Tidwell v. U.S. Department of Health and Human Services

Background

Edward C. Tidwell, a self-represented litigant, alleged that his daughter died in June 2022 because of negligence and medical malpractice by Kaiser Permanente. He alleged that, during a Medicare appeals process, Livanta conducted a quality-of-care review in 2024. He sued Livanta LLC, Ellen R. Evans M.D., and Matthew Stofferahn M.D. for personal injury, fraud-related claims, unjust enrichment, breach of fiduciary duty, and other theories. He also asserted three claims under the Freedom of Information Act against Livanta.

This order addressed only the motion to dismiss filed by Livanta, Evans, and Stofferahn. The court treated the defendants’ challenge to subject-matter jurisdiction as a factual challenge, allowing it to consider materials beyond the complaint. The court took judicial notice of public records showing that Evans was licensed in Nebraska and Oklahoma and that Stofferahn was licensed in Nevada. It did not rely on those records to reject Tidwell’s factual allegations for purposes of the motion.

Analysis

The defendants represented that Livanta is a Beneficiary and Family Centered Care Quality Improvement Organization that contracts with the Centers for Medicare & Medicaid Services to receive Medicare complaints and independently review whether Medicare-covered services meet applicable standards of care. Tidwell did not dispute that description, Livanta’s relationship with the federal agency, or the defendants’ contention that the claims concerned their contractual duties.

The defendants argued that they had absolute immunity from suit for performing the Medicare quality-of-care review. Absolute immunity is protection from a lawsuit for certain functions that are sufficiently similar to protected government or judicial functions. The court concluded that medical peer-review groups contracted by the federal government to promote Medicare quality are treated as federal officials for immunity purposes and are immune when carrying out quality-of-care review functions.

Tidwell argued that Evans and Stofferahn were not acting as federal officials because they were not licensed in Maryland or Virginia. The court rejected that argument. It found that Tidwell did not explain why employees of a Medicare quality-review organization had to be licensed in the states where the organization maintained offices. The court also found that the licensing materials Tidwell cited concerned physicians providing medical services, while employment by the quality-review organization was not the same as providing medical services in a state. Tidwell did not identify facts showing that the defendants acted outside their statutory authority.

The court separately held that Tidwell could not state a Freedom of Information Act claim against Livanta because that statute does not apply to Beneficiary and Family Centered Care Quality Improvement Organizations. Tidwell did not dispute that conclusion. The court also denied Tidwell’s request for judicial notice because his cited materials were irrelevant to the allegations at issue. It granted the defendants’ request for judicial notice of the public medical-license records.

Disposition

The court found that amendment would be futile because absolute immunity applied to the claims concerning the quality-of-care review and because Tidwell could not state a Freedom of Information Act claim against Livanta. Chief Magistrate Judge Donna M. Ryu granted the motion to dismiss. The court dismissed Tidwell’s claims against Livanta, Evans, and Stofferahn with prejudice and without leave to amend, and directed the clerk to enter judgment for those defendants. The order did not rule on claims against the other defendants.