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Decatur Hospital Authority v. Aetna Health, Inc.

United States Court of Appeals, Fifth Circuit

April 18, 2017

DECATUR HOSPITAL AUTHORITY, doing business as Wise Regional Health System, Plaintiff - Appellee
v.
AETNA HEALTH, INCORPORATED, Defendant-Appellant

          Appeal from the United States District Court for the Northern District of Texas

          Before JOLLY, HIGGINBOTHAM, and GRAVES, Circuit Judges.

          JAMES E. GRAVES, JR., Circuit Judge

         This appeal relates to ongoing litigation between Wise Regional Health System, a Texas municipal hospital authority, and Aetna Health Inc., an insurance plan administrator, regarding medical insurance claims Wise Regional submitted on behalf of its patients. Wise Regional sued Aetna in Texas state court, and, when Aetna removed, it relied in part upon the federal officer removal statute, 28 U.S.C. § 1442. Finding Aetna's removal untimely, the district court remanded and awarded attorneys' fees.

          We have appellate jurisdiction over the remand order, and, upon de novo review, we AFFIRM. We also perceive no abuse of discretion in the separate attorneys' fee award, and we AFFIRM.

         BACKGROUND

         On May 27, 2015, Wise Regional sent Aetna a demand letter "to address claims Wise [Regional] has against Aetna for Aetna's violations of the timely claim processing requirements imposed by the Texas Prompt Pay Act." Wise Regional's letter claimed state-law late-payment penalties in excess of $17.4 million had accrued.

         Wise Regional's demand letter made three specific requests. First, the letter asked Aetna to contact Wise Regional's counsel to coordinate a "secure, HIPPA-compliant" transmission of "a detailed list of the claims at issue." Second, "[t]o make pre-suit negotiations more productive, " Wise Regional asked Aetna to conduct a "line-of-business analysis" on the claims list to identify "the payment arrangement (e.g., self-funded ERISA, fully insured, Medicare Advantage, FEHBA)" implicated by each claim.[1] Third, Wise Regional asked Aetna to provide information regarding any claim "Aetna believes was timely paid." Aetna's counsel asked for the claims list on June 19, 2015, and Wise Regional provided it three days later.

         On June 24, two days after sending the claims list, Wise Regional filed in Texas state court a lawsuit predicated upon insurance claims it alleges Aetna paid, but paid too slowly. On November 4, 2015, Wise Regional provided objections and answers to Aetna's first set of interrogatories. On December 4, 2015, Aetna removed the case to federal court pursuant to 28 U.S.C. § 1441(a) and 28 U.S.C. § 1442.

          Wise Regional filed a motion to remand, and the district court issued a remand order on February 19, 2016. The district court's memorandum opinion stated that "the action should be remanded because [Aetna] did not timely remove it."

         Wise Regional also filed a motion for attorneys' fees. The district court granted that motion on March 7, 2016, and awarded Wise Regional $14, 500. The district court ruled that Aetna "lacked an objectively reasonable basis for seeking removal of this action almost five months after expiration of the thirty-day deadline for removal, " and stated that "[Aetna's] contention that it first ascertained from the interrogatory answers that the case is one that was removable borders on being absurd considering that the state court pleading of [the] plaintiff provided exactly that same information."

         Aetna timely noticed its appeal of both the remand order and the attorneys' fees award.

         JURISDICTION

         The parties dispute whether this court has jurisdiction to review the remand order. Aetna contends that we may review the remand ...


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