QuickMed Diagnostic, Inc. v. Cigna Health Corporation, et al.
- Proceeding
- district
- Area
- civil
- Panel
- Cynthia Ann Bashant (author)
Analysis
The court reviewed Defendants' motion to dismiss a complaint alleging underpayment of claims for COVID-19 diagnostic testing. The court granted the motion in part, dismissing the FFCRA/CARES Act claims, Medicare claims (for lack of jurisdiction), and state law claims (for preemption), while denying the motion to dismiss the ERISA benefits claim and declaratory relief request.
| What the court decided | The model |
|---|---|
Denied Defendants' motion to dismiss the claim for benefits under 29 U.S.C. § 1132(a)(1)(B).“The Court DENIES Defendants’ motion to dismiss the claim for benefits under 29 U.S.C. § 1132(a)(1)(B);” | agree with court The court adopted the rationale from a related case (Anthem) and found that the plaintiff sufficiently alleged the class of claimants and assignment of rights, satisfying the pleading requirements for standing and notice. |
Granted with leave to amend Defendants' motion to dismiss the claim for breach of fiduciary duty under § 502(a)(2).“The Court GRANTS with leave to amend Defendants’ motion to dismiss the claim for breach of fiduciary duty under § 502(a)(2);” | agree with court The court adopted the rationale from the related Anthem case, which presumably found the fiduciary duty claim insufficiently pleaded. The court granted leave to amend, allowing the plaintiff an opportunity to cure the deficiency. |
Granted without leave to amend Defendants' motion to dismiss the claim for violation of the FFCRA and CARES Act.“The Court GRANTS without leave to amend Defendants’ motion to dismiss the claim for violation of the FFCRA and CARES Act;” | agree with court The court adopted the rationale from the related Anthem case. The denial of leave to amend suggests the court found the claims were not susceptible to cure, likely due to a fundamental defect in the statutory application or standing. |
Granted with leave to amend Defendants' motion to dismiss for lack of jurisdiction Plaintiff’s Medicare claims, given Plaintiff’s failure to exhaust.“The Court GRANTS with leave to amend Defendants’ motion to dismiss for lack of jurisdiction Plaintiff’s Medicare claims, given Plaintiff’s failure to exhaust;” | agree with court The court determined that Medicare exhaustion is a jurisdictional requirement. Since the complaint failed to allege exhaustion, the court lacked subject matter jurisdiction and dismissed the claims. The court granted leave to amend to allow the plaintiff to allege exhaustion if possible. |
Granted with leave to amend Defendants' motion to dismiss the state law claims, given ERISA’s preemption provision.“The Court GRANTS with leave to amend Defendants’ motion to dismiss the state law claims, given ERISA’s preemption provision;” | agree with court The court adopted the rationale from the related Anthem case, finding that the state law claims were preempted by ERISA. The court granted leave to amend, likely to allow the plaintiff to attempt to plead around preemption or clarify the claims. |
Denied Defendants' motion to dismiss the request for declaratory relief.“The Court DENIES Defendants’ motion to dismiss the request for declaratory relief.” | agree with court The court adopted the rationale from the related Anthem case, finding that the request for declaratory relief was sufficiently pleaded and not subject to dismissal at this stage. |
The order itself: sound — The court's reasoning is sound. It correctly applies the principle that subject matter jurisdiction (specifically, exhaustion of administrative remedies for Medicare claims) is a non-waivable issue that must be addressed sua sponte. It also correctly relies on established pleading standards for class descriptions and assignment of rights in the context of ERISA and insurance claims. The adoption of the rationale from the related Anthem case is procedurally appropriate and ensures consistency across related litigation.
Opinion
1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 SOUTHERN DISTRICT OF CALIFORNIA 10 11 QUICKMED DIAGNOSTIC, INC., Case No. 25-cv-3114-BAS-JAC 12 Plaintiff, ORDER GRANTING IN PART AND 13 v. DENYING IN PART DEFENDANTS’ MOTION TO DISMISS (ECF No. 14) 14 CIGNA HEALTH CORPORATION, et al., 15 Defendants. 16 17 18 Presently before the Court is Defendants’ motion to dismiss Plaintiff’s complaint. 19 (ECF No. 14.) The motion is fully briefed. (ECF Nos. 14, 15, 16.) The Court finds 20 Defendants’ motion suitable for determination on the papers submitted. See Fed. R. Civ. 21 P. 78(b); Civ. L.R. 7.1(d)(1). 22 This case is one of related cases brought by Plaintiff against private insurance 23 companies for underpaid or unpaid claims related to COVID-19 diagnostic testing 24 services.1 On August 25, 2026, this Court issued an Order granting in part and denying in 25 26 1 The related cases before this Court are: Quickmed Diagnostic, Inc. v. United Healthcare Servs., Inc., No. 25-cv-03132-BAS-JAC (S.D. Cal. filed Nov. 12, 2025); Quickmed Diagnostic, Inc. v. Aetna 27 Health and Life Ins. Co., No. 25-cv-03131-BAS-JAC (S.D. Cal. filed Nov. 12, 2025); and Quickmed Diagnostic, Inc. v. Anthem Blue Cross Life and Health Ins. Co., No. 25-cv-02902-BAS-JAC (S.D. Cal. 28 1 part Defendants’ motion to dismiss in the lead case, Quickmed Diagnostic, Inc. v. Anthem 2 Blue Cross Life and Health Insurance Company, No. 25-cv-02902-BAS-JAC (S.D. Cal. 3 filed Oct. 27, 2025) (“Dismissal Order”). 4 Having reviewed the briefing in the present case, the Court adopts the same rationale 5 as that outlined in the Dismissal Order. The Court briefly addresses a few additional 6 arguments raised in the briefing. 7 First, Defendants argue that Plaintiff failed to sufficiently identify the plans and/or 8 claims at issue. However, Plaintiff’s allegations are adequate. Plaintiff noted the class of 9 claimants within a specified period. See, e.g., Forest Ambulatory Surgical Assocs., L.P. v. 10 United HealthCare Ins. Co., No. 10-CV-04911-EJD, 2011 WL 2748724, at *4 (N.D. Cal. 11 July 13, 2011) (“The name of each individual beneficiary is not necessary at the pleading 12 stages, only the description of the class of beneficiaries is required.” (citation modified)). 13 The Court is unconvinced Defendants lack fair notice. 14 Second, Defendants contend that the complaint’s assignment clause does not 15 mention Plaintiff Quickmed by name. (Compl. ¶ 65.) Yet, the assignment clause embraces 16 Sameday Testing’s partner laboratories, and Plaintiff alleges it was a partner laboratory. 17 (Compl. ¶¶ 34, 64.) See Almont Ambulatory Surgery Ctr., LLC v. UnitedHealth Grp., Inc., 18 99 F. Supp. 3d 1110, 1130 (C.D. Cal. 2015) (“While there are certainly areas for more 19 definiteness, the Court rules that the alleged assignments are sufficiently definite to survive 20 a motion to dismiss on the issue of standing[.]”). Plaintiff sufficiently alleged assignment. 21 Last, Plaintiff’s opposition brief argues that because Defendants did not discuss the 22 Medicare-related allegations, Defendants waived “any potential challenge to those claims.” 23 (Cigna Opp’n 15 at n.1, ECF No. 15.) But Medicare exhaustion is a jurisdictional issue. 24 “When a federal court lacks subject-matter jurisdiction, the court must dismiss the 25 complaint, sua sponte if necessary[.]” Pistor v. Garcia, 791 F.3d 1104, 1111 (9th Cir. 2015) 26 (citation modified). The Court therefore protects its jurisdiction sua sponte. 27 Additionally, Plaintiff has been heard on this issue. The Court has read Plaintiff’s 28 Medicare-related arguments in the briefs of the three related cases before the Court; and 1 the Court rejects the arguments. And Plaintiff does not add anything new to this complaint 2 regarding exhaustion. Relying on the pleadings, without allegations of exhaustion or 3 another defense, the Court lacks subject matter jurisdiction. See Zhang v. 4 UnitedHealthcare, No. CV-20-02064-PHX-GMS, 2022 WL 17537985, at *3 (D. Ariz. 5 Dec. 8, 2022) (“Because Plaintiff must exhaust administrative remedies before this Court 6 can have jurisdiction over a case arising under the Medicare Act, Plaintiff’s complaint is 7 dismissed for lack of subject matter jurisdiction.”). Plaintiff has leave to reallege its claims. 8 Accordingly, upon review, the Court INCORPORATES and ADOPTS the 9 Dismissal Order into this case. 10 Thus, the Court GRANTS IN PART and DENIES IN PART Defendants’ motion 11 to dismiss. Specifically: 12 • The Court DENIES Defendants’ motion to dismiss the claim for benefits under 29 13 U.S.C. § 1132(a)(1)(B); 14 • The Court GRANTS with leave to amend Defendants’ motion to dismiss the claim 15 for breach of fiduciary duty under § 502(a)(2); 16 • The Court GRANTS without leave to amend Defendants’ motion to dismiss the 17 claim for violation of the FFCRA and CARES Act; 18 • The Court GRANTS with leave to amend Defendants’ motion to dismiss for lack of 19 jurisdiction Plaintiff’s Medicare claims, given Plaintiff’s failure to exhaust; 20 • The Court GRANTS with leave to amend Defendants’ motion to dismiss the state 21 law claims, given ERISA’s preemption provision; and 22 • The Court DENIES Defendants’ motion to dismiss the request for declaratory relief. 23 27 28 1 Plaintiff does not have leave to add new claims or parties without the Court’s 2 permission. Plaintiff shall file any amended complaint on or before September 18, 2026. 3 || If Plaintiff declines to file an amended complaint by that deadline, then Defendants shall 4 || file an answer to the complaint by October 2, 2026. 5 IT IS SO ORDERED. 6 ~ 7 || DATED: August 26, 2026 (yi. Duhark H n. Cynthia Bashant, Chief Judge United States District Court 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4A.