MEMORANDUM OPINION AND ORDER
Before the Court are Defendants Blue Cross of California, Anthem Health Plans, Inc., Community Insurance Company, Anthem Health Plans of Kentucky, Inc., Anthem Blue Cross Life and Health Insurance Company, Anthem Health Plans of Virginia, Inc., Blue Cross and Blue Shield of Georgia, Inc., and Anthem Insurance Companies, Inc.’s (collectively “Anthem Defendants”) Motion to Dismiss Plaintiffs’ First Amended Complaint and Brief in Support (ECF Nos. 43, 43-1), filed September 7, 2012; Plaintiffs Innova Hospital San Antonio, L.P. and Victory Medical Center Houston, L.P.’s (collectively “Plaintiffs”) Response in Opposition to Anthem Defendants’ Motion to Dismiss and Brief in Support (ECF Nos. 96, 98), filed October 29, 2012; and Anthem Defendants’ Reply (ECF No. 105), filed November 12, 2012.
After reviewing the motions and the applicable law, the Court finds Anthem Defendants’ Motion to Dismiss (ECF No. 43), BCBS Defendants’ Motion to Dismiss (ECF No. 48); BCBS Tennessee’s Motion to Dismiss (ECF No. 53); and BCBS Kansas’s Motion to Dismiss (ECF No. 106) should be and are hereby GRANTED. The Court also finds BCBS Alabama’s Motion to Compel Arbitration (ECF No. 49) should be and is hereby GRANTED, and Capital’s Motion to Dismiss (ECF No. 52) should be and is hereby GRANTED.
I. BACKGROUND
Plaintiffs are Texas limited partnerships that provide medical services in the fields of spinal, bariatric, and orthopedic medicine in San Antonio and Houston, Texas. Pis.’ 1st Am. Compl. ¶¶ 1-2, ECF No. 35. Plaintiffs filed this lawsuit against thirty-three “plan administrators in the Blue Cross Blue Shield family of insurance companies” (collectively “Defendants”) who insured patients that received medical services from Plaintiffs. Id. ¶¶ 3-34, 36-37. Plaintiffs assert that they conducted an initial intake interview with the patients prior to rendering medical services and contacted Defendants “to verify that the patients were covered under the Defendants’ health benefit plans” and “to verify that the services ... were covered under the insureds’ various plans.” Id. ¶ 37. Plaintiffs allege Defendants verified the services were covered under the various plans before Plaintiffs provided any medical services. Id. Plaintiffs also allege that Plaintiffs required all patients to execute an assignment of benefits form before medical services were provided. Id. ¶ 38.
Plaintiffs allege they submitted claims to the Defendants for payment and billed their “usual and customary charges” after the medical services were provided. Id. ¶ 39. Plaintiffs assert that they provided the medical services in good faith, in part based on the representations by Defendants during the verification process. Id. Plaintiffs allege, however, that Defendants “often either wholly denied Plaintiffs’ claims for payment or unilaterally reduced the amount of payment to an unacceptable and unsustainable level.” Id. Accordingly, Plaintiffs filed the instant lawsuit “for the underpayment and/or non-payment of reimbursement amounts pursuant to the terms of various health benefit plans administered by Defendants.” Id. ¶ 41.
Plaintiffs’ First Amended Complaint asserts four causes of action against the Defendants.
II. ANTHEM DEFENDANTS’ MOTION TO DISMISS
A. Legal Standard
Federal Rule of Civil Procedure 8(a) requires a plaintiffs pleading to include “a short and plain statement of the claim showing that the pleader is entitled to relief.” Fed.R.Civ.P. 8(a)(2). “[T]he pleading standard Rule 8 announces does not require ‘detailed factual allegations,’ but it demands more than an unadorned, the-defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal,
To defeat a motion to dismiss pursuant to Rule 12(b)(6), a plaintiff must plead “enough facts to state a claim to relief that is plausible on its face.” Twombly,
B. Analysis
Anthem Defendants assert that Plaintiffs’ First Amended Complaint is “devoid of any factual basis with which to support its contentions.”
1. Standing to Assert Claims on Behalf of Anthem Defendants’ Members
Plaintiffs’ ERISA and breach of contract claims are based on their alleged status as assignees of the rights of the patients that received medical services from Plaintiffs. See Pis.’ 1st Am. Compl. ¶¶47, 62, ECF No. 35. While the Anthem Defendants do not dispute that an insured may assign rights under a health insurance plan to a medical provider, see Reply 5, ECF No. 105, Anthem Defendants assert Plaintiffs failed to adequately show that they have standing to assert the rights of the pa
A medical provider cannot enforce the terms of a healthcare plan on its own account, Christus Health Gulf Coast v. Aetna, Inc.,
Accepting as true all of Plaintiffs’ allegations, the Court finds that Plaintiffs adequately alleged standing as an assignee of the ERISA and non-ERISA plans. N. Cypress Med. Ctr.,
Plaintiffs first cause of action is brought under Section 502(a) of ERISA “to recover benefits due[J ... to enforce the rights[J ... [and] to clarify the rights to future benefits ... under the terms of the [ERISA-governed plans]----” Pis.’ 1st Am. Compl. ¶¶ 47-49, ECF No. 35. Plaintiffs assert Anthem Defendants are liable for breaching ERISA-governed plans by failing to make payments as required under the terms of the plans. Id. ¶¶ 51-52. Anthem Defendants argue Plaintiffs’ ERISA claim should be dismissed because Plaintiffs fail to identify plan language that shows Plaintiffs are entitled to additional benefits under the plans. See Br. Supp. Mot. Dismiss 13, ECF No. 43-1.
Under Section 502(a), a participant or beneficiary in an ERISA-governed plan may bring a civil action “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). Section 502(a) is “relatively straightforward”:
If a participant or beneficiary believes that benefits promised to him under the terms of the plan are not provided, he can bring suit seeking provision of those benefits. A participant or beneficiary can also bring suit generically to “enforce his rights” under the plan, or to clarify any of his rights to future benefits.
Aetna Health Inc. v. Davila,
The phrase “terms of the plan” is “[w]orthy of emphasis” because parties derive rights to benefits from the plan, Aaron v. Leday, No. 4:13-cv-01716,
Plaintiffs generally allege that Anthem Defendants failed “to make payments of benefits to [Plaintiffs] ... as required under the terms of the [ERISAgoverned] plans,” Pis.’ 1st Am. Compl. ¶ 51, ECF No. 35, and argue the Claim Schedule “gives more than sufficient detail ... of each patient claim.” Br. Supp. Resp. Opp’n Mot. Dismiss 15, ECF No. 98; see also Pis.’ 1st Am. Compl. ¶¶ 47-53, ECF No. 35. Plaintiffs acknowledge that Section 502(a) allows a beneficiary to seek provision of “benefits promised to him under the terms of the plan,” Br. Supp. Resp. Opp’n Mot. Dismiss 16, and seek “to recover benefits due ... under the terms of the plans” and “to enforce the rights ... under the terms of the plans,” Pis.’ 1st Am. Compl. ¶¶ 47-48, ECF No. 35. Plaintiffs do not, however, identify the terms of the plans that were allegedly breached.
Furthermore, the Claim Schedule provides information about patient claims and charges, but does not provide facts about the benefits due under the terms of the plans or provide factual allegations about the terms of the plans to show that Anthem Defendants breached the plans. See Pis.’ 1st Am. Compl. Exs. 1-2 (Claim Schedule), ECF Nos. 35-1, 35-2. Plaintiffs’ general allegations that Anthem Defendants did not reimburse the amounts
The First Amended Complaint and Claim Schedule allege Anthem Defendants failed to pay reimbursements required by the plans and that Plaintiffs are entitled to additional payment under the plans, but do not identify facts about Plaintiffs’ rights under the plans or how Anthem Defendants violated the plans. Plaintiffs fail to allege facts that allow the Court to reasonably infer that Anthem Defendants violated the terms of the plans and that Plaintiffs are entitled to recover benefits, enforce their rights, or clarify their rights to future benefits “under the terms of the plan[s].” 29 U.S.C. § 1132(a)(1)(B). Accordingly, the Court finds that Plaintiffs fail to state a claim under ERISA.
3. Count II-Breach of Contract
Plaintiffs second cause of action alleges Anthem Defendants breached the health benefits plans not governed by ERISA by failing to pay the reimbursement rate “required by the contracts.” Pis.’ 1st Am. Compl. ¶¶ 62-63, ECF No. 35. Anthem Defendants argue Plaintiffs’ conclusory allegations that Anthem Defendants breached unidentified terms of the plans are insufficient to state a claim. See Br. Supp. Mot. Dismiss 15-16, ECF No. 43-1. Plaintiffs counter that the pleadings provide sufficient notice and state that they are not required to outline all the elements of their claim. Br. Supp. Resp. Opp’n Mot. Dismiss 17-19, ECF No. 98 (quoting Walker v. S. Cent. Bell Tel. Co.,
To establish a breach of contract cause of action, a plaintiff must show “(1) the existence of a valid contract; (2) performance or tendered performance by the plaintiff; (3) breach of contract by the defendant; and (4) damages suffered by the plaintiff as a result of the breach.” Beauty Mfg. Solutions Corp. v. Ashland, Inc.,
“A breach of contract ... only occurs when a party fails or refuses to perform an act that it expressly promised to do.” Gonzales v. Columbia Hosp. at Med. City Dall. Subsidiary LP,
Plaintiffs allege Anthem Defendants were “required to abide by the terms and conditions of the contracts ... [and] materially breached the terms of the contracts” by paying reimbursements that were “substantially less ... than what [wa]s actually owed” under the plans. Pis.’ 1st Am. Compl. ¶¶ 45, 63, ECF No. 35. Plaintiffs are not required to outline all the elements of the claim, but Plaintiffs must provide enough factual allegations to draw the reasonable inference that the elements exist. See Patrick v. Wal-Mart, Inc.-Store No. 155,
Plaintiffs failed to allege enough facts about the terms of the plans to raise their right to relief above the speculative level. Bell Atl. Corp. v. Twombly,
Plaintiffs rely on the Claim Schedule attached to their First Amended Com
Plaintiffs’ allegations - that they did not receive the reimbursements owed under the plans and their general conclusion that “the acts and omissions on part of [Anthem] Defendants noted hereinabove constitute breaches of contract” are not sufficient to state a claim for relief. See Pis.’ 1st Am. Compl. ¶ 62, ECF No. 35; see also Whiddon v. Chase Home Fin., LLC,
4. Count Ill-Negligent Misrepresentation
Plaintiffs also allege Anthem Defendants negligently misrepresented that the patients and medical services were covered under the health benefit plans. Pis.’ 1st Am. Compl. ¶¶ 37, 65, ECF No. 35. Plaintiffs assert that they justifiably relied on these representations and that they suffered damages as a result of their reliance. Id. ¶¶ 65-66. To establish a cause of action for negligent misrepresentation, a plaintiff must plead:
(1) the defendant made a representation in the course of his business, or in a transaction in which he has a pecuniary interest; (2) the defendant supplied false information for the guidance of others in their business; (3) the defendant did not exercise reasonable care or competence in obtaining or communicating the information; and (4) the plaintiff suffered pecuniary loss by justifiably relying on the representation.
Miller v. CitiMortgage, Inc.,
Plaintiffs again contend that they are not required to outline each element of their claim and argue the Claim Schedule “sets out additional details involving each and every instance of a misrepresentation.” Br. Supp. Resp. Opp’n Mot. Dismiss 20-21, ECF No. 98. Rule 8(a) does not require detailed factual allegations, but Plaintiffs must offer more than “labels and conclusions,” and must plead enough facts to raise Plaintiffs’ right to relief above the speculative level. Jebaco, Inc. v. Harrah’s Operating Co., Inc.,
The Court finds that Plaintiffs’ allegations, taken as true, do not allege enough facts to state a claim for relief that is plausible on its face. Plaintiffs allege Anthem Defendants represented that the patients and the medical services were covered under the health benefit plans before Plaintiffs provided the services. Pis. 1st Am. Compl. ¶¶37, 65, ECF No. 35. These allegations are sufficient to show that Anthem Defendants made a representation in the course of its business. Plaintiffs’ allegations, however, do not allow the Court to draw the reasonable inference that Anthem Defendants supplied false information for the guidance of others and did not exercise reasonable care or competence in obtaining or communicating the information.
In pleading its negligent misrepresentation claim, Plaintiffs merely recite the elements of the cause of action:
• “[T]he representations supplied false information for the guidance of [Plaintiffs] in its business” (¶ 65);
• “[Anthem] Defendants did not exercise reasonable care or competence in obtaining or communicating the information” (Id.);
• “Plaintiffs ... would not have provided such services, but for the representations made by [Anthem] Defendants ----[and] [Plaintiffs] would show that it justifiably relied upon [Anthem] Defendants’ representations that were made in the course of its business or in the transaction in which it had a pecuniary interest” (¶¶ 39, 65);
• “[Anthem] Defendants’ negligent misrepresentations have resulted in damages and harm to the [Plaintiffs]” (¶ 65).
Plaintiffs’ pleadings contain no factual allegations to support their claim that Anthem
Other than the assertion that Anthem Defendants “wholly denied Plaintiffs’ claims for payment or unilaterally reduced the amount of payment” after they “verified” that the patients and services were “covered,” Plaintiffs do not provide factual allegations concerning what information was supplied to Plaintiffs or how the information was false, especially in light of Plaintiffs’ assertion that they charged their usual and customary rates for the services. See Pis.’ 1st Am. Compl. ¶¶ 37, 39, ECF No. 35. Plaintiffs must allege facts that permit the Court to infer more than the “mere possibility” that Anthem Defendants supplied false information. Harold H. Huggins Realty, Inc. v. FNC, Inc.,
Plaintiffs’ conclusory allegations and formulaic recitation of the elements of a claim for negligent misrepresentation does not raise Plaintiffs’ right to relief above the speculative level. See Twombly,
5. Count IV-Promissory Estoppel
Plaintiffs’ claim for promissory estoppel is similarly conclusory and devoid of well-pleaded factual allegations. To establish a cause of action for promissory estoppel, a plaintiff must show: (1) a promise; (2) foreseeability by the promisor that the promisee would rely on the promise; (3) substantial reliance by the promisee to his detriment; and (4) a definite finding that injustice can be avoided only by enforcement of the promise. Zenor v. El Paso Healthcare Sys., Ltd.,
Anthem Defendants argue Plaintiffs failed to identify: (1) how reliance by Plaintiffs was foreseeable to Anthem Defendants, (2) how actual reliance by Plaintiffs was reasonable, and (3) why injustice can be avoided only by enforcement of the alleged promise. Br. Supp. Mot. Dismiss 17, ECF No. 43-1. Plaintiffs again rely on the assertion that they are not required to outline each element of the claim and contend that the Claim Schedule sufficiently alleges facts to support the claim. See Br.
6. Plaintiffs’ Motion for Leave to Amend
Anthem Defendants assert that Plaintiffs’ “repeated failure to cure deficiencies by amendments ... is a proper basis for this Court to deny Plaintiffs leave to amend.” Anthem Defs.’ Mot. Dismiss 19, ECF No. 43-1 (citing Foman v. Davis,
“Under Rule 15(a), ‘leave to amend shall be freely given when justice so requires,’ and should be granted absent some justification for refusal.” United States ex rel. Willard v. Humana Health Plan of Tex. Inc.,
It appears that Plaintiffs may be able to state a claim upon which relief could be granted, and the Court notes that none of the above-mentioned five factors are present in this case. Accordingly, the Court finds it appropriate to allow Plain
III. BCBS ALABAMA’S MOTION TO COMPEL
BCBS Alabama filed a Motion to Compel Arbitration and for Dismissal of Certain Claims (ECF No. 49), addressing Plaintiff Victory Medical Center Houston, L.P.’s (“Victory)” claims relating to a patient, “SB,” who is covered under a plan issued by BCBS Alabama.
A. Legal Standard
The Federal Arbitration Act (“FAA”) states that a written agreement “to submit to arbitration an existing controversy arising out of such a contract ... shall be valid, irrevocable, and enforceable .... ” 9 U.S.C. § 2. Section 2 evidences a “liberal federal policy favoring arbitration agreements,” AT & T Mobility LLC v. Concepcion, — U.S. -,
Courts conduct a two-step inquiry to determine whether a party should be compelled to arbitrate. JP Morgan Chase & Co. v. Conegie ex rel. Lee,
B. Analysis
BCBS Alabama asserts that on or around October 12, 2011, SB received medical services from Victory and the total charge for the services was $13,362.60. Mot. Compel 3, ECF No. 49. BCBS Alabama paid Victory $7,634.15. Id. BCBS Alabama contends Victory’s breach of contract, negligent misrepresentation, and promissory estoppel claims against BCBS Alabama relating to SB are subject to a binding arbitration provision in SB’s plan. Id. at 4.
1. Is There a Valid Agréement to Arbitrate?
The Court must first determine whether there is a valid agreement to arbitrate. BCBS Alabama must establish that an arbitration agreement exists. ASW Allstate Painting & Constr. Co. v. Lexington Ins. Co.,
BCBS Alabama withheld SB’s application from its motion because the application contained patient-identifying information, but provided Victory with a copy of SB’s application. See Mot. Compel 5 n. 6, 10, ECF No. 49. BCBS Alabama attached a form application to its motion and an affidavit from its Direct Billing Manager stating that the form application is a “true and correct copy of a form application for coverage” under the Classic Contract that was “in use at the time SB applied for coverage and identical to the form completed by SB.” Mot. Compel Ex. 1 (Oliver Aff.), App. at 3, ECF No. 49-1. BCBS Alabama also attached “a true and correct copy of the [Classic Contract] contract booklet, issued to SB subsequent to the inception of coverage ....” Id. BCBS Alabama subsequently submitted an unredacted copy of SB’s application to the Court that contains SB’s signature. See Sealed Appl. 5, ECF No. 134; see also id. at 2 (“Attached to this affidavit is a record from [BCBS Alabama] consisting of ... an Individual Blue Application for Health Coverage signed by S.B. [that is] kept by [BCBS Alabama] in the regular course of business.”).
The signature block on SB’s application states: “I acknowledge by my signature that I have read and understand the front and back of this application and agree to binding arbitration as described on the back of this page.” Id. at 2. The back of the application states that “any disagreement will be settled by arbitration — not a court” and the insured “agree[s] to settle any disagreement by arbitration instead of a court trial.” Mot. Compel Ex. 2 (Form Appl.), App. at 5, ECF No. 49-2. The application also provides that the insured “agree[s] to the arbitration provisions in
“[A] written arbitration agreement is prima facie valid and must be enforced unless the opposing party ... alleges and proves that the arbitration clause itself was a product of fraud, coercion, or such grounds as exist at law or in equity for the revocation of the contract.” Freudensprung v. Offshore Tech. Servs., Inc.,
BCBS Alabama has made the prima facie showing necessary to compel arbitration and Victory has not offered any evidence to establish that the SB’s arbitration provision is unenforceable. See Overstreet,
2. Is the Dispute Within the Scope of the Agreement?
Finding that a valid agreement exists, the Court must next determine whether Victory’s claims regarding services provided to SB fall within the scope of the arbitration agreement. JP Morgan Chase & Co. v. Conegie ex rel. Lee,
• “Any claim that arises out of or relates to the plan;”
• “Any claim that involves any relationships that result from or relate in any way to the plan (including claims involving persons or organizations who are not parties to the plan);”
*612 • “Any claim that alleges any conduct by you or us, regardless of whether related to the plan;” or
• “Any claim that concerns the validity, enforceability, scope, or any other aspect of this arbitration provision.”
Mot. Compel Ex. 3 (Contract Booklet), App. at 47, ECF No. 49-3.
a. Breach of Contract
Victory’s only argument against compelling arbitration of its breach of contract claim is its assertion that BCBS Alabama failed to provide evidence of a valid agreement between the parties. See Br. Supp. Resp. Opp’n Mot. Compel 6-7, ECF No. 74. Victory seeks to recover for the “underpayment ... of reimbursement amounts pursuant to the terms” of SB’s plan and alleges BCBS Alabama “materially breached the terms” of the plan by “refusing to pay [Victory] the contractually agreed upon amounts .... ” Pis.’ 1st Am. Compl. ¶¶ 41, 62-63, ECF No. 35. Victory alleges SB assigned “all right, title and interest” in benefits “due under the [plan].” Id. ¶ 62. BCBS Alabama’s contract booklet explains that the arbitration agreement applies to “any claim that arises out of or relates to the plan.” Mot. Compel Ex. 3 (Contract Booklet), App. at 47, ECF No. 49-3 (emphasis omitted). Accordingly, the Court finds that Victory’s breach of contract claim is within the scope of the arbitration agreement.
b. Negligent Misrepresentation and Promissory Estoppel
Victory contends that its claims for negligent misrepresentation and promissory estoppel are claims against BCBS Alabama for representations and promises made directly to Victory, and not brought by Victory as an assignee of SB’s benefits. See Br. Supp. Resp. Opp’n Mot. Compel 7, ECF No. 74. Therefore, Victory asserts that these claims do not arise out of or relate to the plan and do not fall within the scope of the agreement. Id. at 8-10.
To determine whether a dispute falls within the scope of an arbitration agreement, courts must determine whether the arbitration clause is “broad” or “narrow.” Jureczki v. Banc One Tex., N.A.,
Here, Victory’s negligent misrepresentation claim is based on BCBS Alabama’s representations that the patients “were covered under healthcare plans and
3. Stay or Dismissal
District courts must stay a suit containing issues that are referable to arbitration under a written agreement to arbitrate until the arbitration “has been had in accordance with the terms of the agreement.” 9 U.S.C. § 3. The statute, however, is not intended to limit dismissal of a case in the proper circumstances. Alford v. Dean Witter Reynolds, Inc.,
BCBS Aabama contends that Victory’s claims against BCBS Aabama relating to SB’s plan should be dismissed because all of the claims are subject to the arbitration agreement. Mot. Compel 8, ECF No. 49. Victory argues that dismissal is improper because (1) Victory maintains causes of action against BCBS Aabama relating to SB that are not subject to the arbitration agreement, (2) Victory maintains causes of action against BCBS Aabama for other patients, and (3) Victory maintains causes of action against other named Defendants that are unrelated to the arbitration agreement. Br. Supp. Resp. Opp’n Mot. Compel 11, ECF No. 74. Having found that Victory’s causes of action against BCBS Aabama relating to SB’s plan are subject to a valid arbitration agreement, the Court finds that Victory’s first objection lacks
Victory contends that not all of the issues raised in this case are subject to the arbitration agreement because Victory maintains causes of action outside of those related to SB’s plan. See id. It may be appropriate, however, to dismiss all of the claims subject to a valid arbitration agreement if the claims relate to specific parties subject to the agreement and retaining jurisdiction serves no useful purpose. See, e.g., In re Titanium Dioxide Antitrust Litig.,
IV. CAPITAL’S MOTION TO DISMISS FOR LACK OF PERSONAL JURISDICTION
Defendant Capital filed a Motion to Dismiss for Lack of Personal Jurisdiction Pursuant to Rule 12(b)(2), and Alternatively, Motion to Dismiss for Improper Venue Pursuant to Rule 12(b)(3), and Alternatively, Motion to Dismiss for Failure to State a Claim Pursuant to Rule 12(b)(6) (ECF No. 52), filed October 1, 2012.
“When a nonresident defendant presents a motion to dismiss for lack of personal jurisdiction, the plaintiff bears the burden of establishing the district court’s jurisdiction over the nonresident.” Rolls-Royce Corp. v. Heros, Inc.,
“A federal district court sitting in diversity may exercise personal jurisdiction over a nonresident defendant if (1) the long-arm statute of the forum state confers personal jurisdiction over that defendant; and (2) exercise of such jurisdiction by the forum state is consistent with due process under the United States Constitution.” Latshaw v. Johnston,
The exercise of personal jurisdiction comports with due process when “first, the defendant has the requisite minimum contacts with the forum state and second, requiring the defendant to submit to jurisdiction in the forum state would not infringe on ‘traditional notions of fair play and substantial justice.’ ” E.g., Companion Prop. & Cas. Ins. Co. v. Palermo,
These minimum contacts give rise to either general or specific personal jurisdiction. See TGI Friday’s,
If the plaintiff establishes that the nonresident defendant has the requisite minimum contacts, courts must determine whether the exercise of jurisdiction over the defendant satisfies traditional notions of fair play and substantial justice. See Companion Prop. & Cas.,
B. Analysis
1. General Personal Jurisdiction
To establish general jurisdiction, a nonresident defendant’s contacts with the forum state “must be substantial; random, fortuitous, or attenuated contacts are not sufficient.” Choice Healthcare, Inc. v. Kaiser Found. Health Plan of Colo.,
Plaintiffs must plead sufficient jurisdictional facts to make a prima facie showing that Capital has continuous and systematic contacts with Texas. See Oblio Telecom, Inc. v. Patel,
Furthermore, Capital included a sworn declaration from its Vice President for Account Management, Commercial Markets, Therese A. Bretz (“Bretz”), describing Capital’s business activities.
Plaintiffs apparently concede that Capital does not have the required business presence in Texas for the Court to exercise general jurisdiction. Rather than contesting or presenting evidence to rebut Capital’s assertions, Plaintiffs request that the Court permit jurisdictional discovery to allow Plaintiffs to “meet their jurisdictional burden.” Br. Supp. Resp. Mot. Dismiss 8, ECF No. 80; see also Bell Helicopter Textron Inc. v. Am. Eurocopter, LLC,
2. Specific Personal Jurisdiction
Courts may exercise specific jurisdiction if a nonresident defendant “purposefully avails himself of the privileges of conducting activities in the forum state” and “the controversy arises out of or is related to the defendant’s contacts with the forum state.” Choice Healthcare,
Here, Plaintiffs’ claims arise from Capital’s three payments to Plaintiffs for medical services provided to Capital’s members. See Br. Supp. Mot. Dismiss 10-11, ECF No. 52-1; Pis.’ 1st Am. Compl. Ex. A (Claim Schedule), App. at 25, ECF No. 35-1. Plaintiffs’ allegations consist of the Claim Schedule showing three claims against Capital, Plaintiffs’ assertion that it believes Capital does business in Texas, and its request for jurisdictional discovery to “establish jurisdiction over [Capital].” See Br. Supp. Resp. Mot. Dismiss 8, ECF No. 80; Pis.’ 1st Am Compl. ¶ 26, ECF No. 35; Pis.’ 1st Am. Compl. Ex. A (Claim Schedule), App. at 25, ECF No. 35-1. Plaintiffs, however, do not plead facts showing that Capital purposefully directed its commercial activities at Texas. See Clemens v. McNamee,
Capital also provided evidence that it only provides insurance coverage for individuals and groups within Capital’s twenty-one county service area in Pennsylvania and does not contract with hospitals or medical facilities in Texas. Mot. Dismiss Ex. A (Bretz Decl.), App. at 4-5, ECF No. 52-2. Capital asserts that Plaintiffs are non-participating providers without a contract with Capital, and Capital “do[es] not encourage or advise their members to seek treatment from non-participating providers.” Id. at 5. Capital also states that any coverage provided to members that seek treatment from non-participating providers “is not intended to expand sales or otherwise develop commercial activity in the forum state” where the non-participating provider is located. Id. Capital also contends that it made the three payments because of Capital’s members’ “respective decisions to seek care from Plaintiffs ... in Texas.” Br. Supp. Mot. Dismiss 12, ECF No. 52-1. Accordingly, the Court finds that it cannot exercise specific personal jurisdiction over Capital.
3. Limited Jurisdictional Discovery
Plaintiffs assert that the Court should grant Plaintiffs an opportunity to conduct jurisdictional discovery to establish personal jurisdiction over Capital. Br. Supp. Resp. Mot. Dismiss 8, ECF No. 80. Plaintiffs contend that jurisdictional discovery is appropriate if the existing record is “inad
Plaintiffs’ pleadings are devoid of factual allegations that reasonably suggest that personal jurisdiction exists over Capital. Fielding,
Furthermore, Plaintiffs have not alleged that jurisdictional discovery will support a finding of personal jurisdiction, nor do they contest Capital’s assertions regarding personal jurisdiction; rather, Plaintiffs essentially concede that personal jurisdiction does not exist by requesting jurisdictional discovery to allow them to “meet their jurisdictional burden” and “establish jurisdiction over [Capital].” See Br. Supp. Resp. Mot. Dismiss 5-8, ECF No. 80; see also Bell Helicopter Textron,
4. Improper Venue and Failure to State a Claim
Finding that it lacks personal jurisdiction over Capital, the Court need not address Capital’s Motion to Dismiss for Improper Venue or Motion to Dismiss for Failure to State a Claim.
V. CONCLUSION
Based on the foregoing, it is ORDERED that Anthem Defendants’ Motion to Dismiss (ECF No. 43), BCBS Defendants’ Motion to Dismiss (ECF No. 48), BCBS Tennessee’s Motion to Dismiss (ECF No. 53), and BCBS Kansas’s Motion to Dismiss (ECF No. 106), should be and are hereby GRANTED. Therefore, Plaintiffs’ claims against Anthem Defendants,
It is further ORDERED that BCBS Alabama’s Motion to Compel Arbitration (ECF No. 49), should be and is hereby GRANTED. Therefore, Victory Medical Center Houston, L.P.’s claims against BCBS Alabama relating to SB’s health benefit plan are hereby DISMISSED.
It is further ORDERED that Capital’s Motion to Dismiss for Lack of Personal Jurisdiction (ECF No. 52), should be and is hereby GRANTED. Therefore, Plaintiffs’ claims against Capital BlueCross are hereby DISMISSED.
Notes
. Plaintiffs named thirty-three parties as Defendants in this action. See Pis.’ 1st Am. Compl. 2-3, ECF No. 35. Six other motions to dismiss have been filed by the other Defendants in this action. Defendants Health Care Service Corporation, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of South Carolina, Hawaii Medical Service Association d/b/a Blue Cross and Blue Shield of Hawaii, Blue Cross and Blue Shield of Rhode Island, BCBSM, Inc. d/b/a Blue Cross and Blue Shield of Minnesota, Regence BlueShield, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of Nebraska, Blue Cross and Blue Shield of Mississippi, Noridian Mutual Insurance Company, Highmark West Virginia, Inc., Wellmark, Inc. d/b/a Blue Cross and Blue Shield of Iowa, Highmark, Inc. d/b/a Highmark Blue Cross Blue Shield of Pennsylvania, Premera Blue Cross, Blue Cross and Blue Shield of Florida, Blue Cross and Blue Shield of Michigan, Care First of Maryland, Inc., USAble Mutual Insurance Company d/b/a Arkansas Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, and Louisiana Health Service & Indemnity Company d/b/a Blue Cross Blue Shield of Louisiana (collectively "BCBS Defendants”) (ECF No. 48); Blue Cross Blue Shield of Tennessee, Inc. ("BCBS Tennessee”) (ECF No. 53); and Blue Cross and Blue Shield of Kansas, Inc. ("BCBS Kansas”) (ECF No. 106), filed motions to dismiss asserting arguments similar to those asserted by the Anthem Defendants. Accordingly, the
. Capital adopted the arguments made in BCBS Defendants Motion to Dismiss in its alternative Motion to Dismiss for Failure to State A Claim. See Capital’s Br. Supp. Mot. Dismiss 17, ECF No. 52-1.
. Plaintiffs also assert a cause of action for the breach of the health benefit plans governed by the Federal Employees Health Benefits Program ("FEHBA”). Pis.’ 1st Am. Compl. ¶¶ 54-60, ECF No. 35. Plaintiffs, however, only assert FEHBA claims against Defendant Health Care Service Corporation ("HCSC”). See id. ¶¶ 44, 55-59.
. As noted, BCBS Defendants’ Motion to Dismiss (ECF No. 48), BCBS Tennessee’s Motion to Dismiss (ECF No. 53), and BCBS Kansas’s Motion to Dismiss (ECF No. 106) present arguments similar to those raised in Anthem Defendants' Motion to Dismiss, and the Court incorporates these motions in its analysis of Anthem Defendants’ Motion to Dismiss.
. Anthem Defendants also assert that Plaintiffs' state law claims for negligent misrepresentation and promissory estoppel that relate to an ERISA plan are preempted. See Br. Supp. Mot. Dismiss 18, ECF No. 43-1. Plaintiffs argue that the Fifth Circuit has consistently found that claims similar to Plaintiffs' negligent misrepresentation and promissory estoppel claims are not preempted by ERISA. See Br. Supp. Resp. Opp'n Mot. Dismiss 23-24, ECF No. 98. In light of the Court’s finding that Plaintiffs' First Amended Complaint fails to state a claim for negligent misrepresentation or promissory estoppel, the Court finds that it is not necessary at this time to determine whether these claims are preempted.
. BCBS Defendants also argue Plaintiffs failed to allege an "express and knowing assignment of an ERISA fiduciary breach claim,” as required by the Fifth Circuit in Texas Life, Accident Health & Hospital Service Inc. Guaranty Ass’n v. Gaylord Entertainment Co.,
. Plaintiffs also concede that they “lack the information necessary to determine which of the claims ... fall within ERISA” and hope to determine this through discovery. Pis.’ 1st Am. Compl. ¶ 53 n. 1, ECF No. 35. Rule 8, however, does not "unlock the doors of discovery for a plaintiff armed with nothing more than conclusions.” Ashcroft v. Iqbal,
. Plaintiffs acknowledge they billed their “usual and customary charges,” and, therefore, it appears the Claim Schedule likely reflects these "customary charges,” rather than the rates required by the contracts. Pis.’ 1st Am. Compl. ¶ 39, ECF No. 35.
. Courts within the Fifth Circuit require a plaintiff to allege specific facts that, if proven, would show the elements of a claim for negligent misrepresentation. See Borneo Energy Sendirian Berhad v. Sustainable Power Corp.,
. Pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), BCBS Alabama refers to the individual patient as "SB.” BCBS Alabama Mot. Dismiss 1 n. 2, ECF No. 49. BCBS Alabama joined BCBS Defendants’ Motion to Dismiss (ECF No. 48), but filed the instant motion to specifically address Victory’s claims that relate to SB's plan. Id. at 1 n. 1. SB’s plan is not subject to ERISA and Plaintiffs only assert FEHBA claims against HCSC. See id.; Pis.’ 1st Am. Compl. ¶¶ 55-59, ECF No. 35. Accordingly, the only causes of action asserted by Victory against BCBS Alabama relating to SB’s plan are for breach of contract, negligent misrepresentation, and promissory estoppel.
. Victory's breach of contract, negligent misrepresentation, and promissory estoppel claims against BCBS Alabama relating to SB’s plan are state law claims and the Court's jurisdiction is based on diversity. See Pis.' 1st Am. Compl. ¶ 35 (citing 28 U.S.C. §§ 1331, 1332). Therefore, Texas choice-of-law rules apply. See Coghlan v. Wellcraft Marine Corp.,
The Court notes that federal courts in Alabama also consider whether a valid agreement to arbitrate exists and whether the dispute falls within the scope of the agreement when determining whether parties agreed to arbitrate a dispute. See King v. Cintas Corp.,
. Victory, as a non-signatory plaintiff, does not allege that it is not bound by the arbitration provision, and an arbitration clause is enforceable if it is "in writing and signed by the party invoking it.” Westmoreland v. Sadoux, 299 F.3d 462, 465 (5th Cir.2002). A non-signatory plaintiff may be compelled to arbitrate under six theories: (1) incorporation by reference; (2) assumption; (3) agency; (4) alter ego; (5) equitable estoppel; and (6) third-party beneficiary. In re Kellogg Brown & Root, Inc.,
. Capital and Capital Advantage Insurance Company, a wholly-owned subsidiary of Capital, specially appeared to contest the Court’s personal jurisdiction. Capital’s Mot. Dismiss 1, ECF No. 52. Capital Advantage Insurance Company issued the contract at issue in this case, but is not a named party. Br. Supp. Mot. Dismiss 5, ECF No. 52-1; see also Pis.' 1st Am. Compl. ¶ 26, ECF No. 35. The Court will only refer to Capital.
. Plaintiffs assert Bretz’s Declaration is not properly authenticated as a business records affidavit pursuant to Federal Rule of Evidence 901. Br. Supp. Resp. Mot. Dismiss 7, ECF No. 80. Business records affidavits are used to authenticate evidence prior to admission. See Fed.R.Evid. 901; United States v. Brown,
Furthermore, "a business record affidavit ... requires only that the affiant have ‘personal knowledge to testify as custodian of documents' and 'personal knowledge as to some of the statements in the affidavit.' " Tex. A & M Research Found. v. Magna Transp., Inc.,
. The Fifth Circuit also found that a nonresident insurer that belonged to a national membership and received in-state health care provider's rates offered to members had not purposefully availed itself of the benefits and privileges of the forum state. Choice Healthcare,
