The Regents of The University of California v. Triple S Steel Holdings Inc et al

NOTICE OF MOTION AND MOTION to Dismiss Case to Plaintiff's First Amended Complaint

C.D. Cal.September 30, 2016

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2592542v.1 Gary S. Pancer (State Bar No. 160223) Email: gary.pancer@wilsonelser.com Donald P. Sullivan (State Bar No. 191080) Email: donald.sullivan@wilsonelser.com WILSON, ELSER, MOSKOWITZ, EDELMAN & DICKER LLP 555 S. Flower Street, Suite 2900 Los Angeles, California 90071 Telephone:(213) 443-5100 Facsimile: (213) 443-5101 Attorneys for Defendant TRIPLE S STEEL HOLDINGS, INC. UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA SOUTHERN DIVISION THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, a public trust corporation, on behalf of the University of California, Irvine Medical Center, Plaintiff, v. TRIPLE S STEEL HOLDINGS, INC, a Texas for Profit Corporation; and DOES 1 through 25, INCLUSIVE, Defendants. ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Case No. 16-cv-01408 DOC FFM DEFENDANT’S NOTICE OF MOTION AND MOTION TO DISMISS TO PLAINTIFF’S FIRST AMENDED COMPLAINT Date: November 7, 2016 Time: 8:30 a.m. Place: Courtroom 9D Judge: Hon. David O. Carter / / / / / / / / / Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 1 of 16 Page ID #:368 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 2592542v.1 NOTICE OF MOTION AND MOTION TO DISMISS TO PLAINTIFFS the Regents of the University of California, and its Attorneys of Record: PLEASE TAKE NOTICE, that on November 7, 2016 at 8:30 am, or as soon thereafter as the matter may be heard, in Courtroom 9D of the above- referenced Court, located at 411 West Fourth Street, Santa Ana, California, 92701-4516, Defendant Triple S Steel Holdings, Inc., will and hereby does move for an Order from the Court pursuant to Federal Rules of Civil Procedure 12(b)(6) dismissing the First Amended Complaint in this action. This Motion is made on the ground that the Complaint does not state a claim against Defendant Triple S Steel Holdings, Inc., for which relief can be granted because the purported cause of action is preempted by the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. section 1001, et seq. To the extent the state-law cause of action is not preempted, it must still be dismissed because Plaintiff has failed to meet the federal pleading standards mandated by Federal Rule of Civil Procedure 8. This Motion will be based on this Notice of Motion and Motion, the Memorandum of Points and Authorities, and the previously-filed Declaration of Leonard Abrams, the pleadings and papers on file herein, as well as such other oral and documentary evidence as may be presented at the hearing of this Motion. / / / / / / / / / Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 2 of 16 Page ID #:369 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 2592542v.1 Local Rule 7-3 Certification This Motion is made following a conference of counsel, pursuant to L.R. 7- 3, which took place on September 29 and 30, 2016. Date: September 30, 2016 By: /s/ Gary S. Pancer Gary S. Pancer Donald P. Sullivan WILSON, ELSER, MOSKOWITZ, EDELMAN & DICKER LLP 555 S. Flower Street, Suite 2900 Los Angeles, California 90071 Tel: (213) 443-5100 / Fax: (213) 443-5101 Em: gary.pancer@wilsonelser.com EM: donald.sullivan@wilsonelser.com Attorneys for Defendant TRIPLE S STEEL HOLDINGS, INC Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 3 of 16 Page ID #:370 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4 2592542v.1 TABLE OF CONTENTS I. INTRODUCTION ........................................................................................... 7 II. FACTS AND ALLEGATIONS ...................................................................... 7 III. ARGUMENT .................................................................................................. 9 A. Plaintiff’s State Law Quantum Meruit Claim Is Conflict Preempted by ERISA ............................................................................ 9 B. Plaintiff Fails to Allege Sufficient Factual Matter to State Claim for Quantum Meruit ............................................................................ 13 IV. CONCLUSION ............................................................................................. 16 Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 4 of 16 Page ID #:371 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 5 2592542v.1 TABLE OF AUTHORITIES CASES Ashcroft v. Iqbal 556 U.S. 662 (2009) ................................................................................. 13, 14, 15 Bell Atlantic Corp. v. Twombly 550 U.S. 544, 555 (2007)............................................................................... 13, 14 Curtiss-Wright Corp v. Schoonejongen 514 U.S. 73 (1995) ............................................................................................... 11 Day v. Alta Bates Med. Ctr. 98 Cal. App. 4th 243 (2002) .......................................................................... 14, 15 Fresno Community Hosp. & Med. Ctr. v. Souza, No. CVF07-0325, 2007 U.S. Dist. LEXIS 56048, at *11-16 (E.D. Cal. July 23, 2007) .................................................................... 10 Ingersoll-Rand Co. v. McClendon 498 U.S. 133 (1990) ............................................................................................. 10 Kanne v. Conn. Gen. Life Ins. Co. 867 F.2d 489 (9th Cir. 1988) ............................................................................... 10 Lodi Mem’l Hosp. Ass’n v. Tiger Lines, LLC No. 2:15-cv-00319, 2015 U.S. Dist. LEXIS 110495 at *19 (C.D. Cal. Aug. 20, 2015) ......................................................................... 10 Maglica v. Maglica 66 Cal.App.4th 442 (1998). ................................................................................. 14 Marin Gen. Hosp. v. Modesto & Empire Traction Co., 581 F.3d 941 (9th Cir. 2009) ........................................................................... 9, 12 Mass. Mut. Life Ins. Co. v. Russell 473 U.S. 134 (1985) ............................................................................................. 11 Metro. Life Ins. Co. v. Taylor 481 U.S. 58 (1987) ................................................................................................. 9 Olson v. Gen. Dynamics Corp. 960 F.2d 1418 (9th Cir. 1991) ............................................................................. 10 Peralta v. Hispanic Business, Inc. 419 F.3d 1064 (9th Cir. 2005) ............................................................................. 10 Pilot Life Ins. Co. v. Dedeaux 481 U.S. 41 (1987) ................................................................................................. 9 Shaw v. Delta Airlines, Inc. 463 U.S. 85 (1983) ................................................................................................. 9 Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 5 of 16 Page ID #:372 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 6 2592542v.1 Starr v. Baca 652 F.3d 1202 (9th Cir. 2011) ............................................................................. 14 The Meadows v. Employers Health Insurance 47 F.3d 1006 (9th Cir. 1995) ............................................................................... 12 U.S. Airways, Inc. v. McCutchen 133 S. Ct. 1537 (2013) ......................................................................................... 11 Zavala v. Trans-System 258 Fed. Appx. 155 (9th Cir. 2007) .............................................................. 10, 15 STATUTES 29 U.S.C. § 1144(a). .................................................................................................. 9 Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 6 of 16 Page ID #:373 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 7 2592542v.1 MEMORANDUM OF POINTS AND AUTHORITIES I. INTRODUCTION In its Amended Complaint, Plaintiff seeks to recover additional payment from Triple S for medical services provided to the Patient, who is a participant in the ERISA-governed employee welfare benefit plan sponsored and administered by Triple S. Plaintiff’s purported state law quantum meruit claim is based on Triple S’s alleged issuance of a treatment authorization number. However, unlike cases in which medical providers assert state law claims to enforce actual promises to cover certain procedures and pay certain charges, Plaintiff had failed to allege that Triple S took any action or made any statement inconsistent with issuing an alleged treatment authorization number. Plaintiff merely wants more money for the services it provided to the Patient. Unfortunately for Plaintiff, the benefits available to him/her under the ERISA plan for medical services are governed by the terms of that ERISA plan. Plaintiff’s state law claim is premised and depends for its survival upon the existence of the ERISA plan; therefore, it is conflict preempted by ERISA and should be dismissed. In fact, if claims such as the one asserted by Plaintiff are not preempted, the entire body of ERISA law would be gutted and employers sponsoring and administering ERISA plans would be liable to employees for unplanned and unknown amounts. Even if Plaintiff’s claim is not preempted by ERISA, which it is, the Court should still dismiss the Amended Complaint because Plaintiff fails to plead sufficient factual matter to show either of the two elements of a state law claim for quantum meruit. II. FACTS AND ALLEGATIONS Defendant Triple S Steel Holdings, Inc., sponsors and administers the Triple S Steel Holdings, Inc. Health Plan (the “Plan”), which provides medical benefits to its employees and their eligible dependents. See Declaration of Leonard Abrams (“Abrams Decl.”), ¶ 2, ECF No. 7-1, pp.1-6; Plan Document and Summary Plan Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 7 of 16 Page ID #:374 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 8 2592542v.1 Description (“Plan Document”), ECF No. 1-2, at p.4;1 Amended Complaint, ECF No. 12, at ¶ 2. The Plan is self-funded by Triple S. See Plan Document, ECF No. 1-2, at p.4; Amended Complaint, ECF No. 12, at ¶ 7. Plaintiff, The Regents of the University of California, alleges that University of California, Irvine Medical Center provided medical services to a patient identified by the initials P.K. (the “Patient”). Amended Complaint, ECF No. 12, at ¶ 9. Plaintiff alleges that the Patient was covered by the Plan. Amended Complaint, ECF No. 12, at ¶ 7. After allegedly providing services to the Patient, Plaintiff billed the Plan in the amount of $297,590 for those services. Amended Complaint, ECF No. 12, at ¶¶ 10-11. According to Plaintiff, the Plan paid $65,459.80 for the services allegedly provided to the Patient. Amended Complaint, ECF No. 12, at ¶ 12. Plaintiff asserts the Plan should have paid an additional $232,130.20, and it seeks to collect that amount from Plaintiff in this action. Amended Complaint, ECF No. 12, at ¶ 13. Plaintiff alleges it treated the Patient at “Triple S’s implied and/or express request.” Amended Complaint, ECF No. 12, at ¶ 16. According to Plaintiff, Triple S made such request “by its words and/or conduct,” but the only action Plaintiff actually alleged was that Triple S’s issued “treatment authorization number 1340460.” Amended Complaint, ECF No. 12, at ¶ 15. Plaintiff further alleged the services provided benefitted the Patient “and, therefore, Triple S.” Amended Complaint, ECF No. 12, at ¶ 17. Finally, Plaintiff alleges Triple S is obligated to pay Plaintiff for the services provided to the Patient because the Patient was covered by the Plan. Amended Complaint, ECF No. 12, at ¶¶ 8, 11-13. 1 As this Court previously recognized, although evaluation of a Rule 12(b)(6) motion is typically limited to the contents of the complaint, the Court may also consider documents “whose contents are alleged in a complaint and whose authenticity no party questions, but which are not physically attached to the pleading.” Branch v. Tunnell, 14 F.3d 449, 454 (9th Cir. 1994), overruled on other grounds by 307 F.3d 1119, 1121 (9th Cir. 2002). Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 8 of 16 Page ID #:375 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9 2592542v.1 III. ARGUMENT The Court should dismiss Plaintiff’s Amended Complaint for two independent reasons. First, Plaintiff’s state law claim for quantum meruit is conflict preempted by ERISA. Unlike complete preemption, which is a jurisdictional doctrine conferring federal subject matter jurisdiction on federal courts, conflict preemption is an affirmative defense warranting dismissal of the preempted claim. Second, even if the purported state law claim is not preempted, Plaintiff has not pled facts sufficient to show Triple S requested that Plaintiff provide services to the Patient or that the provision of such services conferred a benefit on Triple S, which are the two elements of a cause of action for quantum meruit. A. Plaintiff’s State Law Quantum Meruit Claim Is Conflict Preempted by ERISA ERISA contains two types of preemption: complete preemption and conflict preemption. Marin Gen. Hosp. v. Modesto & Empire Traction Co., 581 F.3d 941, 945-46 (9th Cir. 2009). Complete preemption is a jurisdictional doctrine, not at issue in this motion to dismiss, while conflict preemption is a substantive defense warranting dismissal of state law claims. Id. The tests for complete preemption and conflict preemption are distinct; thus, a claim that is not completely preempted may nevertheless be conflict preempted. Id. at 946. ERISA’s conflict preemption clause states that ERISA “shall supersede any and all State laws insofar as they now or hereafter relate to any employee benefit plan . . . .” 29 U.S.C. § 1144(a). State laws “relate to” an employee benefit plan if they have a connection with or reference to such plan. Shaw v. Delta Airlines, Inc., 463 U.S. 85, 96-97 (1983). State common law tort and contract actions asserting improper processing of a claim for benefits under an employee benefit plan are preempted by ERISA. 29 U.S.C. § 1144(a); Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 48 (1987); Metro. Life Ins. Co. v. Taylor, 481 U.S. 58, 62 (1987). State Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 9 of 16 Page ID #:376 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 10 2592542v.1 laws relate to an ERISA plan for purposes of preemption, “even if the law is not specifically designed to affect such plans, or the effect is only indirect.” Ingersoll- Rand Co. v. McClendon, 498 U.S. 133, 139 (1990). ERISA preempts state law claims that require interpretation of an ERISA plan or ERISA law. Peralta v. Hispanic Business, Inc., 419 F.3d 1064, 1069 (9th Cir. 2005). State law tort and implied contract remedies are conflict preempted even when ERISA does not authorize a similar cause of action. Olson v. Gen. Dynamics Corp., 960 F.2d 1418, 1424 (9th Cir. 1991). ERISA preempts state law causes of action based on alleged improper payment of claims for medical benefits, as alleged here. Kanne v. Conn. Gen. Life Ins. Co., 867 F.2d 489, 493 (9th Cir. 1988); Fresno Community Hosp. & Med. Ctr. v. Souza, No. CVF07-0325, 2007 U.S. Dist. LEXIS 56048, at *11-16 (E.D. Cal. July 23, 2007). A hospital’s state law quantum meruit claims are preempted when they depend upon the obligations under the ERISA plan and require an interpretation of the Plan’s terms. Souza, 2007 U.S. Dist. LEXIS 56048, at *15- 16. Such claims are preempted because the ERISA plan was the basis for the claims and the entitlement to receive benefits. Id. at 15. As one district court recently held, when the gravamen of the state law claim is the improper payment of benefits, the state law claim is conflict preempted. Lodi Mem’l Hosp. Ass’n v. Tiger Lines, LLC, No. 2:15-cv-00319, 2015 U.S. Dist. LEXIS 110495, at *19 (C.D. Cal. Aug. 20, 2015). If the existence of the ERISA plan is essential to the claim’s survival, the claim is preempted. Zavala v. Trans-System, 258 Fed. Appx. 155, 157 (9th Cir. 2007). Here, Plaintiff’s state law claim is based entirely on the existence of the Plan because its right to any payment is dependent upon the Plan’s terms and existence. Aside from alleging that it provided treatment to a Plan participant and the Plan paid less than Plaintiff desired, the only other allegation contained in the Amended Complaint is that Triple S issued “treatment authorization number 1340460.” See Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 10 of 16 Page ID #:377 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 11 2592542v.1 Amended Complaint, ECF 12, at ¶ 15. Significantly, Plaintiff does not allege that Triple S later denied that the treatment was authorized; rather, Plaintiff alleges that Triple S paid for the authorized treatment, but did so at an amount lower than Plaintiff desired. ERISA plans routinely provide authorizations for treatment, but such authorizations merely indicate that the ERISA plan covers the contemplated service and do not obligate the plan to pay whatever amount the provider charges. The obligation of an ERISA plan to pay for benefits is controlled by the terms set forth in the ERISA plan documents. See U.S. Airways, Inc. v. McCutchen, 133 S. Ct. 1537, 1548 (2013) (“The plan, in short, is at the center of ERISA”); Curtiss-Wright Corp v. Schoonejongen, 514 U.S. 73, 83 (1995) (ERISA “is built around reliance on the fact of written plan documents”); Mass. Mut. Life Ins. Co. v. Russell, 473 U.S. 134, 148 (1985) (ERISA’s principal function is to “protect contractually defined benefits”). Because Plaintiff does not allege any facts creating an obligation to pay an amount different than that which is set forth in the Plan Document, Plaintiff’s claim for additional payment is not merely related to the Plan Document, but controlled by it. See McCutchen, 133 S. Ct. at 1548. If the mere authorization of treatment created a cause of action for quantum meruit to pay an amount different than the amount defined by the ERISA plan, the terms of ERISA plans and the entire body of well-delineated federal ERISA law would be displaced by state law quantum meruit claims. If Plaintiff’s claim against Triple S for quantum meruit, based solely on the preauthorization of treatment, is not preempted by ERISA, then any ERISA plan sponsor is subject to unpredictable, non-contractual liability for medical services provided to participants of the plan it sponsors. In short, state law quantum meruit claims would preempt ERISA plan language, which is clearly improper and contrary to controlling law and Congressional intent in drafting ERISA to include a purposefully broad preemption provision. Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 11 of 16 Page ID #:378 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 12 2592542v.1 Holding that Plaintiff’s quantum meruit claim is conflict preempted is not inconsistent with The Meadows v. Employers Health Insurance, 47 F.3d 1006 (9th Cir. 1995). That case is inapposite for two reasons. First, Meadows is about federal subject matter jurisdiction and the complete preemption doctrine. Id. at 1007. The Ninth Circuit was asked to decide whether the district court properly remanded the case to state court for lack of subject matter jurisdiction. Id. Since issuing the Meadows decision, the Ninth Circuit has remarked that case was decided on the basis of complete preemption, and not conflict preemption. See Marin, 581 F.3d at 946 (9th Cir. 2009). The tests for complete preemption and conflict preemption are different, such that the analysis in a complete preemption case like Meadows is inapposite in a conflict preemption case like this one. Id. Second, the claim that was not preempted in Meadows was based on the ERISA plan’s failure to act in accordance with its authorization. Here, Plaintiff does not complain Triple S revoked its prior authorization, as was the case in Meadow; instead, Plaintiff merely claims it was not paid enough for the authorized services. In Meadows, the defendant verified coverage of a patient over the phone, then signed a letter confirming that patient was covered under the ERISA plan. Meadows, 47 F.3d at 1007. With respect to another patient, the defendant twice confirmed that the patient was covered over the phone. Id. at 1008. In actuality, the patients were not covered by the ERISA plan. Id. at 1009. Accordingly, the defendant denied payment on the basis that the patients were not covered. Id. at 1008. The provider asserted claims for negligent misrepresentation, estoppel, and breach of contract premised on the defendant’s failure to honor its representation that the patients were covered. Id. The similarities between Meadows and the instant case end with the fact that Triple S allegedly authorized treatment. Unlike the defendant in Meadows, Triple S has never contended the Patient is not covered. In fact, Triple S has acted consistently with the alleged authorization by treating the services provided to the Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 12 of 16 Page ID #:379 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 13 2592542v.1 Patient as authorized services and paying for them pursuant to the terms of the Plan Document. In Meadows, the plaintiff merely sought to bind the defendant to its promise that the patients were covered and that the plan would pay billed charges for the servives; here, Triple S has abided by its alleged promise that the services were authorized. In this action, Plaintiff is not seeking to hold Triple S to its alleged authorization, but rather seeking to obtain additional benefits under the Plan for the services. The authorization has nothing to do with the amount of the payment for the services. At its core, Plaintiff’s quantum meruit claim merely seeks additional benefits under the Plan. Plaintiff does not allege any promise outside the terms of the Plan to pay those additional benefits. Thus, Plaintiff’s claim is dependent upon the Plan Document and the existence of the Plan. The Court should hold that Plaintiff’s quantum meruit claim is conflict preempted and dismiss the Amended Complaint. B. Plaintiff Fails to Allege Sufficient Factual Matter to State Claim for Quantum Meruit Even if ERISA does not conflict preempt Plaintiff’s quantum meruit claim, the Court should still dismiss the Amended Complaint for failure to state a claim upon which relief can be granted under state law. To survive a Rule 12(b)(6) motion to dismiss, the plaintiff must plead “more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007). The plaintiff must plead enough factual matter to “raise a right to relief above the speculative level” and “raise a reasonable expectation that discovery will reveal evidence supporting” the claim. Id. at 555-56. “[N]aked assertions devoid of further factual enhancement” are not sufficient to survive a 12(b)(6) motion. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 557). Allegations that are “no more than conclusions[] are not entitled to the assumption of truth.” Iqbal, 556 U.S. at 679. Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 13 of 16 Page ID #:380 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 14 2592542v.1 “[A]llegations in a complaint or counterclaim may not simply recite the elements of a cause of action, but must contain sufficient allegations of underlying facts to give fair notice and to enable the opposing party to defend itself effectively.” Starr v. Baca, 652 F.3d 1202, 1216 (9th Cir. 2011). The complaint must state a “plausible claim for relief.” Iqbal, 556 U.S. at 679. Conclusory allegations do not “unlock the doors of discovery.” Id. at 678-79. The well-pled factual allegations of the complaint “must plausibly suggest an entitlement to relief, such that it is not unfair to require the opposing party to be subjected to the expense of discovery and continued litigation. Starr, 652 F.3d at 1216. The plausibility assessment is a “context-specific task” requiring courts to analyze well-pled factual matter against the elements of the cause of action while employing its “judicial experience and common sense.” Id. Turning to the elements of the claim asserted by Plaintiff, a claim for quantum meruit requires the plaintiff to allege “both that he or she was acting pursuant to either an express or implied request for such services from the defendant and that the services rendered were intended to and did benefit the defendant. Day v. Alta Bates Med. Ctr., 98 Cal. App. 4th 243, 248 (2002) (emphasis in original). “[W]hen services are rendered by the plaintiff to a third person, the courts have required that there be a specific request from the defendant.” Id. at 249. The plaintiff’s ability to show it conferred a benefit on the defendant is “integral to recovery in quantum meruit.” Maglica v. Maglica, 66 Cal.App.4th 442, 450 (1998). The Court should dismiss Plaintiff’s quantum meruit claim because Plaintiff fails to allege sufficient factual matter to show either a benefit conferred on Triple S or that Triple S expressly requested Plaintiff to provide services to the Patient. Plaintiff’s Amended Complaint is based almost entirely upon formulaic recitations of the cause of action and conclusory statements, neither of which should be considered by the Court when deciding this motion to dismiss. See Twombly, 550 Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 14 of 16 Page ID #:381 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 15 2592542v.1 U.S. at 555; Iqbal, 556 U.S. at 679. Accordingly, allegations of “Triple S’s implied and/or express request,” Triple S’s request “by its words and/or conduct,” providing a benefit to the Patient “and therefore Triple S,” are not entitled to any presumption of truth and can be disregarding when evaluating the sufficiency of the Amended Complaint. Aside from the facts pertaining to the existence of the Plan, the Patient’s eligibility under the Plan, Plaintiff’s provision of services to the Patient, the submission of a bill to the Plan, and the Plan’s payment, the only well-pled factual allegation is Triple S’s alleged “issuance of treatment authorization number 1340460.” See Amended Complaint, ECF No. 12, at ¶¶ 2, 7-12, 15. The allegation that Triple S authorized treatment does not sufficiently allege Triple S requested services. When a plaintiff provides services to a third person, the request must be express and cannot be implied. See Day, 98 Cal.App.4th at 249. Merely authorizing services is not an express request for services. At best, an authorization is an implicit request, but it is not even necessarily that. Because an implicit request is not sufficient to support Plaintiff’s claim for quantum meruit against Triple S, the Amended Complaint fails to state a claim. See id. Plaintiff also fails to allege facts to show the second element of a claim for quantum meruit: a benefit conferred on Triple S. The only allegation related to any benefit purportedly conferred on Triple S is the conclusory allegation that since the services benefitted the Patient, they also benefitted Triple S. Amended Complaint, ECF No. 12, at ¶ 17. Such blanket assertions without factual development cannot be considered on a motion to dismiss. See Iqbal, 556 U.S. at 678. Not only does Plaintiff fail to allege any facts showing a benefit to Triple S, but it is clear that outside of the existence of the ERISA Plan, Triple S does not benefit from services provided to the Patient. Of course, if the benefit is dependent upon the existence of an ERISA plan, the claim depends for its survival on the Plan and is, therefore, conflict preempted. See, e.g., Zavala, 258 Fed. Appx. at 157. There is no reason Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 15 of 16 Page ID #:382 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 16 2592542v.1 that providing medical services to the Patient confers a benefit upon Triple S- particularly where, as Plaintiff alleges, Triple S becomes obligated to pay for those services. In sum, Plaintiff failed to allege any factual matter showing a benefit conferred on Triple S and the only conceivable benefit to Triple S possibly implicated by this scenario arises if at all from the existence of the Plan. To the extent some benefit is conferred on Triple S solely because of the existence of an ERISA plan, the quantum meruit claim is conflict preempted by ERISA. IV. CONCLUSION For the foregoing reasons, the Court should dismiss the Amended Complaint with prejudice. Date: September 30, 2016 By: /s/ Gary S. Pancer Gary S. Pancer Donald P. Sullivan WILSON, ELSER, MOSKOWITZ, EDELMAN & DICKER LLP 555 S. Flower Street, Suite 2900 Los Angeles, California 90071 Tel: (213) 443-5100 / Fax: (213) 443-5101 Email: gary.pancer@wilsonelser.com Email: donald.sullivan@wilsonelser.com Attorneys for Defendant TRIPLE S STEEL HOLDINGS, INC. Case 8:16-cv-01408-DOC-FFM Document 13 Filed 09/30/16 Page 16 of 16 Page ID #:383 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 1637343v.1 UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA SOUTHERN DIVISION THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, a public trust corporation, on behalf of the University of California, Irvine Medical Center, Plaintiff, v. TRIPLE S STEEL HOLDINGS, INC, a Texas for Profit Corporation; and DOES 1 through 25, INCLUSIVE, Defendants. ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Case No. 16-cv-01408 DOC FFM [PROPOSED] ORDER GRANTING MOTION TO DISMISS FIRST AMENDED COMPLAINT The Motion to Dismiss Plaintiff’s First Amended Complaint filed in this action by Defendant Triple S Steel Holdings, Inc., came on for hearing before this Court on November 7, 2016. Having considered the Parties’ respective arguments / / / / / / / / / Case 8:16-cv-01408-DOC-FFM Document 13-1 Filed 09/30/16 Page 1 of 2 Page ID #:384 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 1637343v.1 and good cause appearing, this Court Orders that Defendant’s Motion is hereby GRANTED and Plaintiff’s First Amended Complaint is dismissed WITH PREJUDICE. The Clerk of the Court is hereby instructed to close the case. IT IS SO ORDERED: Date: The Honorable David O. Carter United States District Judge Case 8:16-cv-01408-DOC-FFM Document 13-1 Filed 09/30/16 Page 2 of 2 Page ID #:385