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Tri State Advanced Surgery Center LLC et al v. Health Choice LLC et al

RESPONSE in Opposition re MOTION TO DISMISS FOR FAILURE TO STATE A CLAIM Plaintiffs' Response in Opposition to Motion to Dismiss

35 Cited authorities

  1. Ashcroft v. Iqbal

    556 U.S. 662 (2009)   Cited 254,855 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. Silva v. Metro. Life Ins. Co.

    762 F.3d 711 (8th Cir. 2014)   Cited 228 times   4 Legal Analyses
    Holding that ERISA plaintiff could plead alternative theories of liability

  3. Innova Hosp. San Antonio, L.P. v. Blue Cross & Blue Shield of Ga., Inc.

    995 F. Supp. 2d 587 (N.D. Tex. 2014)   Cited 115 times
    Finding the plaintiffs failed to plead sufficient facts to state a claim for negligent misrepresentation because they did not allege how the defendants provided the information to them

  4. Korotynska v. Metro. Life

    474 F.3d 101 (4th Cir. 2006)   Cited 136 times   3 Legal Analyses
    Holding that a plaintiff may not seek recovery under § 1132 when § 1132 provides adequate relief

  5. Kerr v. Charles F. Vatterott Co.

    184 F.3d 938 (8th Cir. 1999)   Cited 144 times
    Holding the statute does not require receipt and "there is a general rebuttable presumption that a properly mailed document is received"

  6. Baptist Health v. Murphy

    2010 Ark. 358 (Ark. 2010)   Cited 73 times
    Holding that the circuit court properly heard equitable matters of declaratory judgment and injunctive relief

  7. Chalmers v. Toyota Motor Sales

    326 Ark. 895 (Ark. 1996)   Cited 71 times
    Recognizing that the defendant's satisfaction of its burden may be "clear from the face of the complaint"

  8. N. Cypress Med. Ctr. v. Cigna Healthcare

    782 F. Supp. 2d 294 (S.D. Tex. 2011)   Cited 43 times
    Finding a plaintiff's allegation "that it obtained an express assignment of benefits and rights from the plan participants" sufficient to withstand a 12(b) facial attack

  9. Allen v. Allison

    356 Ark. 403 (Ark. 2004)   Cited 51 times
    Holding that those rules are to provide guidance to lawyers and to provide a structure for regulatory conduct through disciplinary agencies; no cause of action should arise from a violation, nor should it create any presumption that a legal duty has been breached

  10. Prof'l Orthopedic Assocs. v. Excellus Blue Cross Blue Shield

    Civil Action No. 14-6950 (FLW)(DEA) (D.N.J. Jul. 15, 2015)   Cited 28 times
    Finding that a patient sufficiently alleged injury-in-fact, despite his failure to plead that he paid any of the costs of his medical expenses out-of-pocket, where the patient signed documents rendering him personally liable for all medical charges

  11. Rule 8 - General Rules of Pleading

    Fed. R. Civ. P. 8   Cited 157,408 times   196 Legal Analyses
    Holding that "[e]very defense to a claim for relief in any pleading must be asserted in the responsive pleading. . . ."

  12. Section 1132 - Civil enforcement

    29 U.S.C. § 1132   Cited 26,353 times   171 Legal Analyses
    Holding liable "[a]ny administrator" who fails to provide documents in a timely manner

  13. Rule 13 - Counterclaim and Crossclaim

    Fed. R. Civ. P. 13   Cited 4,937 times   21 Legal Analyses
    Determining whether counterclaims are compulsory

  14. Section 1140 - Interference with protected rights

    29 U.S.C. § 1140   Cited 2,084 times   15 Legal Analyses
    Making it unlawful to “discharge ... any person because he has given information or has testified or is about to testify in any inquiry or proceeding relating to [ERISA]”

  15. Section 23-99-204 - Terms of health benefit plan

    Ark. Code § 23-99-204   Cited 6 times   1 Legal Analyses

    (a) A healthcare insurer shall not, directly or indirectly: (1) (A) Impose a monetary advantage or penalty under a health benefit plan that would affect a beneficiary's choice among those healthcare providers who participate in the health benefit plan according to the terms offered. (B) "Monetary advantage or penalty" includes: (i) A higher copayment; (ii) A reduction in reimbursement for services; or (iii) Promotion of one healthcare provider over another by these methods; (2) Impose upon a beneficiary

  16. Section 23-99-202 - Legislative findings and intent

    Ark. Code § 23-99-202   Cited 4 times

    The General Assembly finds that patients should be given the opportunity to see the healthcare provider of their choice. In order to assure the citizens of the State of Arkansas the right to choose the provider of their choice, it is the intent of the General Assembly to provide the opportunity of providers to participate in health benefit plans. Ark. Code § 23-99-202 Acts 1995, No. 505, § 2.