Martinez v. Ila Prssa
U.S. Court of Appeals for the First Circuit
Martinez v. Ila Prssa
Opinion
USCA1 Opinion
August 11, 1992 [NOT FOR PUBLICATION]
UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
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No. 91-2335
ORESTE MORCELO-MARTINEZ, ET AL.,
Plaintiffs, Appellants,
v.
WELFARE FUND ILA-PRSSA,
Defendant, Appellee.
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APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Jaime Pieras, Jr., U.S. District Judge]
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Before
Breyer, Chief Judge,
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O'Scannlain,* and Cyr, Circuit Judges.
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John Ward-Llambias for appellants.
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Roberto E. Vega-Pacheco with whom Trias, Acevedo & Otero was on
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brief for appellee.
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*Of the Ninth Circuit, sitting by designation.
Per Curiam. The Morcelos brought this action against
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Mr. Morcelo's employer-provided health care insurer for
reimbursement of medical expenses pursuant to the Employee
Retirement Income Security Act ("ERISA"), 29 U.S.C. 1132. The
trial court dismissed the complaint for failure to state a claim
upon which relief could be granted. Fed. R. Civ. P. 12(b)(6). We
now affirm.
Mr. Morcelo was advised by his doctor to seek heart
surgery in Texas. The defendant allegedly denied coverage for
such treatment and the surgery was eventually performed in Puerto
Rico and paid for by the Medicaid program of the Puerto Rico
Department of Health. The Morcelos assigned "any right to
remuneration, payment or aid for medical expenses which I or which
any other person may have" to the Medicaid Program. The district
court concluded that the Morcelos lacked standing to bring this
action since they were not the real parties in interest after
having assigned all their rights to reimbursement of medical
expenses to the Medicaid Program.
I.
Mr. Morcelo argues that he is entitled to recover the
difference between what the Medicaid Program paid for his less
expensive operation in Puerto Rico and what an operation in Texas
would have cost. He analogizes his attempted recovery to the
collateral source rule under which a tortfeasor cannot lessen his
liability because the injured party receives assistance from a
separate source. Without reaching the merits of the claim,
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however, we must agree with the district court that the Morcelos'
ERISA claim is barred for lack of standing.
We are persuaded by its express language that the
assignment effectively assigned any and all rights regarding
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medical services for this procedure to Medicaid, not just the
right to payment for the particular services he received. Hence,
the Morcelos are not the real parties in interest in this action
and could not state a claim against the Welfare Fund. Fed. R.
Civ. P. 17(a); Maddalone v. Okada Shosen, KK, 756 F.2d 886, 887
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(1st Cir. 1985) (once injured worker settles with workers
compensation insurer, the insurer is the real party in interest).
Consequently, the district court properly dismissed the action
against the Welfare Fund.
II.
The trial court also properly dismissed Mrs. Morcelo's
pendent state claims for various tort remedies. Once the court
dismissed the federal ERISA claim, it had the discretion also to
dismiss the pendent state claims. 28 U.S.C. 1367(c)(3); United
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Mine Workers v. Gibbs, 383 U.S. 715, 726 (1966).
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Affirmed.
Affirmed.
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Reference
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