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North Shore-Long Island Jewish Health Care System, Inc. v. Multiplan, Inc.

Citations: 953 F. Supp. 2d 419; 56 Employee Benefits Cas. (BNA) 2491; 2013 U.S. Dist. LEXIS 97784; 2013 WL 3488560Docket: No. 12-cv-1633 (JFB)(AKT)

Court: District Court, E.D. New York; July 12, 2013; Federal District Court

Narrative Opinion Summary

In this case, North Shore-Long Island Jewish Health Care System, Inc. sought to remand a lawsuit to state court following its removal to federal court by Defendant Local 812 Health Fund. The dispute centered on whether claims brought by North Shore were preempted by the Employee Retirement Income Security Act (ERISA), which would establish federal jurisdiction. The court reviewed the procedural history, including objections to a magistrate judge's recommendation for remand, and considered new evidence submitted by the defendants. The court ultimately denied the motion to remand, concluding that some claims were preempted by ERISA, thus granting subject matter jurisdiction. The court found that North Shore's claims involved a 'right to payment,' necessitating interpretation of the ERISA plan, contrary to their characterization as mere 'amount of payment' disputes. Additionally, the court determined that North Shore had standing to bring claims under ERISA, given the assignment of benefits from plan participants, as evidenced by UB-04 forms. The court's decision rested on the application of the Davila test, which examines whether claims could have been brought under ERISA and whether an independent legal duty existed, ultimately concluding that ERISA's broad preemption applied to the claims at issue.

Legal Issues Addressed

Assignment of Benefits and Standing under ERISA

Application: The court concluded that the plaintiff had standing to bring claims under ERISA based on assignments of benefits from plan participants, as suggested by UB-04 forms.

Reasoning: The Court concludes that the plaintiff has standing to bring claims under ERISA based on a comprehensive review of submitted documentation and relevant case law.

ERISA Preemption of State Law Claims

Application: The court found that some of North Shore's claims were completely preempted by ERISA, thereby establishing federal subject matter jurisdiction.

Reasoning: Consequently, the court finds that both prongs of the Davila test are met, leading to the conclusion that some of the plaintiffs' claims are completely preempted by ERISA, establishing federal subject matter jurisdiction.

Federal Court Jurisdiction and Preemption Doctrine

Application: The court emphasized that when a federal statute like ERISA completely preempts a state-law cause of action, the state claim can be moved to federal court.

Reasoning: When a federal statute completely preempts a state-law cause of action, the state claim can be moved to federal court, as established in Davila, 542 U.S. at 207.

Removal by Third-Party Defendants

Application: The court concluded that removal to federal court was appropriate, rejecting North Shore's argument that Local 812, as a third-party defendant, lacked authority to remove the case.

Reasoning: The Court agrees with the recommendation that Local 812's removal of the case was timely and appropriate, as Local 812 is a direct defendant in the matter.

Subject Matter Jurisdiction under ERISA

Application: The court determined that it had subject matter jurisdiction based on the preemption of the claims by ERISA, as the claims involved the interpretation of an ERISA-governed plan.

Reasoning: Ultimately, the court denied North Shore's motion to remand, finding that it had subject matter jurisdiction over the case.