ROBERT B. KUGLER, District Judge.
This matter comes before the Court on the motion of Transitions Recovery Program ("Defendant" or "Transitions") for reconsideration of this Court's June 5, 2011 Order denying Defendant's motion to dismiss. In the alternative, Defendant moves for certification of the issue of preemption for interlocutory appeal to the Third Circuit Court of Appeals. Because Defendant has not shown a clear error of law necessitating this Court's reconsideration, and because Defendant has not demonstrated that interlocutory review would materially advance the termination of this litigation, Defendant's motion is denied.
Plaintiff is a not-for-profit health service corporation that provides health coverage and benefits for its subscribers in New Jersey. Plaintiff authorizes the payment of subscribers' claims subject to the conditions, limitations, and exclusions contained in its health benefits plans. Defendant is a drug and alcohol treatment center located in Florida, which provided treatment to subscribers of Plaintiff's health benefit plans, and submitted claims to Plaintiff for payment of that treatment. Plaintiff alleges that, between January 2002 and March 2008, Defendant submitted 8,652 claims to Plaintiff that contained diagnoses of alcohol dependency—a diagnosis whose treatment receives broader coverage from Plaintiff's plans than is afforded to treatment of other substance abuse dependencies and behavioral disorders. Plaintiff alleges that it conducted an audit of Defendant's records and concluded that Defendant misrepresented non-alcohol-related diagnoses as alcohol dependencies in order to receive Horizon's broader coverage.
Plaintiff's Complaint was filed in the Superior Court of New Jersey. Defendant removed the case to this Court, and moved to dismiss under Federal Rule of Civil Procedure 12(b)(6). This Court denied Transitions's motion to dismiss, finding unavailing Defendant's argument that the issue is preempted by two provisions of the Employee Retirement Income Security Act of 1974 ("ERISA")—namely, § 502(a), ERISA's complete preemption provision, and § 514(a), the section of ERISA that provides for express preemption. Defendant now moves for reconsideration only of this Court's finding that Plaintiff's claim is not completely preempted by § 502(a).
In the District of New Jersey, Local Civil Rule 7.1(i) governs motions for reconsideration.
In order to prevail on a motion for reconsideration, the moving party must show: "(1) an intervening change in the controlling law; (2) the availability of new evidence that was not available when the court [made its initial decision]; or (3) the need to correct a clear error of law or fact or to prevent manifest injustice."
A litigant may apply for interlocutory review of an otherwise non-appealable district court order by petitioning the district court to certify its order to the appropriate appellate court pursuant to 28 U.S.C. § 1292(b).
Defendant bases its motion for reconsideration on "the need to correct a clear error of law or fact to prevent manifest injustice."
In its Opinion denying Defendant's motion to dismiss, the Court determined that Horizon qualifies as a "fiduciary" for the purposes of § 502(a), and then went on to find that, because Plaintiff seeks money damages as the remedy for its fraud claim, Plaintiff cannot pursue its desired relief under ERISA's civil enforcement mechanism (§ 502(a)(3)), and therefore could not be completely preempted by ERISA. In arguing that "the Court should not have considered whether the ultimate relief being sought would be available under ERISA," Def. Br. 3, Transitions rearticulates an argument that the Court considered in its Opinion.
Thus Defendant now seeks to bolster the argument considered and dismissed by this Court in its Opinion. However, a motion for reconsideration is not a proper forum for such reargument. The case law defining the scope of motions for reconsideration in the District of New Jersey is clear: a party moving for reconsideration "must show that dispositive factual matters or controlling decisions of law were overlooked by the court in reaching its prior decision."
Here, by contrast, jurisdiction is based upon diversity of the parties, pursuant to 28 U.S.C. § 1332; thus the
Interlocutory appellate review of this decision would not materially advance the termination of this dispute, because even reversal by the Third Circuit would still leave Plaintiff's claim unresolved. As Plaintiff explains, "[c]ertification will not advance the termination of this matter because the controlling issue is whether Defendant's submission of claims constitutes fraud, an issue that must be decided regardless of whether Horizon seeks equitable or legal relief." Pl. Br., 7. Accordingly, Defendant has not made the requisite showing that the "exceptional" grant of interlocutory appeal is warranted in this case.
For the foregoing reasons, Defendant's motion for reconsideration or, in the alternative, certification for interlocutory appeal, is