United States District Court, N.D. Indiana, Fort Wayne Division
OPINION AND ORDER
THERESA L. SPRINGMANN CHIEF JUDGE
matter comes before the Court on a Motion for Judgment on the
Pleadings as to Count I [ECF No. 24], filed by Plaintiff
Renal Care Group Indiana LLC. The Plaintiff filed its
Complaint [ECF No. 1] on February 23, 2017. Defendant City of
Fort Wayne filed its Answer [ECF No. 6] on April 3, 2017. In
its Complaint, the Plaintiff brings four causes of action
against the Defendant: Declaratory relief under the federal
Declaratory Act (Count I) or, in the alternative, under the
Indiana Uniform Declaratory Judgment Act (Count II); breach
of contract (Count III); and a private cause of action under
the Medicare Secondary Payer Act (Count IV). The instant
matter involves only declaratory relief as requested in Count
I, and has been fully briefed and is ripe for review.
following background is taken from the pleadings. The
Plaintiff, a domestic corporation organized under the laws of
Delaware with its principal place of business in Waltham,
Massachusetts, operates a dialysis facility in Fort Wayne,
Indiana. (Compl. ¶ 1, ECF No. 1.) The Defendant operates
a municipal retiree health benefits plan, the City of Fort
Wayne Employee Benefit Plan (Plan), which provides health
care medical benefits to municipal retirees. (Answer ¶
2, ECF No. 6.) One participant in the Defendant's Plan,
the Patient,  received treatment at the Plaintiff's
dialysis facility in Fort Wayne. (Compl. ¶ 1.) The Plan
provided health care coverage for the Patient from March 11,
2014, through May 31, 2014. (Answer ¶ 9.) During that
time period, the Defendant paid the Plaintiff directly for
the dialysis services that the Patient received from the
Plaintiff at an agreed upon rate set by an insurance network,
the Parkview Signature Network. (Id. ¶ 24.) On
June 1, 2014, the Patient became entitled to Medicare
coverage based on the Patient's end-stage renal disease
(ESRD) diagnosis. (Id. ¶ 25.) Because the
Patient was newly eligible for Medicare, the City terminated
the Patient's coverage under the Plan beginning on June
1, 2014. (Id. ¶ 26.) The City admits that it
“took into account the Patient's eligibility for
and entitlement to Medicare and terminated coverage for the
Patient so that he would no longer be covered by the Plan
beginning June 1, 2014.” (Id. ¶ 27.)
Federal Rule of Civil Procedure 12(c), a party may move for
judgment after the plaintiff has filed a complaint and the
defendant has filed an answer. See Fed. R. Civ. P.
12(c). The reviewing court must consider only the pleadings,
which “include the complaint, the answer, and any
written instruments attached as exhibits.” N. Ind.
Gun & Outdoor Shows, Inc. v. City of S. Bend, 163
F.3d 449, 452 (7th Cir. 1998) (citations omitted).
“Where the plaintiff moves for judgment on the
pleadings, the motion should not be granted unless it appears
beyond doubt that the non-moving party cannot prove facts
sufficient to support [its] position.” Hous. Auth.
Risk Retention Grp. v. Chi. Hous. Auth., 378
F.3d 596, 600 (7th Cir. 2004) (citing All Am. Ins. Co. v.
Broeren Russo Const., Inc., 112 F.Supp.2d 723, 728 (C.D.
Ill. 2000)) (internal quotations omitted). Judgment may be
granted on the pleadings only if “all material
allegations of fact are admitted or not controverted in the
pleadings and only questions of law remain to be decided by
the district court.” 5C Charles Alan Wright &
Arthur R. Miller, Federal Practice and Procedure
§ 1367 (3d. 2017).
Plaintiff has moved for Judgment on the Pleadings on Count I
only. Count I seeks a declaratory judgment under 28 U.S.C.
§ 2201(a), stating that the Defendant violated the
Medicare Secondary Payer Act, 42 U.S.C. § 1395y (MSP
Act) when it terminated coverage for the Patient, and that
the Defendant was required to remain the primary payer
responsible for the Patient's dialysis treatments through
the end of the Patient's 30-month coordination of
benefits period. The Defendant attacks both the procedure and
the merits of the Plaintiff's Rule 12(c) motion.
Standing to Pursue Declaratory Relief
Plaintiff contends that it has standing to pursue declaratory
relief. A federal court may issue a declaratory judgment to a
party so long as the parties present a justiciable case or
controversy. See Vickers v. Henry Cty. Sav. & Loan
Ass'n, 827 F.2d 228, 230 (7th Cir. 1987). A cause of
action for a declaratory judgment is justiciable when
“there is a substantial controversy, between parties
having adverse legal interests, of sufficient immediacy and
reality to warrant the issuance of a declaratory
judgment.” Id. at 231 (quoting Alcan
Aluminum Ltd. v. Dep't of Revenue of Or., 724 F.2d
1294, 1298 (7th Cir.1984)).
Plaintiff has met its standing requirements. The Plaintiff
asserts that, under the MSP Act, the Defendant has had to pay
for the Patient's dialysis treatment since June 1, 2014.
The Defendant has not paid the Patient because the Defendant
denies that has an obligation to pay. Medicare, meanwhile,
has reimbursed the Plaintiff at a lower rate than the
Defendant was required to pay. The Plaintiff thus argues that
it has incurred an economic injury caused by this dispute
over whether a legal requirement applies to the Defendant.
Declaratory relief would redress such an injury.
Plaintiff has, therefore, brought a justiciable cause of
action for declaratory relief as to Count I, and the Court
may proceed to the merits of the Plaintiff's Rule 12(c)
The Medicare Secondary Payer Act
Plaintiff argues that the Defendant violated the MSP Act when
the Defendant terminated the Patient's coverage under the
Plan on June 1, 2014. Before 1980, Medicare generally paid
for health care services regardless of whether a Medicare
beneficiary was covered by another health plan. United
Seniors Ass'n v. Philip Morris USA, 500 F.3d 19, 21
(1st Cir. 2007). In an effort to reduce health care costs,
Congress passed the MSP Act in 1980. Id. Under
certain circumstances, the MSP Act makes Medicare a secondary