Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Hill v. Pikeville Medical Center, Inc.

United States District Court, E.D. Kentucky, Southern Division, Pikeville

February 21, 2017



          Amul R. Thapar, United States District Judge

         Joshua Hill is a podiatrist who used to work at Pikeville Medical Center (“PMC”). He believes that PMC might have miscalculated the payments he deserved for the services he performed. R. 12 at 1-2. So he sued PMC, seeking “a full and complete accounting of its calculations” of his payments and a judgment against PMC for any leftover payments that the accounting might reveal. R. 1-1 at 6. As this would seem to be a run-of-the-mill contract dispute, and as contract disputes are governed by state law, Hill brought this case in state court. Id. PMC removed it here, R. 1, and Hill moved to remand. R. 9. As the removing party, PMC has the “burden” of convincing the Court that it has jurisdiction. Alexander v. Elec. Data Sys. Corp., 13 F.3d 940, 948 (6th Cir. 1994). If the Court does not, the case must go back to where it came from.

         A federal court can assert jurisdiction based either on diversity (when the plaintiff and defendant are citizens of different states arguing over an amount greater than $75, 000, 28 U.S.C. § 1332) or a federal question (when the dispute “aris[es] under the Constitution, laws, or treaties of the United States” rather than of an individual state, 28 U.S.C. § 1331). Hill and PMC are both citizens of Kentucky, so diversity will not work. But PMC contends that this case involves a federal question. R. 1 at 3-4; R. 10 at 3-5.

         “To determine whether [Hill's] claims arise under federal law, ” the Court must “examine the ‘well pleaded' allegations of [his] complaint and ignore [PMC's] potential defenses.” Beneficial Nat'l Bank v. Anderson, 539 U.S. 1, 6 (2003). In simpler terms, the Court must ask: Do Hill's claims depend on federal law? If the answer is yes, then the Court has jurisdiction. If the answer is no, then the Court does not have jurisdiction- even if PMC might raise a federal-law defense. This well-pleaded complaint rule makes the plaintiff the “master” of his complaint. Caterpillar Inc. v. Williams, 482 U.S. 386, 398 (1987). Thus, although the removing defendant (PMC) must prove that jurisdiction exists, the plaintiff (Hill) may choose whether to establish that jurisdiction in the first place.

         He may do so in two ways, which this Court mapped out in Dillon v. Medtronic, Inc., 992 F.Supp.2d 751, 755-757 (2014). There is the easy way: stating a federal cause of action. See id. at 755-56 (“As Justice Holmes famously quipped, ‘[a] suit arises under the law that creates the cause of action.'” (quoting Am. Well Works Co. v. Layne & Bowler Co., 241 U.S. 257, 260 (1916))). And then there is the hard way: bringing a state-law cause of action that “contain[s] ‘significant federal issues.'” Id. at 756 (quoting Grable & Sons Metal Prods., Inc. v. Darue Eng'g & Mfg., 545 U.S. 308, 312 (2005)). The hard part lies in determining what exactly a “significant federal issue” looks like. To help out, the Supreme Court has provided a four-part test. A state-law claim triggers federal-question jurisdiction if the embedded federal issue is (1) necessarily raised, (2) actually disputed, (3) substantial, and (4) if a federal court can resolve it “without upsetting the traditional balance of state and federal judicial power.” Id.; see also Grable, 545 U.S. at 313-14.

         PMC argues that Hill wrote his complaint in a way that hides the federal question at issue here. R. 10 at 2. So-called artful pleading creates an exception to the general rule that the federal question must be evident on the face of the complaint. If a plaintiff has artificially pled his claims as state claims when “in reality [they] depend on federal law, ” then, artifice aside, those claims will still give rise to federal-question jurisdiction. Dillon, 992 F.Supp.2d at 758; see Rivet v. Regions Bank of Louisiana, 522 U.S. 470, 476 (1998). It is rather unclear what work this “exception” actually does, as “[t]here is no artifice in failing to plead a claim that does not even exist”-and if a federal claim does exist, a court can find it simply by applying the four-part Grable test. Dillon, 992 F.Supp.2d at 758. So the question really is whether there's any “there” there: Whether Hill meant to or not, has he established federal jurisdiction by either stating a federal cause of action or raising a significant federal issue?

         If handed only Hill's complaint, a reader would not quickly find a federal cause of action. See R. 1-1. Nor on further investigation is there one hiding in the shadows. Hill seeks an accounting and, if appropriate, judgement for money owed under a contract. Both are contract-law claims, and contract-law claims rise under state-not federal-law. See R. 9-2 ¶ 8.8 (Podiatrist Employment Agreement) (“This Agreement shall be governed and construed in accordance with the laws of the Commonwealth of Kentucky.”); see also Prince v. Appalachian Reg'l Healthcare, Inc., 154 F.Supp.3d 516, 519 (E.D. Ky. 2015) (noting that because the plaintiff pled only state-law claims, including breach of contract, “[t]here is no question that, under the well-pleaded complaint rule, there would be no federal-question jurisdiction here”); James T. Scatuorchio Racing Stable, LLC v. Walmac Stud Mgmt., LLC, 941 F.Supp.2d 807, 824 (E.D. Ky. 2013) (“To maintain an accounting, the claimant must have a contractual or fiduciary relationship with the defendant[.]” (quoting Gentry v. Cremeens, No. 2008-CA-830-MR, 2009 WL 1491358, at *2 (Ky. Ct. App. May 29, 2009)) (emphasis added)).

         Compare this case to Berea v. Mesa Medical Group, PLLC, 779 F.3d 352 (6th Cir. 2015), on which PMC relies. R. 10 at 2. There, the plaintiff contended that her hospital employer had wrongfully withheld certain FICA taxes from her paycheck. Id. at 355-56. (The Federal Insurance Contribution Act, or “FICA, ” imposes taxes to pay for Medicare and Social Security. See 26 U.S.C. §§ 3101-28.) She pled her case as a state-law claim for unpaid wages, but the courts were not fooled: She was seeking a federal-tax refund, and thus her cause of action arose directly under the federal tax-refund law. Id. at 357-58; see 26 U.S.C. § 7422(a). Here, however, Hill's claim is no federal claim “in disguise.” Id. at 357. Hill's contract entitles him to payment according to a fee schedule that the Centers for Medicare and Medicaid Services (“CMS”) set via regulation. R. 9-2 ¶ 2.1.1. But neither party has identified a federal statute giving physicians a right to seek payment on those terms. Nor do the fee-schedule regulations; indeed, a regulation “may not create a right that Congress has not.” Alexander v. Sandoval, 532 U.S. 275, 291 (2001). PMC is obliged to pay Hill on these terms because that is what it contracted to do. Because state law governs that contract, Hill's cause of action to enforce its terms arises under state- not federal-law. And because his cause of action does not arise under any federal law, the easy way into federal court is blocked.

         So the hard way it is. PMC argues that Hill's complaint “relies on federal law.” R. 10 at 3. Just from that phrasing, it seems PMC will have a tough time proving its case: It must show not merely that Hill's complaint “relies on federal law, ” but that it raises a “significant federal issue[].” Grable, 545 U.S. at 312.

         PMC would presumably argue that it does. And that argument would be based on the following facts, on which both parties agree. R. 9; R. 10. PMC agreed to pay Hill in terms of “Work Relative Value Units” (WRVUs). R. 9-2 ¶ 2.1.1. If Hill hit his contractual “target”-1, 339.75 WRVUs per quarter-PMC would pay him his full salary. Id. ¶ 2.1.5. If Hill came in a few WRVUs short of target any given quarter, PMC would reduce his salary by that number times $46.65. Id. ¶ 2.3. But if Hill had worked more WRVUs than required, PMC would pay him a bonus of the excess WRVUs times $46.65. Id. ¶ 2.2. Hill says he “has reason to believe that [PMC] did not give him proper credit for the” total number of WRVUs he worked and did not pay him as much as it should have. R. 9 at 3. Thus, Hill wants PMC to “provide him with the underlying documentation [so] that he can verify [its] calculations” and then to “adjust the compensation he has been paid accordingly.” R. 12 at 2.

         The reason PMC believes this dispute raises a federal question is that the value of a single WRVU is defined through Medicare, a federal program. R. 10 at 3. Indeed, CMS-an arm of the Department of Health and Human Services-publishes an updated WRVU schedule every year. See Revisions to Payment Policies Under the Physician Fee Schedule, 81 Fed. Reg. 80, 170 (Nov. 15, 2016). PMC argues that this case-a dispute over the WRVUs for which it should have paid Hill-“brings into conflict WRVU's themselves.” R. 10 at 3. This case also, according to PMC, “involve[s] a dispute o[ver]” the “uniform national definitions” and “codes” that CMS promulgates to determine how (and for what) doctors get paid. R. 10 at 3-4 (quoting 42 C.F.R. § 414.40(a)).

         The first question is whether these allegedly federal issues are “necessarily raised” here. Dillon, 992 F.Supp.2d at 756.[1] It is hard to answer “yes” to that question when these issues might not even arise at all. Before anything else, Hill seeks an accounting. His right to an accounting has nothing to do with the value of WRVUs at any given time; as discussed, this is merely a question of state contract law. And without that accounting, it is not clear whether PMC underpaid Hill. It might not have. If it did not, then Hill has no contract-law claim against it for failing to perform under the compensation agreement, as Hill seems to recognize. R. 12 at 1 (“[Hill] claims that [PMC] may have failed to give him proper credit[.]”). So any such claim-let alone any federal issues that might lurk underneath it-is not “necessarily raised.”

         Even if the claim were “necessarily raised, ” it must involve an “actually disputed” issue of federal law. Dillon, 992 F.Supp.2d at 756. For an issue to be actually disputed, of course, the parties must actually disagree about it. Yet here, Hill is not arguing that PMC misunderstood how WRVUs and the attendant coding system work; he is merely arguing that PMC misapplied those concepts in this case. And he means that in the most clerical of ways: For example, he believes someone at the payroll office miscoded his work, and caused PMC to underpay him, by “hitting ‘2' instead of ‘3'” on the keyboard. R. 12 at 2. This case would perhaps be different if the parties had “crossed swords” over the best way to read a federal law. Mikulski v. Centerior Energy Corp., 501 F.3d 555, 570 (6th Cir. 2007) (quoting Arbaugh v. Y&H Corp., 546 U.S. 500, 512 (2006)). But there is little room for interpretation here. The WRVUs and their related codes are what they are, a tautology that neither party appears to dispute.

         And even if some federal issue were “necessarily raised” and “actually disputed, ” that issue must be “substantial.” Dillon, 992 F.Supp.2d at 756. This prong brings a degree of subjectivity into the mix, requiring a court to “decide whether the question to be resolved is important” enough to deserve a portion of the court's limited store of federal jurisdiction. Mikulski, 501 F.3d at 570; see Empire Healthchoice Assur., Inc. v. McVeigh, 547 U.S. 677, 700 (2006)). Judicial voodoo is always difficult to perform. But whatever “substantial” might mean, it cannot mean the kinds of errors that Hill alleges-errors that he is not sure even occurred. To address the questions of fact and state law presented here, a court will possibly need to refer to a federal regulation. But it will certainly not need to resolve any substantial issue of federal law. Assume for example that everything Hill says is true, that PMC really did misapply the relevant WRVUs, and thus that PMC really did miscalculate Hill's wages. If ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.