Professional Documents
Culture Documents
Before
Howard, Selya and Lipez,
Circuit Judges.
May 9, 2014
completely
preempts
local-law
tort
and
contract
claims
reverse the orders appealed from and direct the district court to
remand the action to the Puerto Rico Court of First Instance.
I.
BACKGROUND
In 2009, physicians diagnosed plaintiff-appellant Raquel
obstacles
loomed.
The
defendant
voiced
newfound
During
the
next
month,
the
plaintiff
unsuccessfully
First, it
claims,
transmogrifying
them
into
federal
questions
acting
under
warranting removal.
the
and
See 28
of
federal
officer,
thus
the removal and entreated the district court to remand the case to
the Court of First Instance.
dismiss
the
case,
arguing
that
the
FEHBA
demanded
(and
the
It
preempted
the
See
id. 1331.
held
that
the
FEHBA
completely
II.
ANALYSIS
We start with an overview of the pertinent provisions of
Empire HealthChoice
Assur., Inc. v. McVeigh, 547 U.S. 677, 682 (2006); see 5 U.S.C.
8905(a)(3).
panoply
of
health-care
offerings
is
constructed
through
with
private
particular plans.
insurers
to
provide
and
administer
pursuance
of
this
authority,
promulgated
disputes
under
FEHBA
plans
must
pass
through
an
-4-
5 U.S.C.
8902(m)(1).
Against this backdrop, we turn to the plaintiff's claims.
The parties agree that the defendant's policy was issued under, and
is subject to, the terms of the FEHBA.
plaintiff insists that her claims are local-law claims for damages,
not claims that seek to reverse an insurer's refusal either to
authorize or pay for certain medical procedures.
In her appeal,
Our
S6, Indus. Union of Marine & Shipbldg. Workers, 132 F.3d 824, 830
-5-
See
Viqueira v. First Bank, 140 F.3d 12, 16 n.2 (1st Cir. 1998).
Eliminating the federal officer removal statute means
that the propriety of removal in this case hinges on whether the
district court had original jurisdiction over the matter.
U.S.C. 1441(a).
citizenship
See 28
28 U.S.C. 1331.
The "arising under" analysis is informed by the wellpleaded complaint rule, which "requires the federal question to be
stated on the face of the plaintiff's well-pleaded complaint."
R.I. Fishermen's All., Inc. v. R.I. Dep't of Envtl. Mgmt., 585 F.3d
42, 48 (1st Cir. 2009); accord Franchise Tax Bd., 463 U.S. at 9-10.
As a general matter, this rule envisions "that the plaintiff is
master of his complaint and that a case cannot be removed if the
complaint's allegations are premised only on local law."
Negrn-
the
general
virtually
rule
that
every
gives
general
birth
rule,
to
these
principles,
like
admits
of
exceptions.
522 U.S. 470, 475 (1998); BIW Deceived, 132 F.3d at 831.
When such
-7-
In
comprises
narrow
exception
to
the
well-pleaded
The doctrine
plaintiff's
local-law
claims
without
any
jurisdictional
See Fayard v.
Ne. Vehicle Servs., LLC, 533 F.3d 42, 45, 48 (1st Cir. 2008).
The linchpin of the complete preemption analysis is
whether Congress intended that federal law provide the exclusive
cause of action for the claims asserted by the plaintiff.
See
-8-
With
this
short
primer
in
place,
we
turn
to
the
We hasten
Id.
That four-
-9-
Id.
distinguish
Empire.
It
notes
that
Empire
involves
the
district
'obviousness'
of
court's
the
pre-emption
jurisdiction
defense
but
is
the
not
intent
the
of
Congress." Metro. Life Ins. Co. v. Taylor, 481 U.S. 58, 66 (1987).
Seen in this light, a stronger factual case for a defense based on
the
FEHBA's
preemption
clause
does
little
to
blunt
Empire's
-10-
This assumption
makes
it
transparently
clear
that
the
Empire
Court's
provisions."
See
Federal
Employees
Health
Care
-11-
at 697.
flawed.
Although we have commented that the FEHBA's preemption
clause "is nearly identical to ERISA's preemption provision,"
Pharm. Care Mgmt. Ass'n v. Rowe, 429 F.3d 294, 299 n.2 (1st Cir.
2005), "nearly identical" does not mean "identical."
The devil is
defendant's
reliance
on
our
dictum
in
Pharmaceutical
The
Care
leaves
the
defendant's
contention
that
the
defendant,
that
an
administrative
claims
process
with
-13-
5 C.F.R.
Id.
v. Nat'l Postal Mail Handlers Union, 36 F.3d 306, 312 (3d Cir.
1994) (noting that the FEHBA only provides for federal-court
jurisdiction over actions against the United States, "[b]ut the
United States is not a party to this action").
Perspectives
evolved.
change
over
time,
and
OPM's
position
authority under the FEHB[A] to order the carrier to pay the claim,
had been civil actions between private parties into actions against
a government agency, thus bringing judicial review of denial-ofbenefits
claims
squarely
jurisdictional provision.
into
the
orbit
of
the
FEHBA's
of
itself,
neither
constituted
We are
action
nor
make
claims
that
in
any
way
relate
to
benefit
denials
-15-
Corp., 558 F.3d 615, 616 (7th Cir.) (per curiam), cert. granted,
558 U.S. 945 (2009), and cert. dismissed, 559 U.S. 965 (2010).
Although the defendant invites us to follow the contrary decision
in Botsford v. Blue Cross & Blue Shield, 314 F.3d 390, 399 (9th
Cir.), amended by 319 F.3d 1078 (9th Cir. 2002), we are constrained
to decline its invitation.
In light of the
add
coda.
We
have
recognized
(although
the
-16-
One &
Ken Valley Hous. Grp. v. Me. State Hous. Auth., 716 F.3d 218, 224
(1st Cir. 2013) (alteration in original) (quoting Gunn v. Minton,
133 S. Ct. 1059, 1065 (2013)), cert. denied, 134 S. Ct. 986 (2014).
In this case, an argument might be made that the claims at issue
implicate this limited category of jurisdiction.
It is
CONCLUSION
We need go no further. For the reasons elucidated above,
we conclude that the district court erred in holding that the FEHBA
affords complete preemption.
-17-
reverse
both
the
district
court's
judgment
of
dismissal and its order denying remand, and we remand the matter to
the district court with instructions to remand the case to the
Puerto Rico Court of First Instance for further proceedings.