Opinion
20-55821
01-20-2022
NOT FOR PUBLICATION
Submitted October 22, 2021 [**] Pasadena, California
Appeal from the United States District Court No. 8:19-cv-00243-DOC-DFM for the Central District of California David O. Carter, District Judge, Presiding
Before: KLEINFELD, R. NELSON, and VANDYKE, Circuit Judges.
MEMORANDUM [*]
ABC appeals the district court's dismissal of ABC's ERISA, contract, and quantum meruit claims. We have jurisdiction under 28 U.S.C. § 1291 and affirm in part and reverse and remand in part for further proceedings.
The parties are familiar with the facts, so we discuss them here only as necessary.
We review de novo the district court's grant of the motion to dismiss under Rule 12(b)(6), accepting as true all allegations in the complaint and construing the facts in favor of the non-moving party. See Knievel v. ESPN, 393 F.3d 1068, 1072 (9th Cir. 2005).
I. ABC's Contract Claims
We affirm the district court's dismissal with prejudice of ABC's contract claims for insufficient pleading. ABC failed to plead "any specific provisions of the contracts," and attached "example plans" of the service agreements, which were impermissible as "conclusory allegations." ABC argues that they could not plead the specifics of each contract because it didn't possess all the plans at this stage of the litigation. ABC relies heavily on a Fifth Circuit case for the proposition that the plaintiff need not plead the contract specifics when they are in the sole possession of Defendants. See Innova Hosp. San Antonio, LP v. Blue Cross & Blue Shield of Ga., Inc., 892 F.3d 719, 730 (5th Cir. 2018). But assuming arguendo our court would follow the Fifth Circuit's rule in Innova, ABC's reliance on Innova fails because ABC did not even plead the specifics of the many plans it did possess. This fact alone distinguishes ABC from the plaintiff in Innova. See id. ("[T]his is not a case in which the plaintiff has ready access to plan documents and fails to identify the specific plan language at issue."). The district court correctly dismissed ABC's contract claims after ABC repeatedly failed to comport with the pleading requirements, and we affirm that decision.
II. ABC's ERISA Claim
The district court dismissed ABC's ERISA claims with prejudice after determining that ABC lacked standing to bring its claims. In so holding, the district court relied on Simon v. Value Behavior Health, Inc., 208 F.3d 1073, 1081 (9th Cir. 2000), overruled on other grounds by Odom v. Microsoft Corp., 486 F.3d 541, 551 (9th Cir. 2007), to conclude "[t]he Ninth Circuit has expressly declined to further extend standing to the assignees of healthcare providers." After the district court issued its ruling, our court published an opinion that clarifies Simon's holding and the ability of an assignee to bring an ERISA cause of action. We therefore reverse the district court's dismissal of ABC's ERISA claims and remand for further proceedings in light of this new case law.
On appeal, Defendants also argue that ABC's ERISA claims should be dismissed as improperly pled, because the operative complaint does not adequately put each individual defendant on notice for its specific alleged actions. ABC disputes both the proper pleading standard in this context as well as the sufficiency of the facts and information it has alleged. The district court did not reach this issue because it was unnecessary given the court's dismissal of the ERISA claims on other grounds, and we decline to address it for the first time on appeal.
See Bristol SL Holdings, Inc. v. Cigna Health and Life Ins. Co., No. 20-56122, __ F.4th __ (9th Cir. Jan. 14, 2022).
III. ABC's Quantum Meruit Claim
To succeed on a quantum meruit claim, ABC must prove that Defendants requested services from ABC. See Ochs v. PacifiCare of Cal., 9 Cal.Rptr.3d 734, 742 (Cal.Ct.App. 2 Dist. 2004) (citing Day v. Alta Bates Med. Ctr., 119 Cal.Rptr.2d 606, 609 (Cal. Dist. Ct. App. 1 Dist. 2002)). But the record reveals that ABC can, at most, argue that Defendants verified coverage and would allow for treatment, not that ABC took the additional step of explicitly requesting such service. The district court correctly dismissed ABC's claim on this basis.
ABC filed two motions to take judicial notice (Docs. 32, 70). Because these motions are unopposed and comply with Federal Rule of Evidence 201, we grant both motions.
AFFIRMED IN PART AND REVERSED AND REMANDED IN PART.
[*] This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3.
[**] The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2).