RICHARD B. FARRER, Magistrate Judge.
This Report and Recommendation concerns the Motions to Dismiss and Alternative Motions to Transfer filed by Defendants Carefirst of Maryland, Inc. ("CFMI") and Group Hospitalization and Medical Services, Inc. ("GHMSI"). See Dkt. Nos. 23 & 25. All pretrial matters in this ERISA litigation, which also involves pendant state law claims, have been referred to the undersigned for disposition pursuant to Rules CV-72 and 1(c) & (d) to Appendix C of the Local Rules for the United States District Court for the Western District of Texas. See Dkt. No. 90. The undersigned has authority to enter this report and recommendation pursuant to 28 U.S.C. § 636(b)(1)(B).
CFMI and GHMSI's motions are the first two of seven Rule 12 motions filed by some of the 67 defendants in this complex multi-party litigation. The plaintiffs in this action, referred to herein as "the Victory Plaintiffs," are seven hospitals; two are plaintiffs in their own names and the remaining five are represented by a bankruptcy trustee. In their motions, CFMI and GHMSI challenge the Court's personal jurisdiction over them as well as the propriety of venue in this district. They seek dismissal under Rules 12(b)(2) & (b)(3) of all claims against them or, alternatively, that the claims asserted against them be transferred to the District of Maryland (for CFMI) and the District of Columbia (for GHMSI). The two motions at issue also raise arguments for dismissal under Rule 12(b)(6). These Rule 12(b)(6) arguments are mirrored in some of the other five Rule 12 motions that have been filed in this case but are not presently at issue.
Matters are further complicated here by the fact that this is one of two closely related actions filed in this district involving a request to recoup payments on claims submitted in connection with the treatment of patients at Victory hospitals across Texas. The first action, which is referred to U.S. Magistrate Judge Elizabeth S. Chestney, involves claims against Aetna Life Insurance Company. See Gilmour et al. v. Aetna Life Ins. Co., No. 5-17-cv-510-FB-ESC (W.D. Tex. filed Jun. 8, 2017). Shortly after filing suit against Aetna, the Victory Plaintiffs filed this substantially similar action against 67 BCBS affiliates. Both cases are pending before the same District Judge, and both involve a variety of ERISA-related claims as well as pendant claims under the Texas Insurance Code and Texas common law. Judge Chestney recently issued her report and recommendation addressing several issues closely related to some of the Rule 12(b)(6) issues raised in this case. See id. at Dkt. No. 23. Judge Chestney's report and recommendation also addresses Rule 12(b)(1) issues that are also implicated in this litigation, although no Rule 12(b)(1) issues are raised in the two motions that are the subject of this report and recommendation. All of this is to say that the undersigned's recommendation regarding the two motions at issue is made in light of the somewhat parallel proceedings in Aetna, and with the understanding that further action in this litigation will very likely depend in large part on the District Court's ruling on Judge Chestney's report and recommendation.
After considering CFMI's and GHMSI's Motions, Dkt. Nos. 23 & 25, the Response filed by the Victory Plaintiffs, Dkt. No. 126, CFMI's and GHMSI's Reply, Dkt. No. 129, the Victory Plaintiffs' Sur-Reply, Dkt. No. 133, the pleadings, and the entire case file, the undersigned finds that the Court has personal jurisdiction over Defendants CFMI and GHMSI. Based on the current record, however, CFMI's and GHMSI's venue objections are well-taken. Accordingly, the undersigned recommends that the District Court: (1)
Finally, to assist the Court and the parties in navigating this complex multi-party litigation—and in light of Judge Chestney's Aetna report and recommendation currently pending with the District Court—the undersigned offers some additional recommendations on how this litigation can be most efficiently managed going forward, as discussed in greater detail below.
Plaintiff Neil Gilmour is a bankruptcy trustee for five hospitals that offered specializedsurgical services. Two additional hospitals are plaintiffs in their own names. Defendants are 67 distinct Blue Cross Blue Shield affiliates (collectively, "BCBS Defendants") that provide healthcare insurance to individuals across the country through plans they administer.
According to the live Complaint, the Victory Plaintiffs provided out-of-network medical treatment to various patients insured by plans administered by the BCBS Defendants. See Compl. ¶¶ 96, 98. As out-of-network providers, the Victory Plaintiffs did not have contracts with the BCBS Defendants to accept payments for less than the usual and customary charges for services provided to patients. Id. The BCBS Defendants, it is alleged, charged and received higher insurance premiums from plan subscribers (also called plan "beneficiaries") in exchange for including out-of-network coverage in their plans. Id. The basic thrust of the Victory Plaintiffs' Complaint is that each of the BCBS Defendants failed to pay or underpaid out-of-network claims submitted by the Victory Plaintiffs on behalf of approximately 1,863 individuals who received treatment and were covered by BCBS plans. Id. ¶¶ 105-109. According to the Complaint, those claims were assigned and transferred to the Victory Plaintiffs, and they now seek recompense for these claims from the BCBS Defendants. See id. ¶ 92.
CFMI and GHMSI filed their motions on July 14, 2017, see Dkt. No. 23 & 25, and five other BCBS Defendants followed suit a few months later with similar, although not identical, motions, see Dkt. Nos. 60-61, 63-64, 98. Altogether, there are seven different motions to dismiss pending in this case. Some of the BCBS Defendants, like CFMI and GHMSI, challenge the propriety of venue in this district, see Dkt. Nos. 23, 25, 64,
The goal of this recommendation is to address some initial issues raised in the first two of the Rule 12 motions that were filed with the Court in this case, and then to set the stage for a more manageable next phase of this litigation.
Personal Jurisdiction. The personal jurisdiction analysis here is governed by ERISA's national service-of-process provision. See 29 U.S.C. § 1132(e)(2). The seminal case in this circuit on this provision—not brought to the Court's attention by any of the parties—is Bellaire General Hospital v. Blue Cross Blue Shield, 97 F.3d 822, 825 (5th Cir. 1996) (providing that where an ERISA action "is brought in a district court of the United States . . . [,] process may be served in any other district where a defendant resides or may be found") (citing 29 U.S.C. § 1132(e)(2)). A number of "circuits have held that national service of process provisions confer nationwide jurisdiction." Med. Mut. of Ohio v. deSoto, 245 F.3d 561, 568 n. 4 (6th Cir. 2001) (citing Bellaire and cases from the Seventh, Eighth, and Second Circuits). The Fifth Circuit is one of those circuits, notwithstanding its expression of "grave misgivings" about ERISA's national service-of-process provision. Dale v. Ala Acquisitions, Inc., 203 F.Supp.2d 694, 699 n.4 (S.D. Miss. 2002). To sum up:
Verizon Employee Benefits Comm. v. Jaeger, No. CIV.A.3:05CV1860L, 2006 WL 2880451, at *3 (N.D. Tex. Sept. 28, 2006).
Because both CFMI and GHMSI indisputably have minimum contacts with the United States, see, e.g., Decl. of Wanda Lessner, the Court's exercise of personal jurisdiction over them is proper. CFMI's and GHMSI's arguments concerning a lack of personal jurisdiction are unavailing.
Venue. The live Complaint invokes only the general venue statute, 28 U.S.C. § 1391, and alleges venue is proper in this district because "a substantial part of the events or omissions giving rise to the claims occurred in this district." Compl. ¶ 3. The Victory Plaintiffs, however, have apparently abandoned that position and argue in response to the motion to dismiss, and in favor of venue in this district, only under ERISA's venue provision. See Resp. at 20; Sur-Reply at 6.
ERISA's venue provision provides that "[w]here an action under this subchapter is brought in a district court of the United States, it may be brought in the district where the plan is administered, where the breach took place, or where a defendant resides or may be found." 29 U.S.C. § 1132(e)(2). The Victory Plaintiffs do not argue that CFMI or GHMSI reside or administer the plans at issue in this district, or that a breach of a plan took place in this district. See Resp. at 20; Sur-Reply at 6. Therefore, to establish the propriety of venue in this district under § 1132(e)(2), the Victory Plaintiffs need to plead facts that could establish that CFI and GHMSI "may be found" in this district.
The Fifth Circuit does not appear to have addressed the circumstances under which a defendant "may be found" in a judicial district for purposes of § 1132(e)(2). The Seventh and Ninth Circuits, however, have held that a party "can be found in a judicial district if it has the sort of `minimum contacts' with that district that would support the exercise of personal jurisdiction." Waeltz v. Delta Pilots Retirement Plan, 301 F.3d 804, 808 (7th Cir. 2002) (citing with approval Varsic v. U.S. District Court for the Cent. District of Cal., 607 F.2d 245, 248 (9th Cir. 1979)). Several district courts in the Fifth Circuit have reached a similar conclusion. See, e.g., Nieves v. Houston Indus., 771 F.Supp. 159, 161 (M.D. La. 1991); Sanders v. State St. Bank & Tr. Co., 813 F.Supp. 529, 533 (S.D. Tex. 1993); Wallace v. Am. Petrofina, Inc., 659 F.Supp. 829, 831-32 (E.D. Tex. 1987). The undersigned is persuaded that a defendant "may be found" for purposes of § 1132(e)(2) in a judicial district where it has minimum contacts.
According to the Victory Plaintiffs, CFMI and GHMSI (along with the other BCBS Defendants) "may be found" in Texas by virtue of their agency relationship with BCBS Texas. See Resp. at 20; Sur-Reply at 6. Specifically, the Victory Plaintiffs allege that "[t]he Blue Cross Entities regularly used Blue Cross Blue Shield of Texas as an agent/representative while dealing with Victory. This included, without limitation, much of the verification of coverage and benefits, pre-certifications, administration of claims and appeals, and benefit/payment determinations described herein." Compl. ¶ 95. "The actions of an agent may establish minimum contacts over a principal." McFadin v. Gerber, 587 F.3d 753, 761 (5th Cir. 2009). Accordingly, the Victory Plaintiffs allege that the BCBS "Defendants are liable for these acts, omissions, and misrepresentations of their agent/authorized representative, Blue Cross Blue Shield of Texas." Compl. ¶ 95. These allegations, which in this procedural posture are taken as true, see Broadway Nat'l Bank v. Plano Encryption Techs., LLC, 173 F.Supp.3d 469, 473 (W.D. Tex. 2016), suffice to show minimum contacts between the BCBS Defendants (via their alleged agent) and the state of Texas. But there still remains an outstanding venue issue.
The parties have neglected to consider that venue is district-specific. See 29 U.S.C. § 1132(e)(2) (authorizing venue in an ERISA action "in the district where the plan is administered, where the breach took place, or where a defendant resides or may be found") (emphasis added). Blue Cross Blue Shield of Texas, the "agent/representative" upon which the Victory Plaintiffs base their venue argument, is located—according to the Victory Plaintiffs—in Richardson, Texas, see Resp. at 20 n. 25, which is located partially in the Northern District of Texas and otherwise in the Eastern District of Texas.
The Victory Plaintiffs, however, should be afforded an opportunity to re-plead to provide additional allegations and venue facts pertinent to whether venue is proper in this district, as they have requested. See, e.g., Williams v. RIP Records, No. CIV.A. H-05-183, 2005 WL 1924181, at *5 (S.D. Tex. Aug. 9, 2005) (recognizing that "[c]ourts can allow a party an opportunity to amend his complaint to support the contention that venue is proper") (citing Brown Schs., 806 F.Supp. at 148 (referencing a previous order allowing a party to amend its complaint and file affidavits in support of its contention that venue was proper in the district)).
The Pending Rule 12(b)(6) Motions and Next Steps. Assuming the District Court agrees with the undersigned's recommendation on CFMI's and GHMSI's 12(b)(3) Motions, CFMI's and GHMSI's Rule 12(b)(6) motions would be rendered moot. Accordingly, the undersigned recommends that CFMI's and GHMSI's Rule 12(b)(6) motions be dismissed as moot, without prejudice to re-filing at a later date if appropriate.
The Victory Plaintiffs also seek leave to amend their Complaint to address other issues raised by various BCBS Defendants' Rule 12(b)(6) arguments. See Resp. at 66. Insofar as the District Court agrees that leave should be granted to amend the Complaint on the venue issue, the undersigned believes leave should be granted to amend the Complaint to address these additional issues as well. As a result, the other BCBS Defendants should expect their pending Rule 12 motions will likewise soon be dismissed as moot, without prejudice to re-filing, assuming the District Court agrees with the undersigned's recommendations and the Complaint is amended.
A pause for such amendment will also provide the parties and the Court an opportunity to streamline and manage this complex litigation, as follows:
For the reasons discussed above, the undersigned recommends that the District Court
The undersigned recommends that the Victory Plaintiffs be permitted to file an amended complaint to address the venue issues discussed above and to cure or clarify other allegations, as requested in their Response. The Victory Plaintiffs should be ordered to file the amended complaint within 30 days from the date the District Court rules on this report and recommendation. The District Court should also direct the parties to refrain from filing any further Rule 12 motions in this case until they receive instructions on whether and how such motions can be filed, which they will receive after a ruling is made on Judge Chestney's report and recommendation in Aetna (and likely after a status conference is held in this case, if one is needed).
The United States District Clerk shall serve a copy of this report and recommendation on all parties by either (1) electronic transmittal to all parties represented by attorneys registered as a "filing user" with the clerk of court, or (2) by mailing a copy by certified mail, return receipt requested, to those not registered. Written objections to this report and recommendation must be filed within fourteen (14) days after being served with a copy of same, unless this time period is modified by the district court. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b). The objecting party shall file the objections with the clerk of the court, and serve the objections on all other parties. A party filing objections must specifically identify those findings, conclusions, or recommendations to which objections are being made and the basis for such objections; the district court need not consider frivolous, conclusory, or general objections. A party's failure to file written objections to the proposed findings, conclusions, and recommendations contained in this report shall bar the party from a de novo determination by the district court. Thomas v. Arn, 474 U.S. 140, 149-52 (1985); Acuña v. Brown & Root, Inc., 200 F.3d 335, 340 (5th Cir. 2000). Additionally, failure to timely file written objections to the proposed findings, conclusions and recommendations contained in this report and recommendation shall bar the aggrieved party, except upon grounds of plain error, from attacking on appeal the unobjected-to proposed factual findings and legal conclusions accepted by the district court. Douglass v. United Servs. Auto. Ass'n, 79 F.3d 1415, 1428-29 (5th Cir. 1996) (en banc).