History
  • No items yet
midpage
MSPA Claims 1, LLC v. National Specialty Insurance Company
1:16-cv-20401
S.D. Fla.
Aug 25, 2016
Read the full case

Background

  • Plaintiff MSPA Claims 1, LLC sues three insurers alleging they failed to reimburse a Medicare Advantage Organization (FHCP) under the Medicare Secondary Payer Act for medical payments made on behalf of an enrollee.
  • Plaintiff claims it has standing as assignee of FHCP: FHCP allegedly assigned rights to La Ley Recovery Systems, and La Ley allegedly assigned those rights to Plaintiff.
  • Plaintiff did not attach the full assignment agreements to the amended complaint but quoted excerpts that suggested assignment occurred.
  • Defendants moved to dismiss for lack of subject matter jurisdiction, arguing Plaintiff lacks standing because the chain of assignment is incomplete or invalid.
  • The court examined the underlying assignment language (judicially noticed from another docket) showing La Ley could assign only with FHCP approval; Plaintiff did not allege FHCP approved the La Ley-to-Plaintiff assignment.
  • A post-filing settlement that might clarify assignment was executed after the complaint was filed; the court held standing must exist at the time of filing and cannot be cured by later events.

Issues

Issue Plaintiff's Argument Defendant's Argument Held
Standing: whether Plaintiff has Article III standing via assignment Plaintiff alleges FHCP assigned to La Ley, and La Ley assigned to Plaintiff, so Plaintiff can sue to recoup payments Defendants argue the La Ley-to-Plaintiff assignment required FHCP approval, which Plaintiff did not allege, so no valid assignment Dismissed for lack of standing; Plaintiff failed to allege a valid assignment at filing
Sufficiency of pleading re: assignment Plaintiff argues factual allegations are sufficient even without attaching documents Defendants point to the assignment language showing approval requirement; court may consider extrinsic documents in a factual attack Court found the quoted excerpt contradicted full document; required approval not alleged, so pleading insufficient
Judicial notice / reliance on later settlement Plaintiff asks the court to take judicial notice of a settlement indicating assignment rights Defendants oppose reliance on post-filing settlement to create standing Court declined to permit standing to be established by a settlement executed after filing; standing must exist at filing
Remedy and disposition Plaintiff implicitly seeks adjudication on merits Defendants seek dismissal for lack of jurisdiction Complaint dismissed without prejudice; case closed

Key Cases Cited

  • Stalley ex rel. U.S. v. Orlando Reg'l Healthcare Sys., Inc., 524 F.3d 1229 (11th Cir. 2008) (standing is a jurisdictional threshold; dismissal for lack of standing is for lack of subject-matter jurisdiction)
  • McElmurray v. Consol. Gov't of Augusta-Richmond Cnty., 501 F.3d 1244 (11th Cir. 2007) (distinguishes facial and factual attacks on subject-matter jurisdiction and permits consideration of evidence in factual attacks)
  • Lawrence v. Dunbar, 919 F.2d 1525 (11th Cir. 1990) (explains difference between facial and factual jurisdictional attacks)
  • Focus on the Family v. Pinellas Suncoast Transit Auth., 344 F.3d 1263 (11th Cir. 2003) (standing must exist at the time the complaint is filed)
Read the full case

Case Details

Case Name: MSPA Claims 1, LLC v. National Specialty Insurance Company
Court Name: District Court, S.D. Florida
Date Published: Aug 25, 2016
Docket Number: 1:16-cv-20401
Court Abbreviation: S.D. Fla.