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Rowekamp v. Providence Health & Services

United States District Court, D. Alaska

September 25, 2019

JOSEPH ROWEKAMP, Plaintiff,
v.
PROVIDENCE HEALTH & SERVICES, PROVIDENCE HEALTH & SERVICES HEALTH AND WELFARE PLAN; and PROVIDENCE HEALTH PLAN, Defendants.

          ORDER

          H. RUSSEL HOLLAND, UNITED STATES DISTRICT JUDGE

         Motion to Compel

         Plaintiff moves to compel discovery responses.[1] Defendants oppose this motion,[2] and plaintiff has filed a reply to defendants’ opposition.[3] Defendants filed a surreply[4] without requesting the court’s leave to do so. The court, however, has considered defendants’ surreply because plaintiff raised new issues and arguments in his reply. Oral argument was not requested and is not deemed necessary.

         Background

         Plaintiff Joseph Rowekamp is alleged to be a beneficiary of defendant Providence Health & Services Health and Welfare Plan (“the Plan”), which is alleged to be an ERISA plan.[5] The Plan is alleged to be a self-funded ERISA plan.[6] Defendant Providence Health and Services is alleged to be the sponsor of the Plan.[7] And, defendant Providence Health Plan is alleged to be the claims administrator.[8] Providence Health Plan is alleged to be “a corporate subsidiary or affiliate of Providence Health and Services.[9] Providence Health & Services is alleged to be a Washington corporation and Providence Health Plan is alleged to be an Oregon corporation.[10]

         Plaintiff alleges that his “doctor performed an OATS (Osteochondral Autograft Transfer System) on [his] right knee and requested preauthorization for the same operation on [his] left knee[,]”[11] but that the Plan refused to pay for the first operation and refused to preauthorize the second operation.[12] Plaintiff alleges that he has exhausted his administrative remedies.[13] He commenced this action on March 14, 2019, and in his amended complaint, he asserts a single ERISA claim based on the allegation that the claims administrator abused its discretion in denying his claims.[14]

         A scheduling order was entered on March 25, 2019.[15] Defendants were ordered to lodge the administrative record within 60 days and the parties were given 15 days after the lodging of the administrative record to agree on any necessary supplementation.[16] Defendant lodged the administrative record on May 24, 2019.[17] On June 12, 2019, the parties were given “an additional 30 days in which to correct deficiencies they have observed in the administrative record. . . .”[18] By July 15, 2019, defendant had lodged the corrected administrative record.[19]

         The scheduling order provided that if, after the administrative record was lodged, plaintiff “contends that discovery should be permitted and if the parties are unable to agree with respect to appropriate, limited discovery, a motion for discovery shall be served on or before 30 days following the filing of the [administrative] record.”[20] Pursuant to this provision, plaintiff sent a discovery request to defendants on June 26, 2019.[21] Plaintiff requested the following discovery:

1. Please provide the CV of the Providence Medical Director [who] denied Rowekamp’s claim “in house.”
2. Please state the total monetary amounts paid by Providence to “All Med” in 2016 & 2017.
3. Please provide Dr. Sloan’s CV and a statement from him listing his experience performing knee surgeries in general and OATs procedures specifically.
4. Please provide the CV of the medical reviewer that Roffe Enterprises t/a HHC utilized to review Providence’s denials of Rowekamp’s claims.
5. Please provide a statement of the Roffe Enterprises t/a HHC reviewer listing [his] experience with knee surgeries in general and OATs procedures specifically.
6. Please state the total amount Providence paid to Roffe Enterprises and HHC in 2016 and 2017.[[22]]

         In response to request #1, defendants provided the CV of Dr. Capp, but, defendants did not otherwise provide any of the information that plaintiff had requested. Plaintiff now ...


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