Opinion
CIVIL ACTION No. 03-2136 Sect. "T" (3)
December 4, 2003
ORDER AND REASONS
Before this Court is the Defendants Motion for Reconsideration of this Court's Order of October 1, 2003, granting the Plaintiffs Motion for Remand. Oral arguments were not heard. The Court, having heard the arguments of counsel, and having studied the legal memoranda and exhibits submitted by the parties and the applicable law, is fully advised on the premises and ready to rule.
ORDER AND REASONS
I Background
On October 1, 2003, this Court issued an Order in which it granted the Plaintiffs Motion to Remand the above-captioned matter back to state court. The Defendants filed the present Motion for Reconsideration, claiming that the Court erred in several respects in denying their Motion to Remand. Specifically, the Defendants allege that the Court erred in determining that preemption under ERISA is not applicable.
II The Law on Motions for Reconsideration
The Federal Rules of Civil Procedure provide that any party may file a motion to alter or amend a judgment within ten business days after its entry. See FED. R. CIV. P. 59; Lavespere v. Niagara Mach. Tool Works, Inc., 910 F.2d 167, 173 (5th Cir. 1990);First Commonwealth Corp, v. Hibernia Nat. Bank of New Orleans, 891 F. Supp. 290 (E.D. La. 1995), amended 896 F. Supp. 634, affirmed 85 F.3d 622. Under Rule 59, a district court enjoys considerable discretion in granting or denying such a motion. Lafargue v. Jefferson Parish. 200 WL 174899, *1 (E.D. La. 2000) (citingLavespere, 910 F.2d at 174). There are certain grounds upon which a Court may grant a Rule 59 motion for reconsideration or to alter or amend the judgment. 200 WL 174899 at *1. In any case in which a party seeks to upset a summary judgment on the basis of evidence that was not introduced on time, two important judicial imperatives clash the need to bring litigation to an end and the need to render just decisions on the basis of all the facts. Id. at * 1. The task of the district court in such a case is to strike the proper balance between these competing interests. Id. at * 1 (citation omitted). In order to do this, the court should consider, among other things, the reasons for the moving party's default, the importance of the omitted evidence to the moving party's case, whether the evidence was available to the non-movant before responding to the summary judgment motion, and the likelihood that the nonmoving party will suffer unfair prejudice if the case is reopened. Id. at * 1 (citation omitted). It is important to note that reconsideration is an "extraordinary remedy which should be used sparingly and should not be used to relitigate old matters, raise new arguments, or present evidence that could have been raised prior to the entry of judgment." Id.
III. Discussion and Analysis
The main thrust of the defendants arguments constitute a rehashing of the previously presented ones. As such, the reasons for the dismissal previously expressed by the Court stand and will not be disturbed. The defendant's argument that this Court failed to properly interpret the facts in light of when a claim necessarily "relates to" an ERISA plan is meritless.
In their primary point of error, defendants argue that the Court's reliance on Jefferson Parish Hosp. Service Dist. No. 2, Parish of Jefferson State of La. v. Principal Health Care of Louisiana, Inc., 934 F. Supp. 206 (E.D. La. 1996) and progeny, is misplaced. Defendants rely heavily on cases that are not binding on this court, specifically,Metroplex Infusion Care, Inc. v. Lone Star Container Corp., 855 F. Supp. 897 (N.D. Tex. 1994). As in the Jefferson progeny, the facts of Metroplex are strikingly similar to those of the present case. Plaintiff-appellant Metroplex received payments for services under an ERISA plan, but sought additional payment on the basis of the defendant's alleged representations regarding the extent of coverage and their subsequent processing of Metroplex's claims. 855 F. Supp. at 901 (emphasis added). The Texas court held that representations made to a health care provider regarding coverage "relate to" an ERISA plan for purposes of ERISA preemption if they concern the nature of the coverage under the plan, but not if they concern the availability of coverage.Id. Thus, the Metroplex Court ruled that state law claims for breach of contract, fraud and quantum meruit were subject to preemption even though they were brought by Metroplex in its independent capacity. Id. Yet, Metroplex is not binding on this court.
The Fifth Circuit has a general test for a cause of action that is preempted by ERISA. ERISA preemption is applicable when:
(1) the state law claim addresses an area of exclusive federal concern, such as the right to receive benefits under the terms of an ERISA plan; and
(2) the claim directly affects the relationship between the traditional ERISA entities-the employer, the plan and its fiduciaries, and the participants and beneficiaries. Jefferson Parish Hospital Service Dist. No. 2, Parish of Jefferson, State of Louisiana v, Principle health Care of Louisiana, Inc., 934 F. Supp. 206, 207 (E.D. La. 1996) (citing Hubbard v. Blue Cross Blue Shield, 42 F.3d 942 (5th Cir. 1995).
The defendant fails to meet the first prong of ERISA preemption because it does not address the right to receive benefits under the terms of an ERISA plan. Although the defendant argues that it is suing for the calculated amount of benefits that were available to Mr. Short under his ERISA plan, this Court finds, as the Fifth Circuit instructs, that the amount of damages equal to the amount of benefits the defendants could potentially receive is insufficient to require a finding of preemption. Jefferson Parish Hospital Dist. No. 2 v. Central States, Southeast and Southwest Areas Health and Welfare Fund, 814 F. Supp. 25, 27 (E.D. La. 1993) (emphasis added). In addition, the defendant does not fall within the second prong because it is not a traditional ERISA entity. The defendant's statuts as a health maintenance organizastion does not qualify it as a participant in an ERISA plan. Since the defendants remain unable to meet either prong of the general test employed by this Circuit, preemption cannot be granted.
The defendant in this case places great significance on the fact that the HDS and OHP had a contractual relationship in that they had entered into a health maintenance organization agreement. However, this Circuit has ruled on this issue and has held that the presence of an HMO agreement between an ERISA health care provider and a third party hospital does not take a cause of action into ERISA. See generally, Principal Health Care of Louisiana, Inc., 934 F. Supp. at 209. This is a distinction without a difference. The terms of the HMO agreement between the parties does not mean that the matter before this Court concerns the right to receive benefits under the terms of an ERISA plan. See id. at 209. There is a prevailing viewpoint on the availability of a hospital's right to recover in this Circuit-Congress did not intent ERISA to regulate commercial transactions between a third party health care provider who sues an ERISA health insurer. See id. at 209. Where the plaintiff is a third party health care provider suing non-derivatively, preemption does not necessarily occur-and should not occur in the present case. See id. at 209 (referring. The Meadows v. Employers Health Ins., 826 F. Supp. 1225, 1231 (D. Ariz. 1993).
Any assertions that Rodrigue v. Western and Southern Life Ins. Co., applies to the present case is unfounded. See generally, 948 F.2d 969 (5th Cir. 1991). Rodrigue addressed federal preemption in the situation where the plaintiff, a participant in an ERISA plan, received treatment for ailments not covered under his ERISA plan provider. Id. Clearly, Rodrigue involved traditional ERISA entities, and does not relate to the facts of this case, which involve an independent plan provider. Id.
IV. Conclusion
In conclusion, for the reasons stated above, this Court finds that none of the Defendants arguments fall within any of the circumstances set forth above that justify reconsideration. They have failed to show any changes in the factual circumstances or controlling law to support the notion that this Courts Order of October 1, 2003, was erroneous. Furthermore, the Defendants have failed to prove that this Court's prior Order contained a clear error of law warranting reconsideration. Finally, the Defendants failed to show that a failure to reconsider the Order of October 1, 2003, would work an unfair prejudice upon the parties.
Accordingly, IT IS ORDERED that Defendants Motion for Reconsideration be, and the same is hereby
DENIED.