Texas Health Choice, L.C. v. Office of Personnel Management

 United States Court of Appeals for the Federal Circuit

                                        04-1400



                            TEXAS HEALTH CHOICE, L.C.,

                                                      Plaintiff-Appellee,

                                           v.


                      OFFICE OF PERSONNEL MANAGEMENT,

                                                      Defendant-Appellant.


        Michael S. Nadel, McDermott Will & Emery LLP, of Washington, DC, argued for
plaintiff-appellee.

       Jane W. Vanneman, Attorney, Commercial Litigation Branch, Civil Division,
United States Department of Justice, of Washington, DC, argued for defendant-
appellant. With her on the brief were Peter D. Keisler, Assistant Attorney General, and
David M. Cohen, Director.

Appealed from: United States District Court for the Eastern District of Texas

Chief Judge Thad Heartfield
 United States Court of Appeals for the Federal Circuit

                                          04-1400


                             TEXAS HEALTH CHOICE, L.C.,

                                                           Plaintiff-Appellee,

                                             v.

                         OFFICE OF PERSONNEL MANAGEMENT,

                                                           Defendant-Appellant.

                                 ______________________

                                  DECIDED: March 3, 2005
                                 ______________________

Before MICHEL∗, Chief Judge, MAYER** and LINN, Circuit Judges.

Opinion for the court filed by Chief Judge MICHEL. Dissenting opinion filed by Circuit
Judge MAYER.

MICHEL, Chief Judge.

        The Office of Personnel Management (“OPM”) appeals the United States District

Court for the Eastern District of Texas’s denial of its motion to dismiss for lack of subject

matter jurisdiction and its separate motion to transfer venue to the United States Court

of   Federal   Claims.    Tex.   Health   Choice,   L.C.    v.   Office   of     Pers.   Mgmt.,

__________________________

        *      Paul R. Michel assumed the position of Chief Judge on December 25,
2004.
      **       Haldane Robert Mayer vacated the position of Chief Judge on December
24, 2004
No. 90:03cv14      (E.D.   Tex.   Mar.    9, 2004) (“March Order”). The appeal was

submitted after oral argument on December 8, 2004. Because Texas Health’s suit

against OPM is governed exclusively by the dispute resolution scheme set forth in the

Contract Disputes Act, (“CDA”) codified at 41 U.S.C. §§ 601-613, under which Texas

Health could file suit to contest the denial of its contract claim only in the United States

Court of Federal Claims, not in district court, we reverse the district court’s decision with

respect to venue and remand for transfer to the Court of Federal Claims, which has

exclusive jurisdiction.

                                     BACKGROUND

       A.     Texas Health’s Contract with OPM

       OPM contracted with Texas Health, a health management organization, to

provide health care services to federal employees and retirees in Texas under the

Federal Employees Health Benefits Act, codified at 5 U.S.C. §§ 8901-8914 (“FEHBA”).

As a services contract with the United States government, the FEHBA contract is

governed by the CDA.        Under the terms of the FEHBA contract, OPM annually

negotiates the compensation rates and benefits with each contractor. Each May, a

contractor proposes interim compensation rates to OPM for the upcoming contract year.

The interim compensation rates represent a contractor’s estimate of the amounts it will

charge a similarly-sized subscriber group.

       The following April, the contractor and OPM reconcile the estimated interim

compensation rates with the rates that the contractor actually charged to the

similarly-sized subscriber group. If the interim compensation rates were lower than the

rates actually charged to the similarly-sized subscriber group, then OPM pays the




                                             2
difference to the contractor. If, however, the interim compensation rates were higher

than the rates actually charged to the similarly-sized subscriber group, then the

contractor reimburses the difference to OPM.

      The FEHBA contract further provides that in the final year of the contract, the

reconciliation process occurs in line with an OPM-promulgated regulation (“Final Year

Regulation”).   See 48 C.F.R. § 1652-216-70(b)(6).      Clause 3.2(b)(6) of the FEHBA

contract mirrors the language of the Final Year Regulation and specifically provides:

      In the event this contract is not renewed, neither the Government nor the
      Carrier shall be entitled to any adjustment or claim for the difference
      between the subscription rates prior to rate reconciliation and the actual
      subscription rates.

The rationale behind this regulation and the corresponding contract provision is that “it

is difficult to get adequate data from plans when they have terminated.” 55 Fed. Reg.

27406 (1996).

      In 2001, the interim compensation rates paid by OPM to Texas Health were

$622,246 lower than the rates actually charged to a similarly-situated subscriber group.

OPM thus paid Texas Health $622,246 following reconciliation.        After receiving this

payment, Texas Health decided to exit the FEHBA program and gave notice to OPM. In

response, OPM requested Texas Health to return the reconciliation payment of

$622,246, invoking Clause 3.2(b)(6). Texas Health refused. OPM then reduced its

premium payment to Texas Health for December 2001 by $622,246.

      In January 2002, Texas Health submitted a certified claim to the OPM contracting

officer demanding payment of the $622,246 withheld from the December 2001 premium

payment.    OPM did not respond and, as a result, the claim was deemed denied

pursuant to the CDA.



                                            3
              B.     Prior Court Proceedings

       In January 2003, Texas Health filed suit against OPM in the United States District

Court for the Eastern District of Texas, alleging that it was entitled to a declaratory

judgment that the Final Year Regulation was invalid on its face or as applied to Texas

Health. Specifically, Texas Health complained that the Final Year Regulation conflicts

with a particular section of the FEHBA, 5 U.S.C. § 8902(i), which provides that health

plans are to be compensated at rates that “reasonably and equitably reflect the cost of

the benefits provided.”

       In April 2003, OPM filed a motion to dismiss the complaint for lack of subject

matter jurisdiction pursuant to Fed. R. Civ. P. 12(b)(1). In June 2003, OPM filed a

separate motion to transfer venue to the Court of Federal Claims pursuant to 28 U.S.C.

§ 1631 based upon a want of jurisdiction.

       The district court delegated the issue of jurisdiction and venue to a magistrate

judge for consideration. The magistrate judge ultimately issued an amended report and

recommendation, concluding that federal question jurisdiction existed in the district court

under 28 U.S.C. § 1331 and that the United States waived immunity from suit under the

Administrative Procedure Act. Tex. Health Choice, L.C. v. U.S. Office of Pers. Mgmt.,

No. 9:03CV14, slip op. at 13 (E.D. Tex. Feb. 10, 2004). Accordingly, the magistrate

judge recommended that the district court deny both OPM’s motion to dismiss and its

motion to transfer. Id.

       The district court adopted the magistrate judge’s amended report and

recommendation and issued a brief order denying both of OPM’s motions.              March

Order, slip op. at 2. OPM appeals that order. We have jurisdiction over the district



                                            4
court’s denial of OPM’s motion to transfer venue to the Court of Federal Claims

pursuant to 28 U.S.C. § 1292(d)(4)(A). We do not have jurisdiction to address the

district court’s denial of OPM’s motion to dismiss for lack of subject matter jurisdiction

because that denial is not an appealable interlocutory order under 28 U.S.C. § 1292.

See 28 U.S.C. § 1295(a)(1). We note, however, that OPM’s motion to transfer venue is

premised on a want of jurisdiction, the same substantive ground presented in OPM’s

motion to dismiss.

                                      DISCUSSION

       OPM argues that the Court of Federal Claims has exclusive jurisdiction over

Texas Health’s challenge to the validity of the Final Year Regulation because the

underlying FEHBA contract is governed by the CDA and the CDA provides for a dispute

resolution process wherein a claim denied by a contracting officer may either be

appealed to the appropriate agency board or litigated in the Court of Federal Claims.

       Texas Health responds that the district court correctly determined that it had

subject matter jurisdiction under 28 U.S.C. § 1331, the general federal question statute.

As an alternative ground to affirm the district court’s denial of OPM’s motions to dismiss

and transfer venue, Texas Health asserts that the district court has subject matter

jurisdiction under 5 U.S.C. § 8912, the jurisdictional provision of the FEHBA.

       We agree with OPM that under the CDA, the Court of Federal Claims has

exclusive jurisdiction over Texas Health’s suit against OPM relating to the validity of the

Final Year Regulation incorporated into the FEHBA contract as Clause 3.2(b)(6). That

is because Texas Health’s claim is related to the FEHBA contract.                “The CDA

exclusively governs Government contracts and Government contract disputes.” Cecile




                                            5
Indus., Inc. v. Cheney, 995 F.2d 1052, 1055 (Fed. Cir. 1993). Put differently, “[w]hen

the Contract Disputes Act applies, it provides the exclusive mechanism for dispute

resolution; the Contract Disputes Act was not designed to serve as an alternative

administrative remedy, available at the contractor’s option.” Dalton v. Sherwood Van

Lines, Inc., 50 F.3d 1014, 1017 (Fed. Cir. 1995).

       Section 605 of the CDA sets forth the process for resolving claims by a

contractor against the United States relating to a contract, providing in pertinent part:

       All claims by a contractor against the government relating to a contract
       shall be in writing and shall be submitted to the contracting officer for a
       decision.

41 U.S.C. § 605(a) (2000) (emphasis added). Section 609 of the CDA addresses the

judicial review of a contracting officer’s decision, providing in pertinent part:

       [I]n lieu of appealing the decision of the contracting officer under section 6
       [41 U.S.C. § 605] to an agency board, a contractor may bring an action
       directly on the claim in the United States Claims Court [United States
       Court of Federal Claims], notwithstanding any contract provision,
       regulation, or rule of law to the contrary.

41 U.S.C. § 609(a)(1) (2000) (emphasis added).              Section 609 thus precludes a

contractor from filing suit in district court; a contractor may only file suit in the Court of

Federal Claims.




                                              6
      Notably, Section 609 of the CDA operates in tandem with the Tucker Act to

confer jurisdiction over such actions on the Court of Federal Claims.1          We have

acknowledged that “the Tucker Act, in conjunction with the CDA, purports to make the

Court of Federal Claims the exclusive trial court for hearing disputes over government

contracts that fall under the CDA.” Quality Tooling, Inc. v. United States, 47 F.3d 1569,

1572-73 (Fed. Cir. 1995). We likewise have stated:

      The CDA provides alternative forums for challenging a [contracting
      officer’s] final decision: a contractor may file an appeal with the
      appropriate board of contract appeals, 41 U.S.C. § 606 (1988), or appeal
      directly to the Court of Federal Claims, 41 U.S.C. § 609(a)(1) (Supp. V
      1993). Courts have consistently interpreted the CDA as providing the
      contractor with an either-or choice of forum.

Bonneville Assocs. v. United States, 43 F.3d 649, 653 (Fed. Cir. 1994) (internal citations

omitted and emphasis added).2 Hence, there is no other alternative such as the district

courts. The purpose for centralizing the resolution of government contract disputes in




      1
             The Tucker Act specifically states:

      The Court of Federal Claims shall have jurisdiction to render judgment
      upon any claim by or against, or dispute with, a contractor arising under
      section 10(a)(1) of the Contract Disputes Act of 1978 [41 U.S.C. §
      609(a)(1)], including a dispute concerning termination of a contract, rights
      in tangible or intangible property, compliance with cost accounting
      standards, and other nonmonetary disputes on which a decision of the
      contracting officer has been issued under section 6 of that Act [41 U.S.C.
      § 605].

28 U.S.C. § 1491(a)(2) (2000).
      2
              The Bonneville court cited to prior publications of the United States Code.
The relevant portions of Sections 606 and 609 of the CDA have not, however, been
amended since the CDA was enacted. Therefore, the text relied upon by the Bonneville
court is identical to the text that appears in the current version of the United States
Code dated 2000.


                                            7
the Court of Federal Claims, rather than in district court, is to ensure national uniformity

in government contract law. See Katz v. Cisneros, 16 F.3d 1204, 1210 (Fed. Cir. 1994).

       In the present case, Texas Health submitted a claim to recoup the $622,246

reconciliation amount it thought due under the contract to the appropriate OPM

contracting officer. The contracting officer did not issue a decision on the claim, causing

it to be “deemed denied.”      See 41 U.S.C. § 605(c)(5) (2000) (“Any failure by the

contracting officer to issue a decision on a contract claim within the period required will

be deemed to be a decision by the contracting officer denying the claim and will

authorize the commencement of the appeal or suit on the claim as otherwise provided in

this Act.”). That denial gave Texas Health the option under Section 605(c)(5) of the

CDA of either appealing to the appropriate agency board or commencing a suit as

otherwise provided in the CDA. Texas Health purportedly chose the latter. In doing so,

however, Texas Health did not comply with the CDA.

       Texas Health filed suit in the district court, not in the Court of Federal Claims.

That Texas Health’s complaint, literally read, sought only to invalidate the Final Year

Regulation, as opposed to recover the $622,246 reconciliation amount, is of no

consequence to the question of jurisdiction because the complaint relates to a dispute

implicating a contract with the Government.          Indeed, Texas Health’s complaint

expressly mentions its FEHBA contract with the Government and the deemed denial of

its claim before the contracting officer. Therefore, the district court simply does not

have jurisdiction over Texas Health’s suit.

       Texas Health’s arguments regarding jurisdiction under the general federal

question statute and the jurisdictional provision of the FEHBA are misplaced in light of




                                              8
the dispute resolution scheme for contract-related disputes against the Government set

forth in the CDA. As previously noted, “[t]he CDA clearly and comprehensively defines

the procedures for all contractual disputes between the United States and private

contractors.” Cecile Indus., 995 F.2d at 1055 (emphasis added). Accordingly, we hold

that the district court erred in denying OPM’s motion to transfer venue to the Court of

Federal Claims for lack of jurisdiction.



                                      CONCLUSION

       Because, pursuant to the CDA, the Court of Federal Claims has exclusive

jurisdiction over suits involving a contract claim filed by a contactor against the United

States, we reverse and remand the case to the district court with instructions to transfer

to the Court of Federal Claims.

                              REVERSED AND REMANDED




                                            9
 United States Court of Appeals for the Federal Circuit


                                          04-1400

                             TEXAS HEALTH CHOICE, L.C.,

                                                         Plaintiff-Appellee,

                                             v.

                       OFFICE OF PERSONNEL MANAGEMENT,

                                                         Defendant-Appellant.



MAYER, Circuit Judge*, dissenting.

        In my view, this case is controlled by Bowen v. Massachusetts, 487 U.S. 879

(1988), and Katz v. Cisneros, 16 F.3d 1204 (Fed. Cir. 1994). By not following those

cases this court is transferring our case to a court without either jurisdiction or the power

to grant the requested relief. The Court of Federal Claims cannot grant the relief sought

because the case challenges a regulation. Categorizing Texas Health’s action as a

contract claim ignores that fact. The Court of Federal Claims can neither entertain a

declaratory judgment action to hold the regulation invalid nor equitably reform the

contract.   Bowen, 487 U.S. at 905 (“The Claims Court does not have the general

equitable powers of a district court to grant prospective relief.”). Accordingly, I would

affirm the order of the district court denying the motion to dismiss and the motion to

transfer the case to the Court of Federal Claims.



        *
            Haldane Robert Mayer vacated the position of Chief Judge on December 24,
2004.