MSPA Claims 1, LLC v. National Specialty Insurance Company
1:16-cv-20401
S.D. Fla.Aug 25, 2016Background
- 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)
