No. 21-471

John Doe 1, et al. v. Express Scripts, Inc., et al.

Lower Court: Second Circuit
Docketed: 2021-10-04
Status: Denied
Type: Paid
CVSGAmici (2)Relisted (3) Experienced Counsel
Tags: benefit-pricing circuit-split erisa erisa-fiduciary fiduciary-duties pegram-v-herdrich plan-management price-control pricing third-party-administrator
Key Terms:
Arbitration ERISA JusticiabilityDoctri
Latest Conference: 2022-06-23 (distributed 3 times)
Question Presented (AI Summary)

Does an administrator hired by an ERISA plan act as a fiduciary when it controls prices paid by the plan or its participants?

Question Presented (OCR Extract)

QUESTIONS PRESENTED ERISA imposes fiduciary duties to the extent that an actor performs a function enumerated in 29US.C. . § 1002(21)(A) (defining fiduciary status in terms of the administration or management of a plan or its assets). ; Until 2010, no circuit disputed that a party hired by an ERISA plan is a fiduciary when it controls the prices paid by the plan or its participants. Then, a split Sixth Circuit panel created an extra-textual exception for third-party administrators whose “business” is to control prices. See DeLuca v. Blue Cross Blue Shield of Mich., 628 F.3d 743, 747 (6th Cir. 2010). Judge Keth; ledge dissented. In this case, the Second Circuit joined the Sixth Circuit on the wrong side of a lopsided circuit split. It then extended that error on a second important issue. . The Questions Presented are: . : 1. Does an administrator hired by an ERISA plan act as a fiduciary when it controls prices paid by the plan or its participants (as the Fourth, Fifth, Sev. enth, Eighth, and Ninth Circuits hold) or is control over pricing exempt from the definition of “fiduciary” (the DeLuca exception) if the administrator is in the “business” of setting prices for its clients (as the Second and Sixth Circuits maintain)? , il ; QUESTIONS PRESENTED—Continued : 2. If the DeLuca exception is, in fact, a proper gloss on ERISA based on this Court’s decision in Pegram v. Herdrich, 530 U.S. 211 (2000), does it exempt from fiduciary status a third-party benefit manager that exercises ongoing discretion over the actual prices charged to the plans pursuant to a contract with the plan administrator? \ iii :

Docket Entries

2022-06-27
Petition DENIED.
2022-06-07
DISTRIBUTED for Conference of 6/23/2022.
2022-06-03
Supplemental brief of petitioners John Doe 1, et al. filed. (Distributed)
2022-05-24
Brief amicus curiae of United States filed.
2021-12-13
The Solicitor General is invited to file a brief in this case expressing the views of the United States.
2021-11-23
DISTRIBUTED for Conference of 12/10/2021.
2021-11-18
Reply of petitioners John Doe 1, et al. filed.
2021-11-03
Brief of respondent Express Scripts, Inc. in opposition filed.
2021-11-03
Brief of respondent Anthem, Inc. in opposition filed.
2021-11-03
Brief amicus curiae of Pension Rights Center filed.
2021-10-04
Motion (21M3) for leave to file a petition for a writ of certiorari with the supplemental appendix under seal Granted.
2021-07-07
MOTION (21M3) DISTRIBUTED for Conference of 9/27/2021.
2021-06-25
Motion (21M3) for leave to file a petition for a writ of certiorari with the supplemental appendix under seal filed.
2021-06-25
Petition for a writ of certiorari filed. (Response due November 3, 2021)

Attorneys

Anthem, Inc.
Glenn Michael KurtzWhite & Case LLP, Respondent
Glenn Michael KurtzWhite & Case LLP, Respondent
Express Scripts, Inc.
Derek L. ShafferQuinn Emanuel Urquhart & Sullivan, LLP, Respondent
Derek L. ShafferQuinn Emanuel Urquhart & Sullivan, LLP, Respondent
John Doe 1, et al.
Peter K. StrisStris and Maher LLP, Petitioner
Peter K. StrisStris and Maher LLP, Petitioner
Pension Rights Center
Teresa S. RenakerRenaker Hasselman Scott LLP, Amicus
Teresa S. RenakerRenaker Hasselman Scott LLP, Amicus
United States
Elizabeth B. PrelogarSolicitor General, Amicus
Elizabeth B. PrelogarSolicitor General, Amicus