No. 20-378

North Cypress Medical Center Operating Company, Ltd., et al. v. Cigna Healthcare, et al.

Lower Court: Fifth Circuit
Docketed: 2020-09-24
Status: Denied
Type: Paid
Experienced Counsel
Tags: administrative-discretion benefits-denial circuit-split conflicts-of-interest employee-retirement-income-security-act erisa firestone-analysis judicial-review standard-of-review totality-of-factors
Key Terms:
AdministrativeLaw Arbitration ERISA HabeasCorpus
Latest Conference: 2021-01-08
Question Presented (AI Summary)

Whether, in reviewing an ERISA administrator's benefits denial, it is automatically dispositive that 'two other courts' upheld the administrator's interpretation (as the Fifth Circuit held below, rendering 'immaterial' the traditional Firestone inquiry), or whether a reviewing court must consider all the traditional factors required in this Court's Firestone analysis (as required by multiple courts of appeals and this Court)

Question Presented (from Petition)

QUESTION PRESENTED This case raises an important and recurring question under the Employee Retirement Income Security Act of 1974 (ERISA), Pub. L. No. 93-406, 88 Stat. 829 (29 U.S.C. 1001 et seq.). In reviewing whether an ERISA administrator abused its discretion in denying a benefits claim, this Court has instructed lower courts to apply a analysis. Under that analysis, reviewing courts “must” consider all relevant “case-specific” factors and weigh them together. In the decision below, the Fifth Circuit abandoned that totality analysis and replaced it with a per se rule: According to the Fifth Circuit, an administrator automatically wins so long as “two other courts,” right or wrong, endorsed the administrator’s plan interpretation in the past—rendering it “immaterial” whether the administrator’s reading was legally correct, infected by conflicts of interest, motivated by bad faith, or applied unevenly to other participants. This mechanical new rule conflicts with the prevailing standard applied by this Court and other circuits—where all factors “must” be considered before deciding if a benefits denial can stand. The question presented is: Whether, in reviewing an ERISA administrator’s benefits denial, it is automatically dispositive that “two other courts” upheld the administrator’s interpretation (as the Fifth Circuit held below, rendering “immaterial” the traditional inquiry”), or whether a reviewing court must consider all the traditional factors required in this Court’s analysis (as required by multiple courts of appeals and this Court). (1)

Docket Entries

2021-01-11
Petition DENIED.
2020-12-18
Reply of petitioners North Cypress Medical Center Operating Company, Ltd., et al. filed. (Distributed)
2020-12-16
DISTRIBUTED for Conference of 1/8/2021.
2020-12-01
Motion to delay distribution of the petition for a writ certiorari until December 16, 2020 granted.
2020-11-30
Motion of petitioner to delay distribution of the petition for a writ of certiorari under Rule 15.5 from December 9, 2020 to December 16, 2020, submitted to The Clerk.
2020-11-25
Brief of respondents Cigna Healthcare, et al. in opposition filed.
2020-10-06
Motion to extend the time to file a response is granted and the time is extended to and including November 25, 2020.
2020-10-05
Motion to extend the time to file a response from October 26, 2020 to November 25, 2020, submitted to The Clerk.
2020-09-18
Petition for a writ of certiorari filed. (Response due October 26, 2020)

Attorneys

Cigna Healthcare, et al.
Michael B. KimberlyMCDERMOTT WILL & EMERY, Respondent
Michael B. KimberlyMCDERMOTT WILL & EMERY, Respondent
North Cypress Medical Center Operating Company, Ltd., et al.
Daniel L. GeyserAlexander Dubose & Jefferson LLP, Petitioner
Daniel L. GeyserAlexander Dubose & Jefferson LLP, Petitioner