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Fremont Emergency Services (Mandavia), Ltd. v. United Healthcare Insurance Co.

United States District Court, D. Nevada

June 27, 2019

FREMONT EMERGENCY SERVICES (MANDAVIA), LTD., Plaintiff,
v.
UNITED HEALTHCARE INSURANCE COMPANY, et al., Defendants.

          MOTION TO STAY [ECF NO. 14]

          CAM FERENBACH UNITED STATES MAGISTRATE JUDGE.

         Before the Court is Plaintiff Fremont Emergency Services' Motion to Stay Proceedings Pending Resolution of Motion to Remand. (ECF No. 14). For the reasons discussed below, Plaintiff's motion is denied.

         BACKGROUND

         As alleged in the operative complaint, Plaintiff is “is a professional emergency medicine services group practice that staffs [] emergency departments…throughout Clark County, Nevada.” (ECF No. 1-1 at 2). Defendants are entities, including several named “United Healthcare, ” related to paying for and administering healthcare. (Id. at 2-3). Plaintiff's “physicians provide emergency medicine services to all patients, regardless of insurance coverage or ability to pay, including to patients with insurance coverage issued, administered and/or underwritten by United HealthCare.” (Id. at 4). “There is no written agreement between United HealthCare and [Plaintiff] for the healthcare claims at issue in this litigation… Notwithstanding the lack of a written agreement” Plaintiff alleges that “an implied-in-fact agreement exists between the parties.” (Id. at 5). “Beginning on July 1, 2017, [Defendants] arbitrarily began drastically reducing the rates at which they paid [Plaintiff] for emergency services for some claims, but not others.” (Id.). Plaintiff alleges that,

38. Through the parties' conduct and respective undertaking of obligations concerning emergency medicine services provided by Fremont to the UH Parties' Patients, the parties implicitly agreed, and Fremont had a reasonable expectation and understanding, that the UH Parties would reimburse Fremont for non-participating claims at rates in accordance with the standards acceptable under Nevada law and in accordance with rates the UH Parties pay for other substantially identical claims also submitted by Fremont.
39. Under Nevada common law, including the doctrine of quantum meruit, the UH Parties, by undertaking responsibility for payment to Fremont for the services rendered to United HealthCare Patients, impliedly agreed to reimburse Plaintiffs at rates, at a minimum, equivalent to the reasonable value of the professional emergency medical services provided by Fremont.
40. The UH Parties, by undertaking responsibility for payment to Fremont for the services rendered to the UH Parties' Patients, impliedly agreed to reimburse Fremont at rates, at a minimum, equivalent to the usual and customary rate or alternatively for the reasonable value of the professional emergency medical services provided by Fremont.

(Id. at 8). Plaintiff brings claims against Defendants for breach of implied-in-fact contract, tortious breach of the implied covenant of good faith and fair dealing, unjust enrichment, violation of NRS 686A.020 and 686A.310, violation of Nevada prompt pay statutes and regulations, consumer fraud and deceptive trade practices, and declaratory judgment. (Id. at 8-17).

         Plaintiff filed its complaint in Nevada state court. (ECF No. 1-1). Defendants removed the case to this Court. (ECF No. 1). Defendants argue that Plaintiff's claims are preempted ERISA due to “the fact that numerous employee welfare benefit plans are implicated.” (Id. at 3). Plaintiff has filed a motion to remand the case to state court, which is currently pending before Judge Dorsey. (ECF No. 5).

         Plaintiff has also filed a motion to stay. (ECF No. 14). Initially, Plaintiff asked that the motion to remand be decided on an expedited basis and that all other proceedings be stayed until the Court ruled on the motion to remand. (Id. at 2). Judge Dorsey denied the motion to expedite briefing and referred the remained of the motion to me. (ECF No. 17). As an initial matter, I am now construing the motion to stay as a motion to stay discovery. The motion to stay discusses staying a pending motion to dismiss. (ECF No. 14). The motion to dismiss (ECF No. 4) is also before Judge Dorsey. I make no recommendation regarding what order Judge Dorsey will use to address the motion to dismiss and motion to remand.[1] The only remaining issue in the case is a potential stay of discovery.

         In its motion to stay, Plaintiff argues that “this action involves disputes concerning the rate of payment rather than the right to payment” and “disputes about the rate of payment are not governed by ERISA and are not subject to complete preemption.” (ECF No. 14 at 3). “[T]he claims arise not from an employee benefit plan, but [Defendants'] statutory and common law duty to pay for its Members' emergency services at usual and customary rates or, alternatively, for the reasonable value of services rendered.” (Id. at 5). “Given the existence of a threshold issue of concerning subject matter jurisdiction, [Plaintiff] respectfully requests that the Court stay all proceedings…until the Court has had an opportunity to adjudicate the Motion to Remand.” (Id. at 3).

         In response, Defendants argue that “the granting of a motion to remand does not obviate the need for discovery.” (ECF No. 20 at 4). Defendants asserts discovery is needed into the types of medial claims that were denied or underpaid. (Id. at 7-8). Finally, Defendant argues that the motion to remand will likely not be granted because “the only legal duties owed by Defendants (if any) flow from the rights [Plaintiff] has as the assignee of Defendants' plan members. Since those rights are directly based on and related to employee benefit plans governed by ERISA, [Plaintiff's] claims are completely preempted.” Id. at 11).

         In its reply, Plaintiff asserts that, “if discovery proceeds, [Plaintiff] will be at a disadvantage because it will not have the benefit of [Defendants'] answer and affirmative defenses and will be unduly hampered in prosecuting this action.” (ECF No. 24 at 5). Plaintiff argues that a motion to remand is dispositive, no discovery is ...


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