A medical provider’s claims for breach of implied contract, fraud (in explanation of benefits forms given plan members), and quantum meruit brought against an ERISA benefit plan and its administrator are conflict preempted under ERISA section 514. A medical provider may generally only sue for payment as an assignee of the plan beneficiary to whom the provider gave services, and such a suit must be brought under ERISA, not state law. Here, the medical provider’s additional claims for violation of the UCL and interference with contract were not conflict preempted since they were based on the theory that the administrator had underpaid the provider in a plot to drive it out of business in favor of a competitor. However, summary judgment was properly entered on those claims because plaintiff produced no evidence of the supposed plot to drive it out of business.
California Court of Appeal, Second District, Division 3 (Lavin, Acting P.J.); May 10, 2018 (published June 1, 2018); 2018 Cal. App. LEXIS 518