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Med-X Global, LLC v. Worldwide Insurance Services, LLC

United States District Court, D. New Jersey

January 8, 2018

MED-X GLOBAL, LLC, Plaintiff,


          PETER G. SHERIDAN, U.S.D.J.

         This matter is before this Court on Plaintiff's motion for an Order to Show Cause with temporary restraint. [ECF No. 2].


         Med-X 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).

         Worldwide 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).

         On 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). (Id.)[1]

         On the 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).

         On December 13, 2017, the Court held oral argument on the motion. There, the Parties clarified that temporary restraint was primarily sought against Defendant GeoBlue.


         Injunctive 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);, Inc. v., Inc., 239 F.3d 1343, 1350 (Fed. Cir. 2001).

         “The 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).


         The 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).

         GeoBlue 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). ...

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