Quintana v. Lightner

• Decision Date: 21 March 2011
• Docket Number: Civil Action No. 3:10–CV–0571–G.
• Citation: 818 F.Supp.2d 964,50 Employee Benefits Cas. 2897
• Parties: Justin QUINTANA, Plaintiff, v. Kem L. LIGHTNER, et al., Defendants.
• Court: U.S. District Court — Northern District of Texas

50 Employee Benefits Cas. 2897

818 F.Supp.2d 964

Justin QUINTANA, Plaintiff,

v.Kem L. LIGHTNER, et al., Defendants.

Civil Action No. 3:10–CV–0571–G.

United States District Court, N.D. Texas, Dallas Division.

March 21, 2011.

Mark A. Ticer, Law Office of Mark A. Ticer, David A. Cole, The Cole Law Firm, Dallas, TX, for Plaintiff.

Melinda R. Burke, Randall E. Betty, Shannon Gracey Ratliff & Miller, Fort Worth, TX, Laura D. Schmidt, Downs & Stanford PC, Dallas, TX, for Defendants.

MEMORANDUM OPINION AND ORDER

A. JOE FISH, Senior District Judge.

Before the court is the motion of the plaintiff, Justin Quintana (“Quintana”), to remand this case to the state court from which it was previously removed (docket entry 6). For the reasons set forth below, the motion is granted.

I. BACKGROUND

This is an action brought by Quintana against defendants Kem L. Lightner (“Lightner”),¹ State Farm Mutual Automobile Insurance Company (“State Farm”), and Ingenix, Inc. (“Ingenix”) for violations of Quintana's right to privacy, conspiracy to invade his privacy, violations of the Health Information Portability and Accountability Act of 1996 (“HIPAA”), and intentional infliction of emotional distress. Defendant's Notice of Removal (“Notice of Removal”) ¶ 6 (docket entry 1); see also Plaintiff's Original Petition and Petition for Injunctive Relief (“Petition”) at 3–4, attached to Appendix to Notice of Removal. Quintana's claims arise out of Ingenix's alleged disclosure of medical information to State Farm.² Notice of Removal ¶ 6.

On January 5, 2005, Quintana was injured in an automobile accident. Id. ¶ 4. At the time of the accident, Quintana was a participant in the Choice EPO Plan for Employees of Tenet Healthcare Corporation (“the Plan”), a self-funded plan established and maintained under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132. Id. On Quintana's behalf, the Plan paid for certain medical expenses resulting from injuries sustained in the accident. Id. Subsequently, Quintana filed suit in state court against the third party he alleges caused his injuries. Id.

In August of 2009, defendant State Farm, the liability carrier for the third party, contacted defendant Ingenix, the Plan's subrogation vendor, regarding the Plan's right to subrogation for the payments it made on Quintana's behalf for medical treatment.³ Id. ¶ 5. Ingenix allegedly provided State Farm's employee, defendant Lightner, an itemization of Quintana's medical bills and the amounts paid to each provider for the treatment. Id. In November of 2009, Ingenix agreed to settle with State Farm on behalf of the Plan for approximately one-third of the Plan's subrogation interests. Id. When Quintana's counsel learned of the settlement, he filed suit in a Dallas County district court seeking an injunction to prevent Ingenix and State Farm from communicating about Quintana's medical information, and alleging “damages against the Defendants for violations of his right to privacy, conspiracy to invade his privacy, violations of HIPAA and intentional infliction of emotional distress.” ⁴ Id. ¶ 6. Quintana asserts “[n]either Lightner nor State Farm held any medical authorization or other authority to communicate with Ingenix to discuss Quintana's medical treatment or records, including billings.” Petition at 2.

On March 22, 2010, Ingenix removed the case to this court, asserting that “[t]he terms of the Summary Plan Document [ (“SPD”) ] control the authority of Ingenix, and determine the outcome of [the] Plaintiff's claims.” Notice of Removal ¶ 6. Because it believes “the terms [of the SPD] are essential” to the resolution of this case, Ingenix contends that “[a]ll matters asserted by [the] Plaintiff are [completely] pre-empted by ERISA” under 29 U.S.C. § 1132, and thus, removal is proper. Id. ¶¶ 6, 11.

II. ANALYSIS

A. ERISA Preemption Generally

District courts have federal question jurisdiction over civil cases “arising under the Constitution, laws, or treaties of the United States.” See 28 U.S.C. § 1331; Frank v. Bear Stearns & Company, 128 F.3d 919, 922 (5th Cir.1997). In determining whether a claim arises under federal law, the well-pleaded complaint rule allows a plaintiff to be the “master to decide what law he will rely upon” in pursuing his claims. The Fair v. Kohler Die & Specialty Company, 228 U.S. 22, 25, 33 S.Ct. 410, 57 L.Ed. 716 (1913); see also Beneficial National Bank v. Anderson, 539 U.S. 1, 6, 123 S.Ct. 2058, 156 L.Ed.2d 1 (2003); Aaron v. National Union Fire Insurance Company of Pittsburg, Pa., 876 F.2d 1157, 1160–61 (5th Cir.1989), cert. denied, 493 U.S. 1074, 110 S.Ct. 1121, 107 L.Ed.2d 1028 (1990). Where potential remedies exist under both state and federal law, a plaintiff may choose to proceed only under state law and avoid federal court jurisdiction. Caterpillar Inc. v. Williams, 482 U.S. 386, 392, 107 S.Ct. 2425, 96 L.Ed.2d 318 (1987); Carpenter v. Wichita Falls Independent School District, 44 F.3d 362, 366 (5th Cir.1995). “There is an exception to the well-pleaded complaint rule, though, if Congress ‘so completely preempt[s] a particular area that any civil complaint raising this select group of claims is necessarily federal in character.’ ” Arana v. Ochsner Health Plan, 338 F.3d 433, 437 (5th Cir.2003) (en banc) (quoting Metropolitan Life Insurance Company v. Taylor, 481 U.S. 58, 63–64, 107 S.Ct. 1542, 95 L.Ed.2d 55 (1987)), cert. denied, 540 U.S. 1104, 124 S.Ct. 1044, 157 L.Ed.2d 889 (2004).

The Supreme Court has held that state-law claims seeking relief within the scope of ERISA § 502(a)(1)(B) ⁵ must be recharacterized as arising under federal law, and, as so recharacterized, are removable to federal court. Metropolitan Life, 481 U.S. at 60, 66–67, 107 S.Ct. 1542; see also Ramirez v. Inter–Continental Hotels, 890 F.2d 760, 762 (5th Cir.1989). When a claimant seeks relief “within the scope of [ERISA's] civil enforcement provisions,” his or her claims are subject to complete preemption. Metropolitan Life, 481 U.S. at 66, 107 S.Ct. 1542. Complete preemption “ ‘recharacterizes' preempted state law claims as ‘arising under’ federal law for the purposes of ... making removal available to the defendant.” McClelland v. Gronwaldt, 155 F.3d 507, 516 (5th Cir.1998), overruled on other grounds, Arana, 338 F.3d at 440 n. 11; see also Johnson v. Baylor University, 214 F.3d 630, 632 (5th Cir.), cert. denied, 531 U.S. 1012, 121 S.Ct. 567, 148 L.Ed.2d 486 (2000).

Another type of preemption, known as “conflict” or “ordinary” preemption, “arises when a federal law conflicts with state law, thus providing a federal defense to a state law claim, but does not completely preempt the field of state law so as to transform a state law claim into a federal claim.” Arana, 338 F.3d at 439. Under ERISA's conflict preemption provision, § 514(a), “any and all State laws [are displaced or superseded] insofar as they ... relate to any employee benefit plan.” 29 U.S.C. § 1144(a); see also Christopher v. Mobil Oil Corporation, 950 F.2d 1209, 1217 (5th Cir.), cert. denied, 506 U.S. 820, 113 S.Ct. 68, 121 L.Ed.2d 35 (1992). Any state law “relates to” an ERISA plan “if it has a connection with or reference to” an employee benefit plan. Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 96–97, 103 S.Ct. 2890, 77 L.Ed.2d 490(1983).⁶ Significantly for this case, even if the court were to find that Quintana's state law causes of action against the defendants relate to an ERISA plan within the meaning of § 514(a), conflict preemption is insufficient to create federal jurisdiction. See McClelland, 155 F.3d at 516–19 (finding that a claim that relates to an ERISA plan, but does not seek to enforce rights under § 502(a), does not create federal removal jurisdiction); Copling v. Container Store, Inc., 174 F.3d 590, 594–95 (5th Cir.1999), overruled on other grounds, Arana, 338 F.3d at 440 n. 11.⁷ The court will, therefore, only examine the contours of Quintana's state law claims insofar as they relate to complete preemption.

The Fifth Circuit, in Memorial Hospital System v. Northbrook Life Insurance Company, 904 F.2d 236, 245 (5th Cir.1990), outlined two unifying characteristics of cases finding ERISA preemption of a plaintiff's state law causes of action. See also Hollis v. Provident Life & Accident Insurance Company, 259 F.3d 410, 414 (5th Cir.2001), cert. denied, 535 U.S. 986, 122 S.Ct. 1538, 152 L.Ed.2d 465 (2002); Baylor University Medical Center v. Arkansas Blue Cross Blue Shield, 331 F.Supp.2d 502, 507 (N.D.Tex.2004) (Fish, Chief J.). Preemption of a plaintiff's state law causes of action has been found when: (1) the state law claim addresses areas of exclusive federal concern, and (2) the claim directly affects the relationship among traditional ERISA entities—the employer, the plan and its fiduciaries, and the participants and beneficiaries. Memorial Hospital, 904 F.2d at 245; Hollis, 259 F.3d at 414; Baylor, 331 F.Supp.2d at 507.

Before analyzing the impact of ERISA's preemption clause on Quintana's claims, the court hastens to note that “any doubts concerning removal must be resolved against removal and in favor of remanding the case back to state court.” Cross v. Bankers Multiple Line Insurance Company, 810 F.Supp. 748, 750 (N.D.Tex.1992); see also Healy v. Ratta, 292 U.S. 263, 54 S.Ct. 700, 78 L.Ed. 1248 (1934) (“Due regard for the rightful independence of state governments, which should actuate federal courts, requires that they scrupulously confine their own jurisdiction to the precise limits which the statute has defined.”). The burden of establishing federal jurisdiction is on the party seeking removal. Miller v. Diamond Shamrock Company, 275 F.3d 414, 417 (5th Cir.2001) (citing Frank, 128 F.3d at 921–22).

B. An Area of Exclusive Federal Concern

The first element of preemption is whether the state law claim addresses areas of exclusively federal concern, including the right to receive benefits under the terms of an ERISA plan. Memorial Hospital, ...