United States District Court, D. Alaska
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 ...