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Cooper Hospital University Medical Center v. Seafarers Health and Benefits Plan

August 17, 2007

COOPER HOSPITAL UNIVERSITY MEDICAL CENTER, PLAINTIFF,
v.
SEAFARERS HEALTH AND BENEFITS PLAN, AND RUFUS PRITCHETT, DEFENDANTS.



The opinion of the court was delivered by: Irenas, Senior District Judge

HONORABLE JOSEPH E. IRENAS

OPINION

This case involves a dispute arising from Defendant Seafarers Health and Benefits Plan's ("Seafarers") partial payment of Plaintiff Cooper Hospital University Medical Center's ("Cooper Hospital") bills. Cooper Hospital seeks to recover the remaining balance due. Seafarers asserts that it is not obligated to pay the remaining balance.*fn1 Before the Court are cross-motions for summary judgment. Because the Court concludes that it lacks subject matter jurisdiction over this case, the case will be remanded to state court and the motions will be dismissed as moot.

I.

The facts of this case are undisputed. Defendant Rufus Pritchett, who is insured by Seafarers,*fn2 was admitted to Cooper Hospital on February 15, 2004, where he stayed for treatment until March 15, 2004.*fn3

For the "medical supplies and treatment rendered" to Pritchett, Cooper Hospital billed Seafarers $363,812.00.

Seafarers, concluding that $160,482.00 was the reasonable charge for the goods and services rendered, paid Cooper Hospital that sum. It refuses to pay the remaining $203,330.00, asserting that the balance exceeds the Plan's allowances for reasonable and customary charges based on a regional comparison.

Cooper Hospital filed suit in the Superior Court of New Jersey, Camden County, on September 15, 2005. The Complaint, which is not a model of clarity, asserts five counts, two against Seafarers only, two against Pritchett only, and one count against both Defendants. All five counts demand a judgment of $203,330.00. A summons, dated November 21, 2005, was issued for Seafarers.

There is no indication in the record that a summons was ever issued for Pritchett.

Seafarers filed its Notice of Removal with this Court on December 22, 2005. The Notice of Removal asserts that this Court has federal question subject matter jurisdiction based on ERISA's complete preemption of Cooper Hospital's claims.

II.

The Court has an obligation to raise, sua sponte, the issue of its subject matter jurisdiction. Meritcare, Inc. v. St. Paul Mercury Ins. Co., 166 F.3d 214, 216 (3d Cir. 1999). Fed. R. Civ. P. 12(h)(3) provides, "whenever it appears by suggestion of the parties or otherwise that the court lacks jurisdiction of the subject matter, the court shall dismiss the action."

Accordingly, before reaching the merits of the present action, the Court must examine whether it has subject matter jurisdiction over any of the claims asserted in the complaint. While neither party addresses the issue in their summary judgment briefs, Seafarers provides the following explanation in its Notice of Removal:

The Plan is an 'employee benefit plan' as defined in the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1002(3). Plaintiff is suing as a purported beneficiary of the Plan, as the term beneficiary is defined in ERISA, 29 U.S.C. § 1002(8), seeking payment of a benefit by the ...


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