§Why CasetextPricing

Gerhart et al v. Department of Health And Human Services et al

BRIEF in support of defendants' motion to dismiss

108 Cited authorities

  1. Ashcroft v. Iqbal

    556 U.S. 662 (2009)   Cited 252,784 times   279 Legal Analyses
    Holding that a claim is plausible where a plaintiff's allegations enable the court to draw a "reasonable inference" the defendant is liable

  2. Bell Atl. Corp. v. Twombly

    550 U.S. 544 (2007)   Cited 266,697 times   365 Legal Analyses
    Holding that a complaint's allegations should "contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face' "

  3. Lane v. Pena

    518 U.S. 187 (1996)   Cited 1,872 times
    Holding that any waiver of "sovereign immunity must be unequivocally expressed in statutory text" and "will be strictly construed, in terms of its scope, in favor of the sovereign"

  4. Nat'l Fed'n of Indep. Bus. v. Sebelius

    567 U.S. 519 (2012)   Cited 958 times   67 Legal Analyses
    Holding that the Patient Protection and Affordable Care Act of 2010 was not a valid exercise of the Commerce Clause power after focusing solely on whether it regulated "economic activity" without discussing the remaining Morrison factors

  5. United States v. Mitchell

    463 U.S. 206 (1983)   Cited 2,626 times   2 Legal Analyses
    Holding that "the Tucker Act effects a waiver of sovereign immunity" and observing that "the existence of consent [to be sued] is a prerequisite for jurisdiction"

  6. United States v. Nordic Village, Inc.

    503 U.S. 30 (1992)   Cited 1,783 times   3 Legal Analyses
    Holding that the existence of "plausible" interpretations that would not permit recovery "is enough to establish that a reading imposing monetary liability on the Government is not ‘unambiguous' and therefore should not be adopted"

  7. King v. Burwell

    574 U.S. 988 (2015)   Cited 670 times   40 Legal Analyses
    Holding that Congress did not delegate health insurance policy to Internal Revenue Service

  8. Boyle v. United Technologies Corp.

    487 U.S. 500 (1988)   Cited 1,165 times   28 Legal Analyses
    Holding that where evidence in a civil trial does not suffice to support a jury verdict for plaintiff under a properly formulated defense, judgment may be entered for defendant on appeal despite the fact that defendant did not object to jury instructions "that expressed the defense differently, and in a fashion that would support a verdict"

  9. Bowen v. Massachusetts

    487 U.S. 879 (1988)   Cited 1,039 times   2 Legal Analyses
    Holding that monetary relief was equitable because it sought reimbursement to which the State was allegedly already entitled, rather than money in compensation for losses suffered

  10. Braden v. Wal-Mart Stores

    588 F.3d 585 (8th Cir. 2009)   Cited 1,862 times   6 Legal Analyses
    Holding fiduciary had duty to disclose "complete and accurate material information about the Plan funds and the process by which they were selected"

  11. Rule 12 - Defenses and Objections: When and How Presented; Motion for Judgment on the Pleadings; Consolidating Motions; Waiving Defenses; Pretrial Hearing

    Fed. R. Civ. P. 12   Cited 345,981 times   922 Legal Analyses
    Granting the court discretion to exclude matters outside the pleadings presented to the court in defense of a motion to dismiss

  12. Section 2201 - Creation of remedy

    28 U.S.C. § 2201   Cited 24,534 times   61 Legal Analyses
    Granting district courts the authority to create a remedy with the force of a final judgment

  13. Section 1292 - Interlocutory decisions

    28 U.S.C. § 1292   Cited 22,309 times   193 Legal Analyses
    Granting appellate jurisdiction over the denial of an injunction

  14. Section 1651 - Writs

    28 U.S.C. § 1651   Cited 11,023 times   60 Legal Analyses
    Granting us the power to "issue all writs necessary or appropriate in aid of [our] . . . jurisdiction[] and agreeable to the usages and principles of law"

  15. Section 701 - Application; definitions

    5 U.S.C. § 701   Cited 9,366 times   36 Legal Analyses
    Adopting the definition given in Section 551

  16. Section 702 - Right of review

    5 U.S.C. § 702   Cited 7,053 times   24 Legal Analyses
    Granting judicial review of "agency action"

  17. Section 704 - Actions reviewable

    5 U.S.C. § 704   Cited 4,250 times   31 Legal Analyses
    Granting judicial review over " final agency action"

  18. Section 7421 - Prohibition of suits to restrain assessment or collection

    26 U.S.C. § 7421   Cited 2,002 times   13 Legal Analyses
    Banning injunctions against future tax collection, subject to enumerated exceptions

  19. Section 1012 - Regulation by State law; Federal law relating specifically to insurance; applicability of certain Federal laws after June 30, 1948

    15 U.S.C. § 1012   Cited 1,019 times   29 Legal Analyses
    Establishing an exception to the reverse preemption rule where federal law "specifically relates to the business of insurance."

  20. Section 3713 - Priority of Government claims

    31 U.S.C. § 3713   Cited 257 times   23 Legal Analyses
    Assigning the government's super priority during insolvency

  21. Section 401.607 - Claims collection

    42 C.F.R. § 401.607   Cited 9 times   5 Legal Analyses

    (a)General policy. CMS recovers amounts of claims due from debtors, including interest where appropriate, by- (1) Direct collections in lump sums or in installments; or (2) Offsets against monies owed to the debtor by the Federal government where possible. (b)Collection in lump sums. Whenever possible, CMS attempts to collect claims in full in one lump sum. However, if CMS determines that a debtor is unable to pay the claim in one lump sum, CMS may instead enter into an agreement to accept regular

  22. Section 153.20 - Definitions

    45 C.F.R. § 153.20   Cited 9 times

    The following definitions apply to this part, unless the context indicates otherwise: Alternate risk adjustment methodology means a risk adjustment methodology proposed by a State for use instead of a Federally certified risk adjustment methodology that has not yet been certified by HHS. Applicable reinsurance entity means a not-for-profit organization that is exempt from taxation under Chapter 1 of the Internal Revenue Code of 1986 that carries out reinsurance functions under this part on behalf

  23. Section 153.310 - Risk adjustment administration

    45 C.F.R. § 153.310   Cited 7 times
    Noting that if a state opts for federal risk adjustment administration, it "will forgo implementation of all State functions"

  24. Section 153.405 - Calculation of reinsurance contributions

    45 C.F.R. § 153.405   Cited 3 times   2 Legal Analyses

    (a)In general. The reinsurance contribution required from a contributing entity for its reinsurance contribution enrollees during a benefit year is calculated by multiplying: (1) The number of covered lives of reinsurance contribution enrollees during the applicable benefit year for all plans and coverage described in §153.400(a)(1) of the contributing entity; by (2) The contribution rate for the applicable benefit year. (b)Annual enrollment count. No later than November 15 of benefit year 2014,

  25. Section 153.220 - Collection of reinsurance contribution funds

    45 C.F.R. § 153.220   Cited 1 times

    (a)Collections. If a State establishes a reinsurance program, HHS will collect all reinsurance contributions from all contributing entities for that State under the national contribution rate. (b)Contribution funding. Reinsurance contributions collected must fund the following: (1) Reinsurance payments that will total, on a national basis, $10 billion in 2014, $6 billion in 2015, and $4 billion in 2016; (2) U.S. Treasury contributions that will total, on a national basis, $2 billion in 2014, $2 billion

  26. Section 153.230 - Calculation of reinsurance payments made under the national contribution rate

    45 C.F.R. § 153.230   Cited 1 times

    (a) Eligibility for reinsurance payments under the national reinsurance parameters. A health insurance issuer of a reinsurance-eligible plan becomes eligible for reinsurance payments from contributions collected under the national contribution rate when its claims costs for an individual enrollee's covered benefits in a benefit year exceed the national attachment point. (b) National reinsurance payment parameters. The national reinsurance payment parameters for each benefit year commencing in 2014