United States District Court, District of Columbia
MEMORANDUM OPINION [# 114]
RICHARD J. LEON DISTRICT JUDGE.
September 7, 2010, Medicaid recipients brought this suit
against the District of Columbia ("the District"),
alleging the District failed to provide them due process when
denying Medicaid coverage for certain prescription
medications. See Compl. [Dkt. #3]. After two amended
complaints, four motions to dismiss, and two appeals to the
D.C. Circuit, plaintiffs filed a motion for a preliminary
injunction on September 24, 2019, nine years after initiating
this lawsuit. See Pls.' Mem. in Support of Mot.
for a Prelim. Injunction ("Pls.' Mot.") [Dkt. #
114-1]. They seek a preliminary injunction compelling the
District to provide individualized notice to persons denied
Medicaid coverage for those prescriptions within sixty days.
Id. at 2. The District moved to stay briefing on
plaintiffs' motion, which I denied on October 10, 2019. I
ordered the parties to complete briefing on plaintiffs'
motion by October 23, 2019, and I held oral argument on
November 1, 2019. Upon consideration of the parties'
briefing and argument, the relevant law, the entire record,
and for the reasons stated below, plaintiffs' motion for
a preliminary injunction is DENIED.
underlying facts of this case have been set forth at great
length in prior opinions of this Court and our Circuit Court,
and I will not belabor them again here. See N.B. v. Dist.
of Columbia, 800 F.Supp.2d 51, 53-54 (D.D.C. 2011);
N.B. ex rel. Peacock v. Dist. of Columbia, 682 F.3d
77, 80-81 (D.C. Cir. 2012); N.B. v. Dist. of
Columbia, 34 F.Supp.3d 146, 148-50 (D.D.C. 2014);
N.B ex rel. Peacock v. Dist. of Columbia, 794 F.3d
31, 35-37 (D.C. Cir. 2015); N.B. v. District of
Columbia, 244 F.Supp.3d 176, 177-79 (D.D.C. 2017). As
relevant to plaintiffs' pending motion, the
District's Department of Health Care Finance
("DHCF") administers D.C.'s Medicaid program.
Second Am. Compl. ("Compl.") ¶ 17
[Dkt. # 98]. Plaintiffs in this case receive Medicaid
benefits in the District, including prescription drug
benefits. Id. ¶¶ 5-8, 10. They allege that
their prescription coverage has been denied on various
occasions, and the District failed to provide "timely
and adequate individualized written notice" of the
reason for the denial. Id. ¶¶ 2-3.
support of their motion for preliminary injunctive relief,
plaintiffs point to specific issues they have had in filling
prescriptions. Plaintiff Elsa Maldonado reports that she
attempted to refill her asthma medication at a District
pharmacy in 2013, but the pharmacy told her that Medicaid did
not cover the kind she had been prescribed. Pls.' Mot.,
Ex. 13 9/25/18 Maldonado Aff. ¶ 14 [Dkt.
#114-15]. She was thus given a substitute medication for her
asthma. Id. Maldonado contacted plaintiffs'
counsel as well as her doctor to obtain an override of the
pharmacy's decision. Id. ¶¶ 17, 18.
She did not take the substitute medication. See Id.
¶ 19. After her prescribed medication ran out, she
sought treatment from an asthma specialist, who provided her
with a temporary supply of the prescribed medication.
BR, a severely disabled child, was prescribed antibiotics for
strep throat in March 2018. Pls.' Mot., Ex. 12 8/8/18
Robertson Aff. ¶¶ 3, 11 [Dkt. # 114-14]. Two
District pharmacies told BR's parents that her
prescription could not be filled because BR's Medicaid
identification information was incorrect and she was not
active in the system. Id. ¶¶ 14, 16,
19-20. Eventually, BR's mother spoke to a representative
at BR's Medicaid managed care organization, who informed
her that BR had been issued a new prescription identification
number at the start of the year. Id. ¶ 24. BR
sometimes refuses to eat or drink when she has a sore throat
and, due to the several hours of delay in filling her
prescription, she became dehydrated and was taken to the
emergency room. Id. ¶¶ 12, 27.
procedural history of this case runs long. Plaintiffs filed
suit in 2010. See Compl. In 2011, I granted
defendants' motion to dismiss, concluding plaintiffs
lacked Article III standing to assert their claims. N.B.
v. Dist. of Columbia, 800 F.Supp.2d 51, 58 (D.D.C.
2011). Our Circuit Court reversed in 2012. N.B. ex rel.
Peacock v. Dist. of Columbia, 682 F.3d 77, 86 (D.C. Cir.
2012). Plaintiffs amended their complaint on remand, and the
District again moved to dismiss. Am. Compl. [Dkt. # 43]; Mot.
to Dismiss Am. Compl. [Dkt. # 46]. In 2014, I concluded that
plaintiffs failed to state claims under Title XIX or the
Fifth Amendment and that I lacked pendent jurisdiction over
their D.C. law claims. KB. v. Dist. of Columbia, 34
F.Supp.3d 146, 156, 160 (D.D.C. 2014). Plaintiffs appealed,
and our Circuit affirmed dismissal of the Title XIX claim but
reversed and remanded plaintiffs' Fifth Amendment claim.
NB ex rel. Peacock v. Dist. of Columbia, 794 F.3d
31, 40-44 (D.C. Cir. 2015). On remand, I denied the
District's third motion to dismiss, holding that
plaintiffs stated a claim that they were not provided
constitutionally adequate notice of the reasons for the
denial of their prescription claims. N.B. v. District of
Columbia, 244 F.Supp.3d 176, 183 (D.D.C. 2017).
months after my ruling, plaintiffs moved to amend their
complaint and to certify a class. See Mot. to Amend
[Dkt. # 79]; Mot. to Certify Class [Dkt. # 80]. One month
later, plaintiffs filed a motion for summary judgment and a
permanent injunction or, in the alternative, a preliminary
injunction. Mot. for Summ. J. [Dkt. # 85]. On April 4, 2019,
I granted plaintiffs' motion for leave to file a second
amended complaint, and the District moved to partially
dismiss on May 31, 2019. Partial Mot. to Dismiss [Dkt # 102].
Plaintiffs opposed and cross moved for partial summary
judgment. Pls.' Mem. in Opp. to Partial Mot. to Dismiss
[Dkt. # 104]; Pls.' Cross Mot. for Summ. J.
[Dkt. # 105]. Those motions became fully briefed on August 2,
2019. On September 24, 2019, plaintiffs filed the instant
motion for preliminary injunctive relief. See
preliminary injunction is "an extraordinary remedy that
may only be awarded upon a clear showing that the plaintiff
is entitled to such relief." Winter v. Natural Res.
Def Council, Inc., 555 U.S. 7, 22 (2008) (citation
omitted). Plaintiffs "seeking a preliminary injunction
must establish  that [they are] likely to succeed on the
merits,  that [they are] likely to suffer irreparable harm
in the absence of preliminary relief,  that the balance of
equities tips in [their] favor, and  that an injunction is
in the public interest." Id. at 20. Although
these factors "interrelate on a sliding scale, the
movant must, at a minimum, demonstrate that irreparable
injury is likely in the absence of an
injunction." Bill Barrett Corp. v. U.S. Dep't of
Interior, 601 F.Supp.2d 331, 334-35 (D.D.C. 2009)
(internal quotation marks and citations omitted). "A
movant's failure to show any irreparable harm is . ..
grounds for refusing to issue a preliminary injunction, even
if the other three factors entering the calculus merit such
relief." Chaplaincy of Full Gospel Churches
(CFCG) v. England, 454 F.3d 290, 297 (D.C. Cir. 2006).