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NOT FOR PUBLICATION (Doc. No. 26) 

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEW JERSEY 

CAMDEN VICINAGE 

_____________________________________ 

 : 

HORIZON BLUE CROSS BLUE SHIELD : 

OF NEW JERSEY, : 

 : 

 Plaintiff, : 

 : Civil No. 10-3197 (RBK/KMW) 

 v. : 

 : OPINION

TRANSITIONS RECOVERY PROGRAM, : 

et al., : 

 : 

 Defendant. : 

____________________________________ : 

KUGLER, United States District Judge: 

 This matter comes before the Court on the motion of Transitions Recovery Program 

(“Defendant” or “Transitions”) for reconsideration of this Court’s June 5, 2011 Order denying 

Defendant’s motion to dismiss. In the alternative, Defendant moves for certification of the issue 

of preemption for interlocutory appeal to the Third Circuit Court of Appeals. Because Defendant 

has not shown a clear error of law necessitating this Court’s reconsideration, and because 

Defendant has not demonstrated that interlocutory review would materially advance the 

termination of this litigation, Defendant’s motion is denied. 

I. BACKGROUND1

 Plaintiff is a not-for-profit health service corporation that provides health coverage and 

benefits for its subscribers in New Jersey. Plaintiff authorizes the payment of subscribers’ 

claims subject to the conditions, limitations, and exclusions contained in its health benefits plans. 

 

1

 Because the facts underlying this case are established in detail in the Opinion accompanying this Court’s June 10, 

2011 Opinion denying Defendant’s motion to dismiss (“Opinion”), the Court recites only the facts relevant to the 

instant motion. 

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Defendant is a drug and alcohol treatment center located in Florida, which provided treatment to 

subscribers of Plaintiff’s health benefit plans, and submitted claims to Plaintiff for payment of 

that treatment. Plaintiff alleges that, between January 2002 and March 2008, Defendant 

submitted 8,652 claims to Plaintiff that contained diagnoses of alcohol dependency—a diagnosis 

whose treatment receives broader coverage from Plaintiff’s plans than is afforded to treatment of 

other substance abuse dependencies and behavioral disorders. Plaintiff alleges that it conducted 

an audit of Defendant’s records and concluded that Defendant misrepresented non-alcoholrelated diagnoses as alcohol dependencies in order to receive Horizon’s broader coverage. 

 Plaintiff’s Complaint was filed in the Superior Court of New Jersey. Defendant removed 

the case to this Court, and moved to dismiss under Federal Rule of Civil Procedure 12(b)(6). 

This Court denied Transitions’s motion to dismiss, finding unavailing Defendant’s argument that 

the issue is preempted by two provisions of the Employee Retirement Income Security Act of 

1974 (“ERISA”)—namely, § 502(a), ERISA’s complete preemption provision, and § 514(a), the 

section of ERISA that provides for express preemption. Defendant now moves for 

reconsideration only of this Court’s finding that Plaintiff’s claim is not completely preempted by 

§ 502(a). 

II. STANDARD

A. Motion for Reconsideration

 In the District of New Jersey, Local Civil Rule 7.1(i) governs motions for 

reconsideration. Church & Dwight Co. v. Abbott Labs., 545 F. Supp. 2d 447, 449 (D.N.J. 2008). 

That rule “permits a party to seek reconsideration by the Court of matters ‘which [it] believes 

the Court has overlooked’ when it ruled on a motion.” NL Indus., Inc. v. Commercial Union Ins. 

Co., 935 F. Supp. 513, 515 (D.N.J. 1996) (quoting local rule); see also United States v. 

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Compaction Sys. Corp., 88 F. Supp. 2d 339, 345 (D.N.J. 1999) (noting that party seeking 

reconsideration must show “that dispositive factual matters or controlling decisions of law were 

overlooked by the court in reaching its prior decision”). “The standard of review involved in a 

motion for [reconsideration] is quite high, and therefore relief under this rule is granted very 

sparingly.” United States v. Jones, 158 F.R.D. 309, 314 (D.N.J. 1994) (citing Maldonado v. 

Lucca, 636 F. Supp. 621, 630 (D.N.J. 1986)). 

 In order to prevail on a motion for reconsideration, the moving party must show: “(1) an 

intervening change in the controlling law; (2) the availability of new evidence that was not 

available when the court [made its initial decision]; or (3) the need to correct a clear error of law 

or fact or to prevent manifest injustice.” Max’s Seafood Café v. Quinteros, 176 F.3d 669, 677 

(3d Cir. 1999). Local Civil Rule 7.1(i) does not allow parties to restate arguments that the Court 

has already considered. See G-69 v. Degnan, 748 F. Supp. 274, 275 (D.N.J. 1990). 

 B. Certification for Interlocutory Appeal 

 A litigant may apply for interlocutory review of an otherwise non-appealable district 

court order by petitioning the district court to certify its order to the appropriate appellate court 

pursuant to 28 U.S.C. § 1292(b).2

 To obtain certification, a movant must show that there is “a 

controlling question of law as to which there is a substantial ground for difference of opinion and 

that an immediate appeal may materially advance the ultimate termination of the litigation . . . .” 

28 U.S.C. § 1292(b); Katz v. Carte Blanche Corp., 496 F.2d 747, 754 (3d Cir. 1974). 

Interlocutory appeal is meant to be used sparingly and only in exceptional cases where the 

interests cutting in favor of immediate appeal overcome the presumption against piecemeal 

 

2

 If the district court certifies its order for interlocutory review, the litigant must apply for appellate review within 

ten days of the order's issuance. 28 U.S.C. § 1292(b). The court of appeals then has largely unfettered discretion to 

hear the appeal. See Katz v. Carte Blanche Corp., 496 F.2d 747, 754 (3d Cir. 1974) (observing that appellate court’s 

discretion to grant leave to appeal may be as broad as that of Supreme Court on certiorari). 

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litigation. S.E.C. v. Lucent Techs., Inc., No. 04-2315, 2009 U.S. Dist. LEXIS 107098, 2009 WL 

4508583, at *8 (D.N.J. Nov. 16, 2009); Hulmes v. Honda Motor Co., 936 F. Supp. 195, 208 

(D.N.J. 1996) (citing 16 Charles A. Wright, et al., Federal Practice and Procedure § 3929, at 134 

(1977)). Merely questioning a court’s ruling is insufficient. Kapossy v. McGraw-Hill, Inc., 942 

F. Supp. 996, 1001 (D.N.J. 1996). The district court may exercise considerable discretion in 

determining whether a particular order is appropriate for interlocutory review. See Bachowski v. 

Usery, 545 F.2d 363, 368 (3d Cir. 1976); Katz, 496 F.2d at 754. 

III. DISCUSSION 

A. Defendant Has Not Shown the Need to Correct a Clear Error of Law or Fact 

 Defendant bases its motion for reconsideration on “the need to correct a clear error of law 

or fact to prevent manifest injustice.” See II.A supra. Specifically, Transitions argues that, “[i]n 

denying Transitions’s motion to dismiss Horizon’s state law claims, this Court made a clear error 

of law by ostensibly creating a bar to complete preemption under ERISA that has been 

universally rejected.” Def. Br. in Support of Motion to Reconsider (“Def. Br. Mot.”), 1. 

 In its Opinion denying Defendant’s motion to dismiss, the Court determined that Horizon 

qualifies as a “fiduciary” for the purposes of § 502(a), and then went on to find that, because 

Plaintiff seeks money damages as the remedy for its fraud claim, Plaintiff cannot pursue its 

desired relief under ERISA’s civil enforcement mechanism (§ 502(a)(3)), and therefore could not 

be completely preempted by ERISA. In arguing that “the Court should not have considered 

whether the ultimate relief being sought would be available under ERISA,” Def. Br. 3, 

Transitions rearticulates an argument that the Court considered in its Opinion. See Op., Horizon 

Blue Cross Blue Shield of N.J. v. Transitions Recovery Program, 2011 U.S. Dist. LEXIS 62184 

at *15 n.4 (June 10, 2011) (addressing the issue of whether claims for damages can be 

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completely preempted by § 502(a), and indicating that the Supreme Court has found that 

“§ 502(a)(3), by its terms, only allows for equitable relief (citing Great-West Life Annuity Ins. v. 

Knudson, 534 U.S. 204, 221 (2002))). 

 Thus Defendant now seeks to bolster the argument considered and dismissed by this 

Court in its Opinion. However, a motion for reconsideration is not a proper forum for such 

reargument. The case law defining the scope of motions for reconsideration in the District of 

New Jersey is clear: a party moving for reconsideration “must show that dispositive factual 

matters or controlling decisions of law were overlooked by the court in reaching its prior 

decision.” Harris v. Rubin, 2012 U.S. Dist. LEXIS 2072 at *2-3 (D.N.J. Jan. 9, 2012) (quoting 

Assisted Living Associates of Moorestown, L.L.C., v. Moorestown Tp., 996 F. Supp. 409, 442 

(D.N.J. 1998)). The only controlling case that Defendant relies upon in its motion for 

reconsideration that was not addresed by the Court in its Opinion is Wood v. Prudential 

Insurance Company of America, 207 F.3d 674 (3d Cir. 2000). Wood is readily distinguishable 

from the instant case because the Wood plaintiff sought equitable relief for his ERISA claim. Id.

at 676. Although Defendant correctly quotes the Third Circuit as stating that “[c]omplete 

preemption would be an empty doctrine if a plaintiff could plead his way into state court by 

seeking only money damages,” Defendant fails to note that the Wood plaintiff sought money 

damages for his claim under the Americans with Disabilities Act, and equitable relief for his 

ERISA claim. Id. at 679. The Wood Court was faced with a situation wherein a complaint 

pleaded both a federal ERISA claim seeking the relief provided in § 502(a), and a state law cause 

of action for money damages that, the defendant argued, might have defeated federal jurisdiction. 

 Here, by contrast, jurisdiction is based upon diversity of the parties, pursuant to 28 U.S.C. 

§ 1332; thus the Wood Court’s concern that plaintiffs might dodge removal to federal court by 

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defeating ERISA preemption by attaching a state law action for money damages is irrelevant. 

Therefore, the Court has already examined and ruled about the relevant legal argument presented 

by Transitions, and the Court accordingly finds that the standard for reconsideration has not been 

met. 

B. Defendant Has Not Shown that Interlocutory Review Would Materially Advance 

the Ultimate Termination of This Litigation

 Interlocutory appellate review of this decision would not materially advance the 

termination of this dispute, because even reversal by the Third Circuit would still leave 

Plaintiff’s claim unresolved. As Plaintiff explains, “[c]ertification will not advance the 

termination of this matter because the controlling issue is whether Defendant’s submission of 

claims constitutes fraud, an issue that must be decided regardless of whether Horizon seeks 

equitable or legal relief.” Pl. Br., 7. Accordingly, Defendant has not made the requisite showing 

that the “exceptional” grant of interlocutory appeal is warranted in this case. SEC v. Lucent 

Techs., Inc., 2009 U.S. Dist. LEXIS 107098 at *28 (D.N.J. Nov. 16, 2009). 

IV. CONCLUSION

 For the foregoing reasons, Defendant’s motion for reconsideration or, in the alternative, 

certification for interlocutory appeal, is DENIED. An accompanying Order shall issue today. 

Date: 1/24/2012 /s/ Robert B. Kugler 

 ROBERT B. KUGLER 

 United States District Judge 

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