United States District Court, D. New Jersey
MEMORANDUM AND ORDER
G. SHERIDAN, U.S.D.J.
matter is before this Court on Plaintiff's motion for an
Order to Show Cause with temporary restraint. [ECF No. 2].
is an international billing agent whose principal business is
processing medical insurance claims and receiving payment on
behalf of medical providers who provide medical care to
citizens of the United States while traveling abroad. (ECF
2-2 pg. 2).
Insurance Services, LLC (“GeoBlue”) is a
corporation that has served as the administrative service
provider for the Blue Cross and Blue Shield Association
(BCBS) since January 1, 2017. In its capacity, GeoBlue
assists BCBS's licensee insurance companies (the other
Defendants in this matter) in their processing and payment of
claims submitted by international providers. Additionally,
GeoBlue assists BCBS insureds in identifying and selecting
appropriate providers, including issuing guarantees of
payment to international providers. (GeoBlue's Opp. pg.
2-3; Puccino's Decl. ¶4).
November 16, 2017, Plaintiff Med-X Global, LLC, a medical
billing agency, filed a complaint against Worldwide Insurance
Services (hereinafter “GeoBlue” or
“Defendant”), an insurance company third-party
administrator, and a number of Blue Cross Blue Shield
defendants that GeoBlue serves, for claims arising under the
Employment Retirement Income Security Act of 1974, 29 U.S.C.
§§1000-1461 (ERISA), for Defendants' failure to
produce their administrative records relating to hundreds of
health insurance claims and implicating ERISA, 29 U.S.C.
§1024(b), 29 U.S.C. §1132(c)(1) and 29 C.F.R.
§2575.502c-1 (COUNT I). (ECF No. 1, Compl. ¶1).
Pursuant to Title 29, Plaintiff seeks Defendant to be
assessed a penalty in the amount of $110/ per day from the
beginning of the violation period which began accruing on
July 31, 2017. (Compl. ¶58). The action also sets forth
claims for an immediate need for Defendants to be temporarily
restrained, pursuant to Fed.R.Civ.P. 65, from attempting to
put the medical billing agency industry, and Plaintiff in
particular, out of business, allegedly causing irreparable
harm to Plaintiff, Plaintiff's international medical
provider clients, and United States citizens receiving
medical care from Plaintiff's international medical
provider clients in the process (COUNT II).
same day as the Complaint was filed, Plaintiff also filed a
motion for a temporary restraining order (TRO), reaffirming
the basis set forth in Count II of the Complaint. The TRO
specifically requested temporary restraint of Defendants from
refusing to accept claims for medical benefits from the
Plaintiff on behalf of foreign medical providers that have
engaged the Plaintiff for medical billing and ordering the
Defendants to show cause why a preliminary injunction should
not be issued. Plaintiff supports that the temporary relief
is necessary “to halt Defendants' unlawful conduct
and to preserve the status quo pending this Court's
ability to issue full and final relief to the parties.”
(ECF No. 2, TRO pg. 2). A motion to show cause for a
temporary restraining order and preliminary injunction was
set to be heard on November 30, 2017. (ECF No. 4). However,
Parties came to a temporary agreement with regard to the
emergency petition and the application for a temporary
restraining order, and consequently, the order to show cause
was reset for a hearing on December 13, 2017. (ECF No. 12).
December 13, 2017, the Court held oral argument on the
motion. There, the Parties clarified that temporary restraint
was primarily sought against Defendant GeoBlue.
relief is an “extraordinary remedy, which should be
granted only in limited circumstances[, ]” Novartis
Consumer Health v. Johnson & Johnson-Merck Consumer
Pharms. Co., 290 F.3d 578, 586 (3d Cir. 2002). The
decision to grant a preliminary injunction is within the
sound discretion of the district court. eBay Inc. v.
MercExchange, L.L.C., 547 U.S. 388, 391, 394, 126 S.Ct.
1837, 164 L.Ed.2d 641 (2006); see, e.g., Abbott
Labs. v. Andrx Pharms., Inc., 452 F.3d 1331, 1334 (Fed.
Cir. 2006); Amazon.com, Inc. v. Barnesandnoble.com,
Inc., 239 F.3d 1343, 1350 (Fed. Cir. 2001).
Court examines the following four factors in determining
whether injunctive relief should be granted: (1) whether the
movant has shown a reasonable likelihood of success on the
merits; (2) whether the movant will be irreparably harmed by
denial of the injunctive relief sought; (3) whether the
injury to the movant in the absence of injunctive relief
outweighs the possible harm to the non-movant if the
injunction is granted; and (4) the impact of a preliminary
injunction on the public interest.” ADP, LLC v.
Jacobs, 2015 U.S. Dist. LEXIS 103207, *8 (D.N.J. Aug. 5,
2015) (citing Abbott Labs., 452 F.3d at 1334). The
movant bears the burden of showing that the injunction sought
should be issued. Id. "A movant cannot be
granted a preliminary injunction unless it establishes both
of the first two factors, i.e., likelihood of success on the
merits and irreparable harm.  However, the Court must
generally weigh all four factors in determining whether to
grant an injunction.” Id. (citations omitted).
first area of inquiry is the likelihood of the movant's
success. Here, Plaintiff argues likelihood of success on the
merit because Defendants have no justifiable bias for
refusing to allow foreign medical providers to utilize the
Plaintiff's services. (Pl. Br. pg. 5).
counters by pointing out that there is no contract between
them and Med-X. (Def. Opp. pg. 7). GeoBlue is an affiliate of
the other BCBS Defendants, and its actions are to best serve
the subscribers of BCBS in the most efficient, cost effective
manner. Defendant also supports that damages foreseen by
Plaintiff as a result of the policy change are only
speculative at this time. (Def. Opp. pg. 9). ...