Emergency Physician Services of New York v. UnitedHealth Group, Inc.

Background

Various medical care providers in New York sued UnitedHealth Group, Inc. and certain subsidiaries and affiliates. The plaintiffs alleged that the defendants failed to reimburse them for the reasonable value of emergency medical services provided to the defendants’ insured members. The case had been pending for approximately four years, discovery was complete, and the court had most recently denied the defendants’ motion for summary judgment.

Motions and legal standard

The defendants asked the court to certify two issues for an interlocutory appeal, meaning an appeal before the case is finally resolved. The proposed issues were:

1. Whether the plaintiffs had satisfied the requirements for an unjust-enrichment claim under New York law. 2. Whether those claims were preempted, or displaced, by the Federal Employee Health Benefits Act and the Employee Retirement Income Security Act.

The defendants also moved to stay, or pause, further proceedings while an interlocutory appeal was pending. Under 28 U.S.C. § 1292(b), certification requires a controlling legal question, substantial grounds for disagreement about that question, and a finding that an immediate appeal may materially advance the end of the litigation. The court explained that interlocutory appeals are exceptional because appellate review ordinarily occurs after final judgment.

Court’s reasoning

The plaintiffs did not dispute that the two proposed issues were controlling issues in the litigation. The court stated that its earlier decision had determined that both issues favored the plaintiffs and that there was no contrary Second Circuit authority. However, the court identified the lack of likely progress toward ending the case as the decisive reason to deny certification.

The parties had been ordered to file a joint pretrial order by October 23, 2024, and the case was ready for trial, which was likely to occur within the next few months. The defendants could prevail at trial by showing that the amounts already paid were the reasonable value of the emergency services. If they did not prevail, they could raise the proposed legal issues, along with trial-related evidence issues, in an appeal from the final judgment. The court concluded that an immediate appeal would cause considerable delay rather than materially advance the case’s resolution. The court also noted that the purely state-law issue might require certification to the New York Court of Appeals.

Disposition

The defendants’ motion for an interlocutory appeal was denied. The motion to stay proceedings pending resolution of that appeal was dismissed as moot. The Clerk was directed to close ECF Nos. 512 and 514.