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Vanderhorst v. Blue Cross Blue Shield Ass'n

United States District Court, D. Columbia.

April 16, 2015

ANNETTE M. VANDERHORST, Plaintiff,
v.
BLUE CROSS BLUE SHIELD ASSOCIATION, et al., Defendants

ANNETTE M. VANDERHORST, Plaintiff, Pro se, Washington, DC.

For BLUE CROSS BLUE SHIELD ASSOCIATION, Defendant: Anthony F. Shelley, Brian Andrew Hill, LEAD ATTORNEYS, MILLER & CHEVALIER, CHARTERED, Washington, DC.

For DEPARTMENT OF HEALTH AND HUMAN SERVICES, CMS MEDICARE CLAIMS OFFICE, Defendants: Peter Rolf Maier, LEAD ATTORNEY, U.S. ATTORNEY'S OFFICE, Civil Division, Washington, DC.

MEMORANDUM OPINION

AMY BERMAN JACKSON, United States District Judge.

Plaintiff Annette M. Vanderhorst brought this pro se lawsuit against defendants

Page 47

Blue Cross Blue Shield Association (" BCBSA" ) and " CMS," which is the Centers for Medicare and Medicaid Services, a component of the Department of Health and Human Services (" HHS" ). Plaintiff's allegations relate to an increase in the cost of certain medications. HHS filed a motion for a more definite statement, or in the alternative, to dismiss. BCBSA filed a motion for judgment on the pleadings. The Court finds that plaintiff has failed to state a claim against either defendant upon which relief can be granted, and so it will grant defendants' motions and dismiss this case.

BACKGROUND

Plaintiff, acting pro se, filed a complaint in the Superior Court of the District of Columbia on August 14, 2014, naming BCBSA and CMS as defendants. Compl. [Dkt. # 9-1] at 1. HHS removed the case to this Court on September 17, 2014. Notice of Removal [Dkt. # 1].

The complaint consists of a one-page form, a two-page letter addressed to the " Civil Court" in the District of Columbia, and many pages of correspondence between plaintiff and various individuals, including the CEO of BCBSA, HHS Secretary Kathleen Sebelius, and personnel at CMS, CareFirst BlueCross BlueShield, and Medi-CareFirst. Compl. Plaintiff states in the letter to the " Civil Court" that she is " complaining of the service being given by Blue Cross Blue Shield Insurance Company a contractual affiliate with the company Keith Glasscock (Plan D), and also Medicare's Appeal office." Id. at 2. Plaintiff explains that " [i]t all started in September 12, 2013, with an increase in the cost of medication with no notice prior to receiving the medication." Id. She then details the ways in which " it has gotten worse" since that time, which include:

o An alleged " [f]ailure to send Explanation of Benefits (EOB) monthly regarding an increase in the cost of medication." Id.
o " A letter (copy enclosed) dated October 23, 2013 with lots of false information." Id. Plaintiff further states that she has received confusing information about people who may or may not have called and worked at a Rite Aid pharmacy, as well as whether the manufacturer of the medications at issue sets prices for the medications. Id.
o An alleged failure to provide " paperwork" to plaintiff " showing the cost increase for Synthroid on July 3, 2013, and Prednisone on August 4, 2013." Id. Plaintiff also states that she did not receive timely responses to several inquiries by letter and phone with various individuals at " Blue Cross Blue Shield." Id. at 2-3.

Plaintiff further states that she made an appeal to " Medicare" regarding these practices, which ...


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