services to Mr. Cagle, Plaintiff alleges he 3 submitted “a total of 2 demands for payment … to First Fleet without response or payment 4 tendered.” (Doc. 1-3 at 6). On May 3, 2022, Plaintiff filed his Complaint against First Fleet 5 in the Dreamy Draw Justice Court in Phoenix, Arizona, alleging First Fleet had not 6 properly paid him for the services he provided Mr. Cagle and seeking $10,000 in damages, 7 including benefits, court costs, interest, and document preparation expenses. (Doc. 1-3 at 8 5; Doc. 6 at 3). 9 On June 7, 2022, First Fleet removed Plaintiff’s action to the U.S. District Court for 10 the District of Arizona and filed a Motion to Dismiss under Federal Rule of Civil Procedure 11 12(b)(6) claiming ERISA preemption. (Doc. 1-4 at 2; Doc. 6). Consequently, Plaintiff filed 12 a Response and Motion for Default on June 28, 2022. (Doc. 9). First Fleet opposed 13 Plaintiff’s Motion for Default on July 5, 2022, and nine days later, First Fleet moved to 14 strike Plaintiff’s Response and Motion for Default (Doc. 9) from the Court record. (Doc. 15 11; Doc. 13). 16 II. LEGAL STANDARD 17 A. Rule 12(b)(6) 18 Dismissal of a complaint, or any claim within it, for failure to state a claim under 19 Rule 12(b)(6) may be based on either “‘a lack of a cognizable legal theory’ or ‘the absence 20 of sufficient facts alleged under a cognizable legal theory.’” Johnson v. Riverside 21 Heatlhcare Sys., LP, 534 F.3d 1116, 1121–22 (9th Cir. 2008) (quoting Balistreri v. Pacifica 22 Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1990)). In determining whether a complaint states 23 a claim under this standard, the Court regards the allegations in the complaint as true and 24 construes the pleadings in the light most favorable to the nonmovant. Outdoor Media 25 Group, Inc. v. City of Beaumont, 506 F.3d 895, 900 (9th Cir. 2007). A pleading must contain 26 “a short and plain statement of the claim showing that the pleader is entitled to relief.” Fed. 27 R. Civ. P. 8(a)(2). This statement “need only give the defendant fair notice of what … the 28 claim is and the grounds upon which it rests,” and “[s]pecific facts are not necessary.” 1 Erickson v. Pardus, 551 U.S. 89, 93 (2007) (internal quotation marks omitted). To survive 2 a motion to dismiss, a complaint must state a claim that is “plausible on its face,” which 3 occurs “when the plaintiff pleads factual content that allows the court to draw the 4 reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. 5 Iqbal, 556 U.S. 662, 678 (2009); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007) (to 6 survive a motion to dismiss, a plaintiff must allege “enough facts to state a claim to relief 7 that is plausible on its face”). 8 Although courts will not generally look beyond the pleadings in a Rule 12(b)(6) 9 motion, a “court may consider material that the plaintiff properly submitted as part of the 10 complaint, or even if not physically attached to the complaint, material that is not 11 contended to be inauthentic and that is necessarily relied upon by the plaintiff’s complaint.” 12 Lee v. City of Los Angeles, 250 F.3d 668, 688 (9th Cir. 2001). The Court may also consider 13 matters of public record, including pleadings, orders, and other papers filed with the Court. 14 Mack v. S. Bay Beer Distribs., 798 F.2d 1279, 1282 (9th Cir. 1986), abrogated on other 15 grounds by Astoria Fed. Savings & Loan Ass’n v. Solimino, 501 U.S. 104 (1991). 16 B. Preemption 17 1. ERISA 18 ERISA derives its preemptive power from two components. Blue Cross of Cal. v. 19 Insys Therapeutics, 390 F. Supp. 3d 996, 1003 (D. Ariz. 2019). The first component, 20 ERISA section 514(a), preempts all state laws “as they may now or hereafter relate to any 21 employee benefit plan.” 29 U.S.C. § 1444 (a). The second component, ERISA section 22 502(a), outlines the scope of civil remedies available to enforce any part of ERISA’s 23 provisions. Insys Therapeutics, 390 F. Supp. 3d at 1003 (citing Cleghorn v. Blue Shield of 24 Cal., 408 F.3d 1222, 1225 (9th Cir. 2005)). If a state cause of action falls within this scope, 25 the Court deems the cause of action preempted as conflicting with the intended exclusivity 26 of ERISA’s civil remedies. Id. This is the case even if the state cause of action is not 27 preempted by section 514(a), as discussed below. Id. 28 1 a. Section 514(a) 2 Section 514(a) requires that ERISA “supersede any and all State laws insofar as they 3 may … relate to any employee benefit plan.” § 1144(a). The Court considers a law to 4 “relate to” an employee benefit plan if it has “a connection with or reference to such a 5 plan.” Insys Therapeutics, 390 F. Supp. 3d at 1003 (quoting Shaw v. Delta Air Lines, Inc., 6 463 U.S. 85, 96–97 (1983) (internal quotations omitted)). The Court considers a state law 7 to “refer to” an ERISA plan when it “acts immediately and exclusively upon ERISA plans 8 … or where the existence of ERISA plans is essential to the law’s operation.” Id. (quoting 9 Cal. Div. of Labor Standards Enforcement v. Dillingham Const., N.A., Inc., 519 U.S. 316, 10 325 (1997) (internal quotations omitted)). 11 Additionally, Ninth Circuit courts use a separate “relationship test” to determine 12 whether a state law has a “connection with” an ERISA plan. Id.

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