BROWNSTEIN HYATT FA

RBER SCHRECK, LLP 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

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John C. West – 007233

jwest@bhfs.com 

Ishra K. Solieman – 028551 

isolieman@bhfs.com BROWNSTEIN HYATT FARBER 

SCHRECK, LLP 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

Telephone: 602.382.4040 

Facsimile: 602.382.4020 

Attorneys for Defendant 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

SurgCenter of Gilbert, LLC,

Plaintiff, 

vs. 

UnitedHealthcare of Arizona, Inc., 

Defendant. 

No. CV15-01933-PHX-DJH

DEFENDANT’S MOTION TO 

DISMISS COMPLAINT 

Defendant UnitedHealthcare of Arizona, Inc. (“United”) respectfully moves the 

Court for an order dismissing Plaintiff’s Complaint [Doc. 1-1 at 4] in its entirety because 

Plaintiff’s state law claim is completely preempted by the exclusive remedial provision of 

the Employee Income Retirement Security Act of 1974, 29 U.S.C. §§ 1001 et seq. 

(“ERISA”). This Motion is supported by the following Memorandum of Points and 

Authorities. 

MEMORANDUM OF POINTS AND AUTHORITIES 

It is well-settled that ERISA has such “extraordinary pre-emptive power” that a 

Complaint comprised solely of state law claims cannot escape removal notwithstanding 

the well-pled complaint rule. Aetna Health Inc. v. Davila, 542 U.S. 200, 209 (2004); see 

also Cleghorn v. Blue Shield of California, 408 F.3d 1222, 1226 (9th Cir. 2005) (“Artful 

pleading does not alter the potential for [a] suit to frustrate the objectives of ERISA.”) 

Plaintiff’s state law claim against United is based on United’s alleged nonpayment of 

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BROWNSTEIN HYATT FA

RBER SCHRECK, LLP 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

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benefits in connection with its role as a claims administrator of an ERISA-governed 

employee benefit plan and is thus preempted. Further, Plaintiff has not obtained a valid 

assignment from the ERISA beneficiary and therefore does not have standing to sue for 

recovery under an ERISA Plan. Finally, Plaintiff has not exhausted its administrative 

remedies as required under ERISA. For these reasons, Plaintiff fails to state a claim upon 

which relief can be granted and Plaintiff’s Complaint should be dismissed in its entirety. 

I. Relevant Background 

This matter involves the purported nonpayment of benefits by United in 

connection with its role as the claims administrator of the Nationstar Mortgage Welfare 

Benefit Plan (the “Plan”). The Complaint alleges that the Plaintiff provided medically 

necessary services to a patient, who is covered by “Defendant’s health insurance.” [Doc 

1-1 at 4, ¶ 1]. The Plan, identified by Plaintiff as “Defendant’s health insurance,” is an 

employee welfare benefit plan as defined under ERISA and the patient who allegedly 

received the treatment from Plaintiff is a beneficiary of that Plan. [Doc 1 at 2:19-22]. 

On August 26, 2015, Plaintiff filed its Complaint in the justice court asserting a 

state law claim for the recovery of a debt. Plaintiff cannot, however, seek the recovery of 

such amounts through a state law claim as recovery is only available through the 

application of the terms of that Plan, and is thus preempted by ERISA. 

II. Standard of Review 

A motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) should be 

granted where the complaint's factual allegations, even if proved, do not entitle Plaintiff 

to relief. Oregon Natural Resources Council v. Mohla, 944 F.2d 531, 533 (9th Cir. 

1991). Although all factual allegations are assumed to be true and all reasonable 

inferences drawn in the Plaintiff's favor, the Court need not accept a Complaint that fails 

to state a claim that is “plausible on its face.” Moss v. US. Secret Serv., 572 F.3d 962, 

972 (9th Cir. 2009). 

Here, Plaintiff's Complaint fails to state a claim upon which relief can be granted 

because the state law claim is completely preempted by ERISA, the Plaintiff lacks 

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BROWNSTEIN HYATT FA

RBER SCHRECK, LLP 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

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standing, and has failed to exhaust administrative remedies. It should therefore be 

dismissed. 

III. ERISA Preempts Plaintiff’s State Law Claim 

A state cause of action that duplicates, supplements or supplants the civil 

enforcement provision of ERISA is completely preempted under ERISA § 502(a). 

Davila, 542 U.S. at 208-09. Further, ERISA § 514(a) preempts state law claims that 

“relate to” the administration of an ERISA-regulated benefit plan. 29 U.S.C. § 1144(a); 

see also Pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 45-46 (1987) (stating that a cause of 

action that “relates to” an employee benefit plan, meaning it “arise[s] out of the 

administration of a covered plan,” is preempted by ERISA). Because Plaintiff’s claim is 

rooted in the Plan itself and is nothing more than the Plaintiff’s attempt to recover 

benefits alleged to be due under the Plan, the claim for relief is preempted. 

A. The Claims at Issue Arise Under the Plan 

The Complaint alleges that United failed to make a payment to Plaintiff for health 

care services rendered to a patient covered by a health plan administered by United. 

Specifically, the Complaint alleges that Plaintiff provided services to a patient “with 

Defendant’s health insurance” [Doc. 1-1 at 4, ¶ 1] and that United “has paid Plaintiff 

nothing” [Doc. 1-1 at 4, ¶ 2]. No matter how Plaintiff attempts to re-characterize its case, 

the case is at bottom, an action for the failure to pay Plaintiff for the patient’s claim under 

“Defendant’s health insurance” i.e. the Plan. Because the Plan is governed by ERISA 

[Doc. 1 at 2:19-22], the state law claim is preempted and should therefore be dismissed. 

B. Plaintiff’s Claims is Preempted by ERISA’s Exclusive Remedies 

Provision 

ERISA was enacted to provide a “uniform regulatory regime over employee 

benefit plans. To this end, ERISA includes expansive pre-emption provisions.” Davila, 

542 U.S. at 208. ERISA §502(a) is the civil enforcement provision of ERISA. Id. Under 

the provision, a beneficiary (or a valid assignee of the beneficiary), may bring a civil 

action to recover benefits due under the terms of the employee welfare benefit plan, to 

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Phoenix, AZ 85004 

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enforce the beneficiary’s rights under the terms of the plan or to clarify the beneficiary’s 

rights to future benefits under the plan. 29 U.S.C. § 1132(a)(1)(B). 

Any state law claim that duplicates, supplements, or supplants ERISA's civil 

enforcement provision is preempted by ERISA. Davila, 542 U.S. at 209. The state law 

claim does not have to precisely duplicate the elements of an ERISA claim to be 

preempted. Id. at 216. Instead, ERISA preempts any “state cause of action that provides 

an alternative remedy to those provided by the ERISA civil enforcement mechanism” 

because such a claim “conflicts with Congress' clear intent to make the ERISA 

mechanism exclusive.” Id. at 214, n.4; Cleghorn v. Blue Shield of California, 408 F.3d 

1222, 1225 (9th Cir. 2005) (“[a] state cause of action that would fall within the scope of 

this scheme of remedies is preempted”) Therefore, “if an individual, at some point in 

time, could have brought his claim under ERISA [], and where there is no other 

independent legal duty that is implicated by a defendant's actions, then the individual's 

cause of action is completely preempted by ERISA.” Davila, 542 U.S. at 210. 

Plaintiff’s claim in this case falls within the scope of ERISA § 502(a) because it is 

based on the alleged improper denial by United to pay for medical care provided to an 

ERISA plan beneficiary. Thus, the Plaintiff seeks to impose an alternative remedy to 

those provided by the ERISA civil enforcement mechanism. As such, Plaintiff’s claim is 

preempted by Section 502(a), ERISA’s exclusive enforcement provisions. 

IV. Plaintiff Lacks Standing to Bring a Claim under ERISA

A healthcare provider like Plaintiff “cannot bring claims for benefits on its own 

behalf. It must do so derivatively relying on patients’ assignment of their benefits 

claims.” Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc., 770 

F.3d 1282, 1289 (9th Cir. 2014). Plaintiff does not allege that it obtained a valid 

assignment from its patient, a participant in an ERISA-governed Plan, to pursue its claim 

for relief for benefits due under the Plan. Because the Plaintiff does not allege to have a 

valid assignment, it lacks standing to assert claims against United for alleged nonCase 2:15-cv-01933-DJH Document 5 Filed 10/05/15 Page 4 of 6
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Phoenix, AZ 85004 

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payment of benefits due under the ERISA-governed plan. For this reason alone, the state 

law claim should be dismissed. 

V. Plaintiff has Failed to Exhaust Administrative Remedies 

ERISA requires that a Plaintiff exhaust its administrative remedies prior to 

bringing an action in Federal Court. See Diaz v. United Agr. Employee Welfare Ben. 

Plan & Trust, 50 F.3d 1478, 1483 (9th Cir. 1995) (“Quite early in ERISA’s history, we 

announced as the general rule governing ERISA claims that a claimant must avail himself 

or herself of a plan’s own internal review procedures before bringing suit in federal 

court”). Plaintiff has failed to allege exhaustion of such administrative remedies, 

warranting a dismissal of the claim. 

VI. Conclusion 

For the foregoing reasons, United respectfully requests that this Court dismiss 

Plaintiff’s Complaint in its entirety. 

RESPECTFULLY SUBMITTED this 5th day of October, 2015. 

BROWNSTEIN HYATT FARBER 

SCHRECK, LLP 

By: s/Ishra K. Solieman John C. West 

Ishra K. Solieman 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

Attorneys for Defendant 

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BROWNSTEIN HYATT FA

RBER SCHRECK, LLP 

One East Washington Street, Suite 2400 

Phoenix, AZ 85004 

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CERTIFICATE OF SERVICE 

 I hereby certify that on October 5, 2015, I electronically transmitted the attached 

document to the Clerk’s Office using the CM/ECF System for filing and 

transmittal of a Notice of Electronic Filing to the following CM/ECF registrants: 

Elliot S. Isaac – elliot.isaac@azbar.org 

 I hereby certify that on , I served the attached document by mail on the 

following, who are not registered participants of the CM/ECF System: 

By s/Ashly White 

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