Guillermina Parra v. Pacificare of Arizona, Inc.

FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

GUILLERMINA PARRA; TERRI No. 11-16069

CORRALES; FRANCISCO PARRA; JESUS

PARRA, D.C. No. Plaintiffs-counter-defendants- 4:10-cv-00008- Appellees, DCB

v.

OPINION

PACIFICARE OF ARIZONA, INC., an Arizona corporation, Defendant-counter-claimant- Appellant.

Appeal from the United States District Court for the District of Arizona David C. Bury, District Judge, Presiding

Argued and Submitted October 16, 2012—San Francisco, California

Filed April 19, 2013

Before: Richard C. Tallman, Consuelo M. Callahan, and Andrew D. Hurwitz, Circuit Judges.

Opinion by Judge Hurwitz; Concurrence by Judge Callahan SUMMARY*

Medicare Act

Affirming the district court’s judgment, the panel held that a private Medicare Advantage Organization plan cannot sue a plan participant’s survivors for reimbursement for advanced medical expenses out of the proceeds of an automobile insurance policy.

The panel held that the district court had subject matter jurisdiction to determine whether the Medicare Act created a cause of action in favor of the…

Opinion by Judge HURWITZ; Concurrence by Judge CALLAHAN.

OPINION

This case involves the Medicare Act, one of “the most completely impenetrable texts within human experience.” Cooper Univ. Hosp. v. Sebelius, 636 F.3d 44, 45 (3d Cir.2010) (internal quotation marks and ci *1150 tation omitted). The issue is whether a private Medicare Advantage Organization (“MAO”), plan can sue a plan participant’s survivors, seeking reimbursement for advanced medical expenses out of the proceeds of an automobile insurance policy. The district court dismissed the causes of action asserted by the MAO under, the Medicare Act for failure to state a claim and declined to exercise supplemental jurisdiction over the MAO’s contract claim. We affirm.

I.

Facts and Procedural Background

Manuel Parra was injured when struck by a car as he was walking through a parking lot. Parra was a participant, in a MAO plan offered by PacifiCare of Arizona, Inc., which paid his hospital and medical bills.

After Parra died from injuries suffered in the accident, his wife and children (the “Survivors”) made a demand for wrongful death damages against the driver’s $500,000 GEICO automobile insurance policy. See…

concurring:

I concur in the panel’s decision, but write separately to make explicit an important jurisdictional point implicitly addressed by the majority.

As the majority acknowledges, our opinions are less than consistent on whether district courts have jurisdiction to determine if a federal law affords a litigant a private right of action. See Maj. Op. at 1151 & n. 1 (comparing Western Radio Services Co. v. Qwest Corp., 530 F.3d 1186, 1196 (9th Cir.2008), and Lewis v. Transamerica Corp., 575 F;2d 237, 239 n. 2 (9th Cir.1978), rev’d on other grounds, 444 U.S. 11 , 100 S.Ct. 242 , 62 L.Ed.2d 146 (1979), with North County Communications Corp. v. Cal. Catalog & Tech., 594 F.3d 1149, 1151-52 (9th Cir.2010), and Williams v. United Airlines, Inc., 500 F.3d 1019, 1022 (9th Cir.2007)). Accordingly, I offer a further explanation for our decision to affirm the district court’s jurisdiction.

Our opinion in North County Communications accepted without analysis the district court’s conclusion that the lack of a private right of action deprived that court of jurisdiction. 594 F.3d at 1152, 1161 . In addition, although we offered some analysis in Williams , we relied on factually…