Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Crescent City Surgical Centre v. Humana Health Benefit Plan of Louisiana, Inc.

United States District Court, E.D. Louisiana

September 13, 2019

CRESCENT CITY SURGICAL CENTRE
v.
HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC., ET AL.

         SECTION: “J” (5)

          ORDER & REASONS

          CARL J. BARBIER UNITED STATES DISTRICT JUDGE

         Before the Court is a Motion to Remand (Rec. Doc. 4) filed by Plaintiff Crescent City Surgical Centre (“Crescent”) on April 18, 2019. Defendants, Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan, Inc., and Humana Insurance Company (collectively referred to as “Humana”), filed an opposition response on April 30, 2019 (Rec. Doc. 10). Crescent then filed a reply on May 7, 2019 (Rec. Doc. 15). Having considered the briefs, the parties' submissions, the record, and the applicable law, the Court finds, for the reasons expressed below, that the Motion to Remand should be GRANTED.

         FACTS AND PROCEDURAL BACKGROUND

         Crescent initially filed this action on October 5, 2018 in Louisiana's 24th Judicial District in Jefferson Parish. After six months of state court litigation, Humana removed the case to this Court on April 18, 2019.

         Crescent is a medical provider in Jefferson Parish. (Rec. Doc. 1-3). Humana is a health insurance company. Crescent's complaint in state court alleged state law claims such as breach of contract, fraud, and negligent misrepresentation. Crescent repeatedly and exhaustively disclaims any and all potential claims under federal law, as well as any derivative claims it may have on behalf of its clients. Id.

         All of Crescent's claims arise from the same basic set of facts. Although Crescent is not an “in-network” provider under Humana's insurance plans, it regularly provides medical care to Humana customers. As part of this arrangement, Humana utilizes an online portal at humana.com to confirm coverage and communicate to Crescent the portion of Crescent's patients' medical bill that Humana will pay. Crescent alleges that beginning in 2011 Humana started paying them significantly less than what it represented on the web portal. Id.

         In its answer, Humana asserted Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq., . preemption as an affirmative defense. Id. at 32. However, it did not seek to remove until it received patient files from Crescent on March 27, 2019. (Rec. Doc. No. 10 at 3-4). Included in the patient files were copies of “Patient Agreements” that Crescent had executed with its patients. The “Patient Agreements” contained an assignment to Crescent of patients' reimbursement rights under ERISA. Humana used the discovery of the ERISA assignments in the “Patient Agreements” as its basis for removal. Id.

         PARTIES' ARGUMENTS

         Crescent presents two arguments in support of its Motion to Remand. First, Crescent argues that Humana's removal was untimely because it was more than thirty days after the initial complaint in state court. Second, Crescent asserts that there is no federal question jurisdiction here. Specifically, Crescent refutes Humana's assertion that ERISA preemption gives rise to federal jurisdiction over this matter.

         As to Crescent's first argument, Humana counters that its removal was timely, because it removed the case within thirty days of discovering the basis for removal. Furthermore, Humana states that ERISA preemption does apply to Crescent's claims, and therefore federal jurisdiction exists over them.

         LEGAL STANDARD AND DISCUSSION

         Crescent seeks remand for lack of subject matter jurisdiction and untimely removal. Because the Court finds it lacks subject matter jurisdiction in this case, it is not necessary to address the issue of timeliness.

         A. Subject ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.