More that five years after the U.S. Supreme Court decided Aetna Health Inc. v. Davila, 542 U.S. 200 (2004), the Eleventh Circuit officially adopted the Court’s ERISA complete preemption test. Conn. State Dental Ass’n v. Anthem Health Plans, Inc., 2009 U.S. App. LEXIS 28773 (11th Cir. Fla. Dec. 30, 2009). The court determined that some of the plaintiff’s state law claims were properly removed pursuant to § 502(a)(1)(B), ERISA’s civil enforcement provision, 29 USCS § 1132(a)(1)(B). Id. at *2.
Dentists Rutt and Egan and Connecticut State Dental Association brought state law claims against Anthem for improper “‘downcoding’ and ‘improper bundling,’ as a means of underpaying participating dentists for services they performed.” Id. at *3. Anthem removed the case to federal court on the basis that the claims…
In Majeski v. Metropolitan Life Ins. Co., the Seventh Circuit Court of Appeals admitted that it “is still pondering . . . just how to consider a plan administrator’s conflict of interest.” 2009 WL 5088720 (7th Cir. Dec. 29, 2009) (emphasis in original). The court continued to reject a blanket rule that would force a reviewing court to weigh conflict in every case, instead opting for a case-by-case inquiry that weighs conflict only if it is relevant based on its gravity. “Gravity” of conflict might be discerned from the reasonableness of the claim procedures, the safeguards implemented to minimize the conflict and the “terms of employment” of the decision-maker’s staff, the court suggested. The court rejected that the conflict inquiry…
The Eighth Circuit has swung to the left. In two recent decisions, the Eighth Circuit has reached results that would make the Ninth Circuit blush. First, in In re Prempro Prods. Liability Litig., 2009 WL 3518245 (8th Cir. Nov. 2, 2009), the Eighth Circuit threw aside Daubert and held admissible expert testimony that through the alchemy of differential diagnosis one may divine the cause of breast cancer.
Now we have Braden v. Wal-Mart Stores, Inc., 2009 WL 4062105 (8th Cir. Nov. 25, 2009), in which the Eighth Circuit dramatically relaxes the standards governing standing and pleading in ERISA cases. Reversing the district court’s dismissal of a putative class action against Wal-Mart alleging the violation of fiduciary duties imposed by ERISA, the Eighth…
