X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

MEMORANDUM OPINION AND ORDER This case involves the alleged failure by the 1199SEIU National Benefit Fund (“the Fund” or “Defendant”) to pay Plaintiffs Murphy Medical Associates, LLC, Diagnostic and Medical Specialists of Greenwich, LLC, and Steven A.R. Murphy (“Murphy Medical” or “Plaintiffs”) for COVID-19 testing they performed for the Fund’s members. For the reasons discussed herein, Defendant’s Motion to Dismiss, ECF No. 64, is GRANTED. BACKGROUND I. Procedural History On January 13, 2022, Plaintiffs filed their original Complaint in the District of Connecticut, and on April 17, 2022, Defendant filed its first Motion to Dismiss. See ECF No. 1, 17. On July 25, 2022, the Court held oral argument on Defendant’s fully briefed motion, which it granted in full on March 24, 2023. See ECF Nos. 44, 48. However, it dismissed one of Plaintiffs’ claims without prejudice and permitted Plaintiffs to amend their pleadings, instructing them either to “include allegations regarding the manner in which Murphy Medical has exhausted its administrative remedies or [plausibly allege] the factual bases for a claim that it should be excused from doing so.” See Murphy Med. Assocs., LLC v. 1199SEIU Nat’l Benefit Fund, No. 22 Civ. 64, 2023 WL 2631811, at *5 (D. Conn. Mar. 24, 2023). The Court further advised Plaintiffs “that if an Amended Complaint is filed, the Court will issue an Order to Show Cause as to why this matter should not be transferred to either the Southern or Eastern Districts of New York by virtue of the forum selection provisions of the Fund’s Plan.” Id. at *7. On May 15, 2023, Plaintiffs filed their Amended Complaint, see Am. Compl., ECF No. 51, and in lieu of answering, Defendant filed the Motion to Dismiss now before the Court, see ECF No. 64. On May 31, 2023, the Court ordered Plaintiffs “to show cause before June 30, 2023 as to why venue in the District of Connecticut is proper.” ECF No. 54. On June 27, 2023, Plaintiffs consented to transfer, see ECF No. 55, and this case was transferred to this District on July 19, 2023, see July 19, 2023 Min. Entry. This case was reassigned to the undersigned on October 20, 2023. See Oct. 20, 2023 Min. Entry. II. Factual Background The Court assumes familiarity with the background facts of this case, which are summarized further by the Order granting Defendant’s first motion to dismiss. See Murphy Med. Assocs., 2023 WL 2631811. The following additional facts, which are drawn from Plaintiffs’ Amended Complaint and documents incorporated by reference therein, are relevant to — and assumed to be true for the purposes of — this motion. See Buon v. Spindler, 65 F.4th 64, 69 n.1 (2d Cir. 2023).1 A. Allegations Against the Fund Plaintiffs’ allegations against the Fund broadly fall within one of the following three categories. Failure to Explain the Fund’s Administrative Appeals Process. Plaintiffs attach to their Amended Complaint examples of Explanations of Payment (“EOPs”) sent to them by the Fund. These EOPs did not justify the denial of payments to Murphy Medical, and they “did not provide any detailed instruction regarding an administrative appeal process.” Am. Compl.

109-12. After Plaintiffs followed up with the Fund and provided further documentation, Defendant continued to decline to justify the claim denials. See id.

 
Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.

More From ALM

With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now
Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now
Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now
November 27, 2024
London

Celebrating achievement, excellence, and innovation in the legal profession in the UK.


Learn More
December 02, 2024 - December 03, 2024
Scottsdale, AZ

Join the industry's top owners, investors, developers, brokers and financiers for the real estate healthcare event of the year!


Learn More
December 11, 2024
Las Vegas, NV

This event shines a spotlight on how individuals and firms are changing the investment advisory industry where it matters most.


Learn More

The Republic of Palau Judiciary is seeking applicants for one Associate Justice position who will be assigned to the Appellate Division of ...


Apply Now ›

Experienced Insurance Defense Attorney.No in office requirement.Send resume to:


Apply Now ›

Prominent law firm seeks 2 associates to join our defense teams in our downtown New York City and Melville, NY offices.The Litigation Associ...


Apply Now ›