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Mills v. Bluecross Blueshield of Tennessee, Inc.

United States District Court, E.D. Tennessee, Knoxville

January 9, 2017

MARLENA MILLS, DAVID MILLS, and JULIA MILLS, Plaintiffs,
v.
BLUECROSS BLUESHIELD OF TENNESSEE, INC., Defendant.

          MEMORANDUM OPINION AND ORDER

         Before the Court are three motions. First is a motion for judgment on the pleadings filed by BlueCross BlueShield of Tennessee, Inc. Second is BlueCross's motion to strike the amended complaint filed by the Millses. Last is the Millses' motion for leave to refile their amended complaint. For the following reasons, the motion to strike is granted, the motion to dismiss is granted in part and denied in part, and the motion to amend is granted in part and denied in part.

         I

         A

         Marlena Mills lives in Memphis with her parents, David and Julia. Marlena suffers from mental-health issues and is insured by BlueCross. She purchased her BlueCross insurance plan on a state exchange set up by the Affordable Care Act. She has used this plan for in-network and out-of-network mental-health treatment.

         In June 2015, Marlena moved from Memphis to Knoxville. While there, her mental health worsened. Marlena and her parents decided that she needed inpatient care, and they considered her in-network and out-of-network options. They concluded that the best facility for Marlena was Pasadena Villa, an out-of-network treatment center located in Pigeon Forge.

         Because Pasadena Villa was outside Marlena's plan, she would have to pay all costs out of pocket. The only way to avoid this was for BlueCross to give Marlena prior authorization to be treated there. So David began trying to get prior authorization.

         This process proved daunting. From October 31 until November 16, David strove to get prior authorization. Instead, he received conflicting information, had his request for prior authorization shuttled among several departments, and ran up against the slowness of large organizations. Meanwhile, Marlena entered Pasadena Villa.

         B

         Fed up with David's inability to get prior authorization and worried about the out-of-pocket expenses for Marlena's treatment, the Millses sued in Knox County Chancery Court on November 16, 2015. BlueCross removed to this Court a month later and filed its answer.

         In March 2016, BlueCross moved for judgment on the pleadings. The Millses responded by filing an amended complaint. BlueCross replied with a motion to strike the amended complaint, and the Millses moved for leave to refile it. The Court will now consider these three motions.

         II

         First is BlueCross's motion to strike the amended complaint. BlueCross filed its answer to the original complaint in December 2015. In March 2016, the Millses filed an amended complaint without requesting permission from the Court. BlueCross argues that the Millses needed permission.

         BlueCross is correct. If a pleading requires a response, a party may amend that pleading without the court's permission within twenty-one days of serving it. Fed.R.Civ.P. 15(a)(1)(A). And if that party then receives a responsive pleading or a motion to dismiss, a motion for a more definite statement, or a motion to strike, the party has another twenty-one days to amend the pleading without the court's permission. Id. 15(a)(1)(B).[1] If both deadlines have passed, the party may amend the pleading only with the court's permission. Id. 15(a)(2).

         Both deadlines passed before the Millses filed their amended complaint. First, they did not file it within twenty-one days of serving it on BlueCross. BlueCross removed the case to this Court on December 14, 2015. The Millses filed their amended complaint on March 17, 2016.

         Second, the Millses did not file their amended complaint within twenty-one days of receiving a responsive pleading from BlueCross. Answers count as responsive pleadings. United States ex rel. Wall v. Circle C Constr., L.L.C., 697 F.3d 345, 350 (6th Cir. 2012). BlueCross filed its answer on December 21, 2015. The Millses filed their amended complaint three months later.

         The Millses did not file their amended complaint within the periods set out in Rule 15(a)(1). The amendment was therefore untimely. BlueCross's motion to strike the amended complaint is GRANTED. The Millses' request for permission to amend their complaint is considered below.

         III

         A

         When reviewing a motion for judgment on the pleadings, the court looks at all the pleadings filed in the case. Gavitt v. Born, 835 F.3d 623, 640 (6th Cir. 2016). Motions for judgment on the pleadings under Rule 12(c) are reviewed under the same standard as motions to dismiss under Rule 12(b)(6). Id. The complaint will survive a motion to dismiss ...


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