John Kodenkandeth v. UPMC Health Plan Inc

── John Kodenkandeth v. UPMC Health Plan Inc ── Court: Court of Appeals for the Third Circuit Date: June 01, 2026 Category: General NOT PRECEDENTIAL UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT ___________ No. 25-1513 __________ JOHN F. KODENKANDETH, Appellant v. UPMC HEALTH PLAN, INC. d/b/a UPMC for Life; UPMC CORPORATE HOLDING CO.; UNIVERSITY OF PITTSBURGH PHYSICIANS; MAXIMUS d/b/a Maximus Federal Services; SECRETARY DEPARTMENT OF HEALTH AND HUMAN SERVICES ____________________________________ On Appeal from the United States District Court for the Western District of Pennsylvania (D.C. Civil Action No. 2:23-cv-02049) District Judge: Honorable Christy Criswell Wiegand ____________________________________ Submitted Pursuant to Third Circuit LAR 34.1(a) March 10, 2026 Before: KRAUSE, RESTREPO, and PORTER, Circuit Judges (Opinion filed June 1, 2026) ___________ OPINION* ___________ * This disposition is not an opinion of the full Court and pursuant to I.O.P. 5.7 does not constitute binding precedent. PER CURIAM Pro se Appellant John Kodenkandeth appeals the District Court’s order dismissing his amended complaint with prejudice. We will affirm the judgment as modified. I. This case arises out of two disputed claims for Medicare benefits. In the first dispute, Kodenkandeth, a Medicare Advantage plan enrollee, was denied a refund of his $45 co-pay after visiting a specialist. An Administrative Law Judge dismissed the case because Kodenkandeth did not meet the requisite amount in controversy, and the Medicare Appeals Council affirmed the decision. In the second dispute, Kodenkandeth was denied a request to obtain hearing aids out-of-network. The Medicare Appeals Council agreed with the Administrative Law Judge that Kodenkandeth’s plan was not required to pay for out-of-network hearing aids. Subsequently, Kodenkandeth filed a complaint in the Allegheny County Court of Common Pleas (“State Court”) against the Secretary of the Department of Health and Human Services (“HHS”) and other defendants involved in his Medicare claims. Kodenkandeth alleged that the defendants violated various state and federal laws when administering and adjudicating his benefits claims. The HHS Secretary removed the case to the United States District Court for the Western District of Pennsylvania. Kodenkandeth moved to remand the case to State Court, arguing that the District Court lacked subject matter jurisdiction, and that the notice of removal was defective. The District Court denied the remand motion. 2  The defendants then moved to dismiss Kodenkandeth’s complaint pursuant to Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6). The District Court determined that Kodenkandeth’s claims arose under the Medicare Act and that the Court lacked subject matter jurisdiction because Kodenkandeth failed to meet that Act’s amount-in-controversy requirement. The District Court granted Kodenkandeth leave to amend some of his damage claims, but after amendment, it dismissed the amended complaint with prejudice. Kodenkandeth timely appealed.1 II. Kodenkandeth’s claims, though stylized as violations of state and federal law, were in essence challenges to the administrative appeals decisions.