Carleton v. Physician's Health Plan of Maryland, Inc.,
No. CIV.A. 03-1233 (E.D. Pa. Apr. 17, 2003)

A physician terminated his business relationship with a health maintenance organization ("HMO") after the HMO's representatives performed a site survey of the physician's business, and advised the physician of alleged deficiencies in his practice and demanded corrective action. Two months later, the physician learned that the HMO had filed an adverse action report with the Healthcare Integrity and Protection Data Bank ("HIPDB"), a national data collection program for reporting and disclosure of certain final adverse actions taken against health care practitioners, providers and suppliers. The physician subsequently filed a clarifying statement with the HIPDB, requested Secretarial review of the adverse action report, and filed a complaint for defamation in Pennsylvania state court, alleging that the statements communicated and published by defendants to the HIPDB were not privileged and were defamatory. The HMO then removed the case to federal court, alleging federal question jurisdiction because the action was based on federal law. The physician moved to remand the case back to state court.

The U.S. District Court for the Eastern District of Pennsylvania granted the physician's motion, holding that neither the provisions of the Social Security Act establishing the HIPDB nor its implementing regulations created a federal cause of action regarding the contents of reports made to the HIPDB. Accordingly, the court determined that the physician's complaint did not assert a federal question and that it lacked subject matter jurisdiction over the action. The physician's motion to remand back to state court was granted.