The Medical Society of the State of New York v. UnitedHealth Group Inc.

Background

The court had previously granted in part the plaintiffs’ motion to certify a class under Federal Rule of Civil Procedure 23. The certified class consisted of “any United Plan member, or member’s valid assignee, whose claims for facility fees for services rendered by an out-of-network OBS provider accredited under Section 230-d was denied.” UnitedHealth Group Inc. and the other defendants, collectively called “United,” moved for reconsideration of that earlier order.

Arguments and analysis

A motion for reconsideration is an extraordinary request asking a court to revisit an earlier decision. The court explained that reconsideration generally is not appropriate unless the moving party identifies controlling decisions or information the court overlooked that could reasonably change the result.

United made two arguments. First, it said the court had not considered whether a patient who had fully assigned her rights to a provider lacked constitutional standing—the requirement that a person have a legally sufficient connection to bring a claim in federal court. United argued that including such patients would invalidate the class. The court disagreed with United’s reading of the class definition. It held that the definition included only patients who had not assigned their claims to a provider, or providers that had received valid assignments. Patients who had already assigned their claims to a provider were excluded. The court therefore stated that the class remained valid even assuming United was correct about those patients’ standing.

Second, United argued that determining the validity of each assignment would defeat commonality, the requirement that class members share a significant question capable of classwide resolution. The court had previously determined that the assignment issue was more relevant to predominance—the requirement that common issues outweigh individual ones—than to commonality. It also found that whether United had a uniform policy of denying out-of-network OBS facility-fee claims without consulting individual plan language was a common question. Because that question was also a critical merits question, the court concluded that the assignment issue did not defeat commonality.

Disposition

Judge Oetken held that United had not shown a basis for reconsideration. The court denied Defendants’ motion for reconsideration and directed the Clerk of Court to close the motion at Docket Number 208. The opinion did not alter the earlier order’s class certification.