QuickMed Diagnostic, Inc. v. Aetna Health and Life Insurance Company, et al.
- Proceeding
- district
- Area
- civil
- Panel
- Cynthia Ann Bashant (author)
Analysis
The court reviewed Defendants' motion to dismiss a complaint filed by Quickmed Diagnostic, Inc. regarding unpaid claims for COVID-19 diagnostic testing. The court granted in part and denied in part the motion, dismissing certain claims with or without leave to amend while allowing the ERISA benefits claim and request for declaratory relief to proceed.
| 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 adopts the rationale from a prior order in a related case (Anthem) and finds the specific arguments regarding identification of plans and assignment sufficient to survive dismissal. While the specific legal standard for the § 1132(a)(1)(B) claim is not explicitly restated in this order, the decision to deny dismissal based on the adequacy of the pleading (notice and assignment) is consistent with Rule 12(b)(6) standards. |
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);” | unsure The court incorporates the rationale from the Dismissal Order in the lead case. Without the text of the lead case order, the specific legal basis for dismissing the fiduciary duty claim is not visible, but granting leave to amend is a standard procedural remedy when a claim is potentially curable. |
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;” | unsure The court incorporates the rationale from the Dismissal Order. Denial of leave to amend suggests the court found the claim incurable or that amendment would be futile. This is a discretionary determination often supported by the specific facts of the case, which are not fully detailed here but are referenced via the incorporated order. |
Granted with leave to amend Defendants' motion to dismiss for lack of jurisdiction regarding Plaintiff's Medicare claims due to 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 identifies a jurisdictional defect (failure to exhaust administrative remedies) and grants leave to amend. This is a standard application of the exhaustion doctrine in Medicare cases. |
Granted with leave to amend Defendants' motion to dismiss the state law claims due to ERISA preemption.“The Court GRANTS with leave to amend Defendants’ motion to dismiss the state law claims, given ERISA’s preemption provision; and” | agree with court The court applies ERISA preemption to dismiss state law claims. This is a well-established legal principle. Granting leave to amend allows the plaintiff to potentially replead or drop the preempted 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 allows the request for declaratory relief to proceed, likely because it is tied to the surviving ERISA benefits claim. |
The order itself: sound with gaps — The order is a procedural ruling that incorporates the reasoning from a prior, related order (the 'Dismissal Order' in the Anthem case). It addresses specific arguments raised in the current briefing (identification of plans, assignment clause) with appropriate citations. The reasoning is consistent with the cited authorities and the general standards for Rule 12(b)(6) motions. However, because it relies heavily on an external order not provided in the text, the full legal basis for some dismissals (fiduciary duty, FFCRA/CARES) is not visible in this document alone.
How this analysis was made · dispute it
inconsistent with cited authority record incompleteOpinion
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-3131-BAS-JAC 12 Plaintiff, ORDER GRANTING IN PART AND 13 v. DENYING IN PART DEFENDANTS’ MOTION TO DISMISS (ECF No. 27) 14 AETNA HEALTH AND LIFE INSURANCE COMPANY, et al., 15 Defendants. 16 17 18 Presently before the Court is Defendants’ motion to dismiss Plaintiff’s complaint. 19 (ECF No. 27.) The motion is fully briefed. (ECF Nos. 27, 35, 37.) 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 26, 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. Cigna Health Corp., No. 27 25-cv-03114-BAS-JAC (S.D. Cal. filed Nov. 12, 2025); Quickmed Diagnostic, Inc. v. United Healthcare Servs., Inc., No. 25-cv-03132-BAS-JAC (S.D. Cal. filed Nov. 12, 2025); and Quickmed Diagnostic, Inc. 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 Accordingly, upon review, the Court INCORPORATES and ADOPTS the 22 reasoning from the Dismissal Order into this case. 23 Thus, the Court GRANTS IN PART and DENIES IN PART Defendants’ motion 24 to dismiss. Specifically: 25 • The Court DENIES Defendants’ motion to dismiss the claim for benefits under 29 26 U.S.C. § 1132(a)(1)(B); 27 • The Court GRANTS with leave to amend Defendants’ motion to dismiss the claim 28 for breach of fiduciary duty under § 502(a)(2); I e The Court GRANTS without leave to amend Defendants’ motion to dismiss the 2 claim for violation of the FFCRA and CARES Act; 3 e The Court GRANTS with leave to amend Defendants’ motion to dismiss for lack of 4 jurisdiction Plaintiff's Medicare claims, given Plaintiff's failure to exhaust; 5 e The Court GRANTS with leave to amend Defendants’ motion to dismiss the state 6 law claims, given ERISA’s preemption provision; and 7 e The Court DENIES Defendants’ motion to dismiss the request for declaratory relief. 8 9 Plaintiff does not have leave to add new claims or parties without the Court’s 10 |}permission. Plaintiff shall file any amended complaint on or before September 18, 2026. 11 || Tf Plaintiff declines to file an amended complaint by that deadline, then Defendants shall 12 || file an answer to the complaint by October 2, 2026. 13 IT IS SO ORDERED. 14 ~ 15 || DATED: August 28, 2026 yatta Bihar Hon. Cynthia Bashant, Chief Judge 16 United States District Court 17 18 19 20 21 22 23 24 25 26 27 28 □□□