Access Mediquip, L.L.C. v. Unitedhealthcare Insurance
698 F.3d 229
5th Cir.2012Background
- En banc review addressed scope of ERISA preemption for a plan administrator’s allegedly misrepresenting coverage to a health-device provider.
- Panel had held state-law claims (negligent misrepresentation, promissory estoppel, Texas Insurance Code) were not preempted under ERISA.
- The court reconsidered, overruled Cypress Fairbanks, Hermann I, and Hermann II to the extent inconsistent with the panel’s reasoning.
- Court reinstates the panel opinion and remands for proceedings consistent with the decision.
- The district court’s judgment is reversed and the case remanded for further proceedings.
- Access Mediquip’s state-law claims for quantum meruit and unjust enrichment are reinstated as to the panel’s rejection.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| ERISA preemption scope | Plaintiff argues state-law claims are not preempted. | Defendant argues ERISA preempts the claims. | Remanded; preemption resolved by reinstating panel approach. |
| Memorial Hospital test form | Test should be disjunctive for preemption. | Test as previously stated should be conjunctive. | Court adopts panel reasoning; overrules inconsistent prior lines. |
| Effect of en banc decision on Cypress/Hermann | Panel decisions align with Hermann I/II and Cypress Fairbanks. | En banc should align with other circuits and earlier Fifth Circuit authorities. | En banc reinstates panel and overrules inconsistent authorities. |
Key Cases Cited
- Memorial Hosp. Sys. v. Northbrook Life Ins. Co., 904 F.2d 236 (5th Cir. 1990) (ERISA preemption framework for state-law claims)
- Transitional Hosp. v. Blue Cross & Blue Shield of Texas, Inc., 164 F.3d 952 (5th Cir. 1999) (preemption analysis guiding panel decision)
- Cypress Fairbanks Med. Ctr., Inc. v. Pan-American Life Ins. Co., 110 F.3d 280 (5th Cir. 1997) (prior approach criticized/overruled by en banc)
- Hermann Hosp. v. MEBA Med. & Benefits Plan, 845 F.2d 1286, 845 F.2d 1286 (5th Cir. 1988) (Hermann I role in preemption framework)
- Hermann Hosp. v. MEBA Med. & Benefits Plan, 959 F.2d 569, 959 F.2d 569 (5th Cir. 1992) (Hermann II postscript in preemption context)