Thomas v. Blue Cross and Blue Shield Ass'n

• Decision Date: 21 January 2010
• Docket Number: No. 08-15881.,08-15881.
• Parties: M.D. Kenneth A. THOMAS, et al., Plaintiffs, v. BLUE CROSS AND BLUE SHIELD ASSOCIATION, et al., Defendants, Dr. Ronald Robertson, Appellant, Blue Cross Blue Shield of Florida, Inc., Health Options, Inc., Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

594 F.3d 823

M.D. Kenneth A. THOMAS, et al., Plaintiffs, v. BLUE CROSS AND BLUE SHIELD ASSOCIATION, et al., Defendants, Dr. Ronald Robertson, Appellant, Blue Cross Blue Shield of Florida, Inc., Health Options, Inc., Defendants-Appellees.

No. 08-15881.

United States Court of Appeals, Eleventh Circuit.

January 21, 2010.

Guy F. Giberson, Wadsworth Huott, LLP, Miami, FL, for Robertson.

Marie Ann Halpin, Michael A. Pope, Christopher MacNeil Murphy, McDermott, Will & Emery, LLP, Chicago, IL, Steven E. Siff, McDermott, Will & Emery, LLP, Miami, FL, for Defendants-Appellees.

Appeal from the United States District Court for the Southern District of Florida.

Before EDMONDSON and PRYOR, Circuit Judges, and CAMP,^* District Judge.

PRYOR, Circuit Judge:

This appeal presents the issue whether we have jurisdiction to review an order that summarily denied a physician's motion for permission to prosecute a complaint against Blue Cross Blue Shield of Florida, Inc., and its subsidiary, notwithstanding a permanent injunction that barred physicians from prosecuting claims released as part of the settlement of a national class action. A class of physicians had complained that Blue Cross and Blue Shield Association, Inc., and its member plans had engaged in a scheme to deny, delay, and reduce payments to the physicians. As part of the settlement, the physicians agreed to release the Blue Cross plans from all claims arising from or related to the class action and settlement agreement, and the district court permanently enjoined the members of the class from prosecuting released claims against the Blue Cross plans. Dr. Donald W. Robertson later moved for clarification as to whether the injunction barred his complaint in a Florida court against Blue Cross Blue Shield of Florida, Inc., and Health Options, Inc. Because the order that denied Robertson's motion is not final or otherwise appealable, we dismiss this appeal for lack of jurisdiction.

I. BACKGROUND

In May 2003, several physicians, on behalf of themselves and all other similarly situated physicians, filed a complaint against Blue Cross and Blue Shield Association, Inc., and its member plans throughout the United States. The complaint asserted claims of conspiracy and aiding and abetting under the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. §§ 1961-1968, and sought damages as well as declaratory and injunctive relief. The physicians' claims were based on allegations that the health insurance companies had "engaged in a conspiracy to improperly deny, delay, and/or reduce payments to physicians, physician groups, and physician organizations by engaging in several types of allegedly improper conduct."

The parties eventually agreed to a settlement of the class action. The district court later entered an order that certified the class and granted final approval of the settlement agreement. See Love v. Blue Cross & Blue Shield Ass'n, Inc., No. 0321296 (S.D.Fla. Apr. 19, 2008). As part of the settlement, the Blue Cross plans agreed to implement business practice initiatives and establish a settlement fund for payment of claims to class members. In exchange, the class members agreed to release the Blue Cross plans from all claims arising out of or related to matters referenced in the class action and the settlement agreement:

Upon the Effective Date, the "Released Parties[]" ... shall be released and forever discharged ... from any and all causes of action ... of whatever kind, source or character whether arising under any federal or state law, which ... includes, but is not limited to, the Racketeer Influenced and Corrupt Organizations Act, antitrust and other statutory and common law claims, intentional or non-intentional, ... arising on or before the Effective Date, that are, were or could have been asserted against any of the Released Parties by reason of, arising out of, or in any way related to any of the facts, acts, events, transactions, occurrences, courses of conduct, business practices, representations, omissions, circumstances or other matters referenced in the Action, or addressed in this Agreement....

The district court permanently enjoined the releasing parties from filing or prosecuting "any or all Released Claims against one or more Released Parties." The parties do not dispute that Robertson is a releasing party or that Blue Cross Blue Shield of Florida and Health Options are released parties. In a separate order, the district court entered judgment in the class action and dismissed all claims against Blue Cross and its member plans with prejudice. The district court expressly retained jurisdiction as to matters relating to the interpretation, administration, and consummation of the settlement agreement, and the enforcement of extant injunctions.

Robertson commenced a civil action against Blue Cross Blue Shield of Florida and its subsidiary, Health Options, in a Florida court in July 2003, two months after the complaint had been filed in the national class action. Robertson's complaint asserted claims of tortious interference with a business relationship, unauthorized publication, breach of contract, and violation of the duty of good faith and fair dealing. According to Robertson, "the gravamen [of his Florida action] is not Blue Cross' improper policies and procedures with respect to reimbursements and referrals ... but the retaliatory targeting of Dr. Robertson for speaking out against those policies and procedures."

Although all class members were given an opportunity to opt out of the settlement agreement, Robertson failed to opt out by the prescribed deadline. He attempted to opt out two weeks after the deadline, but the settlement administrator denied his request. Several weeks after the district court granted final approval of the settlement agreement and enjoined class members from filing or prosecuting released claims, the Florida Blue Cross plans demanded that Robertson dismiss his Florida action.

Robertson filed a motion in the district court for two kinds of relief. First, Robertson sought an order declaring that the settlement agreement did not release his claims and granting him permission to prosecute his complaint in the Florida court. Second, Robertson sought an order declaring that, if the district court decided to reconsider its earlier order denying the similar request of a class member to opt out belatedly of the settlement agreement, then it would consider Robertson's request to opt out belatedly as well.

On September 4, 2008, the district court denied Robertson's motion in its entirety, but the district court did not address the merits of Robertson's motion. The order stated only that the district court "ha[d] considered the motion, response and the pertinent portions of the record."

II. DISCUSSION

Neither party challenges our jurisdiction to entertain this appeal, but "we are obligated to address jurisdictional questions sua sponte." Frulla v. CRA Holdings, Inc., 543 F.3d 1247, 1250 (11th Cir.2008). In their briefs, both Robertson and the Florida Blue Cross plans asserted that we have jurisdiction because the order that denied Robertson's motion is a final decision that disposed of all of his claims. At oral argument, the Florida Blue Cross plans reluctantly conceded that the order is "probably" not a final decision, but Robertson argued that we should exercise jurisdiction under the Declaratory Judgment Act, which provides that declaratory judgments are final decisions, 28 U.S.C. § 2201.

The potential bases for our jurisdiction are few and well defined. Our jurisdiction is ordinarily limited to appeals from final decisions of the district courts. 28 U.S.C. § 1291; see also World Fuel Corp. v. Geithner, 568 F.3d 1345, 1348 (11th Cir.2009). We also have jurisdiction over a narrow class of cases excepted from the final judgment rule under the collateral order doctrine. Cohen v. Beneficial Indus. Loan Corp., 337 U.S. 541, 546, 69 S.Ct. 1221, 1225-26, 93 L.Ed. 1528 (1949); Miccosukee Tribe of Indians v. S. Fla. Water Mgmt. Dist., 559 F.3d 1191, 1198 (11th Cir.2009). Additionally, we have jurisdiction to review certain interlocutory orders of the district courts—those "granting, continuing, modifying, refusing or dissolving injunctions, or refusing to dissolve or modify injunctions." 28 U.S.C. § 1292(a)(1); see also Birmingham Fire Fighters Ass'n 117 v. Jefferson County, 280 F.3d 1289, 1292 (11th Cir.2002).

Because our jurisdiction is limited to a narrow class of decisions, our jurisdiction to entertain this appeal hinges on the nature of the order that denied Robertson's motion. The district court entered the order in a postjudgment proceeding. Robertson's motion relied on the jurisdiction that the district court retained to interpret the settlement agreement and enforce the permanent injunction barring class members from prosecuting released claims. Robertson's motion sought clarification regarding whether the claims in his Florida action are released claims that are enjoined from prosecution. Robertson's motion, styled as a "Motion for Permission to Proceed with His Claims against Defendants Blue Cross and Blue Shield of Florida, Inc. and Health Options, Inc.," described the relief Robertson sought as "an order allowing the Robertson Action to proceed," an "[o]rder stating that the Robertson Action is not stayed by this action," and an order stating that "the Settlement did not release Blue Cross from Dr. Robertson's claims."

Because the district court did not discuss the merits of Robertson's motion, the effect of the order summarily denying Robertson's motion is unclear. One plausible interpretation is that the denial is an implicit ruling that Robertson's claims are released and that he is enjoined from prosecuting them, but another plausible interpretation is that the district court denied Robertson's motion for a procedural defect. In the absence of an explanation from the district court, we are left...