INTRODUCTION
■ We reverse and remand in part, and affirm in part, the district court’s grant of summary judgment in favor of defendants, American Telephone and Telegraph Company Incorporated (“AT & T”), Lucent Technologies, Inc. (together, “AT & T/Lu-eent”), and International SOS Assistance, Inc. (“SOS”). The district court granted summary judgment on the ground that the Employee Retirement Income Security Act of 1974
FACTS
. ■ Plaintiff, Nga Bui, brings this action as the representative of her deceased husband’s estate. Her husband, Hung M. Duong, died at Erfan Hospital, in Jeddah, Saudi Arabia, on August 10, 1996. Immediately preceding his death, Duong underwent two unsuccessful operations, one of which had never previously been performed at Erfan Hospital, and suffered two myocardial infarctions.
In the week before his death, Duong knew his situation was critical. His physi
Duong consulted SOS, a company with which his employer, AT & T/Lucent, had contracted to provide emergency medical advice and evacuation services. SOS personnel told Duong that evacuation presented a greater risk than remaining in Saudi Arabia for treatment, especially given the quality of the facilities and services available at Erfan Hospital. Thus, SOS advised Duong to remain in Saudi Arabia.
Duong also consulted with a physician employed by AT & T/Lucent, Dr. Waugh. Waugh seconded SOS’s recommendation, advising Duong to remain in Saudi Arabia as well.
At some point, a Lucent employee told Duong that the return of his passport would take one to two weeks.
Bui asserts that, after offering the above advice and information, SOS and Lucent failed to follow up on Duong’s requests for additional information and further advice, as well as his requests for evacuation. When Duong got no response from SOS and Lucent regarding his additional questions and requests, and the date Duong’s doctor had given him for surgery was at hand, Duong checked into the Erfan Hospital and submitted to treatment there, after which he died.
Bui filed suit in federal district court,
The district court granted summary judgment to defendants on the ground that 29 U.S.C. § 1144, ERISA’s preemption clause, preempts all of Bui’s claims. We conclude that summary judgment was proper as to the breach of contract claim against AT & T, the breach of contract claims against Lucent, and the negligence claim against Lucent based on its retention of SOS. Those claims rest on administrative decisions made in the course of administering an ERISA plan. The record does not support summary judgment as to the remaining negligence ' claims against Lu-cent, however. The claim against Lucent for failing to inform Duong that he could receive his passport in an emergency appears not to relate to ERISA at all. ERISA also does not preempt the claim for negligent medical advice and for negligent delay to the extent that the delay was based on actions taken during the course of medical treatment or consultation, rather than ERISA administration. Finally, the record does not support summary judgment on preemption grounds as to any of the claims against SOS.
I. ERISA Preemption and Medical Malpractice
ERISA contains a broadly worded preemption clause.
Medical malpractice is one traditional field of state regulation that several circuits have concluded Congress did not intend to preempt. We join the Third, Fifth, and Tenth Circuits
In accord with our sister circuits and our decision in Roach, we look to the behavior underlying the allegations in the complaint to determine whether ERISA preempts a plaintiffs claims.
If a claim alleges medical malpractice, however, we conclude for several reasons that ERISA does not preempt it and that state law governs. First, under any of the tests applied by this court, it is clear that state medical malpractice standards should not be preempted. They do not mandate employee benefit structures or their administration, do not preclude uniform administrative practices, and do not provide alternative enforcement mechanisms for employees to obtain ERISA benefits.
Second, if ERISA did preempt medical malpractice claims, the results would be absurd. Physicians would be subject to state standards when treating non-ERISA patients, and to another, as-yet-undefined (and possibly undefinable)
Accordingly, we conclude that state law standards for medical malpractice apply equally to service providers treating ERISA and non-ERISA beneficiaries. If a claim involves a medical decision made in the course of treatment, ERISA does not preempt it; but if a claim involves an administrative decision made in the course of administering an ERISA plan, ERISA preempts it. We now apply this framework to the particular claims at issue in this case.
II. Bui’s Claims '
A. Claims against SOS
Bui alleges that SOS caused Duong’s death by (1) negligently advising him to stay in Saudi Arabia; (2) failing to respond to his request for evacuation; and (3) failing to evacuate him. For the following reasons, we conclude that summary judgment on ERISA preemption grounds was inappropriate on all those claims.
The first claim amounts to an assertion of negligence in the provision of a benefit by a direct service provider. Bui alleges that Duong received the benefit promised by his ERISA plan, medical advice, but that the advice was negligent. This claim closely resembles the claim addressed in Roach.
Because the benefit at issue in Roach was promised by an ERISA plan, some reference to the plan was necessary. However, we concluded that the claim alleged medical negligence at its root, and
The second claim against SOS, that the company failed to respond to Duong’s request for evacuation, involves a slightly more complicated analysis. ERISA preempts suits based on administrative delay, such as the delay that occurs when an administrator processes a request for coverage.
First, one of the physicians employed by SOS explained that SOS would have bene-fitted from evacuating Duong, because evacuation would have resulted in additional fees being paid to the company, but that SOS based its decision on the patient’s needs. The first part of the physician’s statement suggests that the interests of SOS were diametrically opposed to those of an ERISA administrator. An administrator bears a fiduciary responsibility to the plan as a whole to pay only covered costs and would not benefit from increased treatment costs. The second part of his statement suggests that SOS’s duty was to determine what was in Duong’s best interests as a patient — in other words, to make treatment recommendations, not coverage decisions.
Second, an agreement between SOS and AT & T/Lucent states that, if SOS could not contact plan administrators, SOS could evacuate a beneficiary without receiving prior approval from Lucent. Although this contractual provision might be read to offer a modicum of support for the argument that SOS could act in lieu of an administrator in these precise circumstances, its negative implication is that SOS did not act as an administrator in most circumstances. Moreover, there is no evidence that SOS had to act in lieu of an administrator in this case, because no one has suggested that SOS could not contact Lucent.
The insufficient development of the record also precludes summary judgment on Bui’s third claim against SOS, that it negligently failed to evacuate Duong. If the failure to evacuate resulted from an administrative decision, ERISA would preempt this claim. But again, we find no evidence in the record suggesting that the failure was in any way administrative. If SOS was a pure service provider and the failure to evacuate resulted from negligent delay or negligent medical evaluation, ERISA would not preempt this claim. Accordingly, summary judgment on preemption grounds is inappropriate.
B. Claims against AT & T
Bui alleges only one claim against AT & T, for breach of contract. AT & T’s role in the facts underlying this case ended when Lucent became Duong’s employer and assumed the ERISA plan.
C. Claims against Lucent
Bui’s claims against Lucent, are more numerous. Bui alleges breach of contract for failure to provide adequate medical evaluation benefits and for failure to provide the evacuation benefit promised by the ERISA plan. In addition, Bui alleges that Lucent committed various negligent acts that led to Duong’s wrongful death, including: Lucent’s retention of SOS as a service provider; Lucent’s failure to advise Duong that the return of his passport could be expedited in an emergency; Lucent’s advice, through Dr. Waugh, that Duong should heed SOS’s recommendation and stay in Saudi Arabia; and Lucent’s delay in responding to Duong’s request for further advice and for evacuation.
ERISA preempts Bui’s contract claims. These claims do not merely reference the ERISA plan,
ERISA also preempts the claim for negligent retention of SOS as a service provider. Like the selection of providers, the retention of providers is a necessary part of the administration of an ERISA plan. Thus, for the same reasons ERISA precludes suit against AT & T for its initial decision to select SOS, ERISA shields Lu-cent’s decision to retain SOS from the reach of state standards.
We cannot affirm the grant of summary judgment on preemption grounds as to Bui’s last three claims against Lucent. The claim against Lucent for failing to inform Duong that his passport could be returned quickly in the event of an emergency appears to have nothing to do with ERISA. The emergency return of an employee’s passport is not a benefit under an ERISA plan and nothing in the record links Lucent’s failure to inform Duong that his passport could be returned to ERISA benefits. Thus, ERISA does not preempt this claim.
Genuine issues of material fact exist regarding Bui’s last two claims against Lucent for negligent medical advice and for delay in responding to Duong. Although ERISA preempts suits based on negligent administrative decisions, including negligent delays in such decisions,
Lucent has countered Bui’s evidence that Waugh gave Duong medical advice with nothing save blanket statements that the evidence is unconvincing and that Lu-cent was an administrator. We may not,
CONCLUSION
ERISA does not preempt claims of medical malpractice against medical service providers for decisions made in the course of treatment or, in this case, evaluation. That is true even if those medical service providers also serve, at other times, as administrators. Accordingly, summary judgment on preemption grounds may not be granted as to Bui’s claims against SOS and as to her claims against Lucent for negligence based on Lucent’s failure to reveal the expedited passport procedure and for negligence and delay in the provision of medical advice, at least on the record as it currently stands. We reverse and remand as to those claims. Summary judgment on preemption grounds was appropriately granted as to the remaining claims against Lucent and as to all the claims against AT & T. We affirm as to those claims.
REVERSED AND REMANDED IN PART; AFFIRMED IN PART.
No costs allowed.
Notes
. 29 U.S.C. §§ 1001-1461 (2000).
. Apparently, AT & T/Lucent's employees in Saudi Arabia surrendered their passports after their entry into the country.
. Bui asserted jurisdiction on diversity grounds pursuant to 28 U.S.C. § 1332. Bui is a citizen of Oregon. AT & T is a New York corporation. Lucent and SOS are Delaware corporations. The amount in controversy exceeds the requirements of § 1332.
. See, e.g., PM Group Life Ins. Co. v. W. Growers Assurance Trust,
. 29 U.S.C. § 1144(a).
. See Cal. Div. of Labor Standards Enforcement v. Dillingham Constr., N.A., Inc.,
. See Rutledge v. Seyfarth, Shaw, Fairweather & Geraldson,
. See Dukes v. U.S. Healthcare, Inc.,
.
. 5 U.S.C. §§ 8901-8914 (2002).
. See Roach,
. See Rutledge,
. See supra note 12.
. Id.
. Id.
. We note that an entity that both provides direct medical services and acts as an administrator may be held liable under state law for its actions as a service provider, though not for its actions as an administrator. See Roach,
. See Rutledge,
. Id.
.. The current statutory scheme provides no mechanism by which federal malpractice standards could be developed. ERISA’s exclusive civil enforcement provision, § 1132, does not provide for malpractice claims against medical personnel. Thus, if § 1144 preempts state claims for medical malpractice, and § 1132 provides no mechanism for developing federal standards, ERISA beneficiaries would seem to have no recourse. Federal standards could not be developed through litigation, state standards would not apply, and physicians treating ERISA-covered
.See Dillingham,
. We review grants of summary judgment de novo. Oliver v. Keller,
. Roach,
. Id. at 851.
. id.
. Id.
. See Bast,
. We note that, even if SOS had pointed to evidence establishing that it could not contact Lucent, it would still be an open question whether ERISA would entirely preempt the claim against the company. The agreement suggests that, even in cases in which Lucent could not be reached, the decision to evacuate would turn directly on SOS’s determination of medical necessity. SOS thus might well be held liable for the determination of medical necessity that informed the decision not to evacuate, even if ERISA preempted the actual decision not to evacuate. Cf. Roach,
. On appeal, Bui does not challenge the district court’s finding that Lucent assumed the ERISA plan when it spun off from AT & T.
. See, e.g., Greany v. W. Farm Bureau Life Ins. Co.,
. See Rutledge,
.See Travelers,
. See Roach,
. See Rutledge,
. See supra Part II.B.
. See, e.g., Bast,
. See Roach,
. Balint v. Carson City,
. See, e.g., Corporate Health,
