Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Maldonado v. District of Columbia

United States District Court, District of Columbia

December 16, 2019

ELSA MALDONADO, et al., Plaintiffs,
v.
THE DISTRICT OF COLUMBIA, Defendant.

          MEMORANDUM OPINION [# 114]

          RICHARD J. LEON DISTRICT JUDGE.

         On 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.

         BACKGROUND

         I. Factual Background

         The 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.

         In 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. Id.

         Plaintiff 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.

         II. Procedural History

         The 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).

         Eighteen 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 Pls.' Mot.

         LEGAL STANDARD

         A 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 [1] that [they are] likely to succeed on the merits, [2] that [they are] likely to suffer irreparable harm in the absence of preliminary relief, [3] that the balance of equities tips in [their] favor, and [4] 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).

         ANALYSIS

         I. ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.