G. v. Hawaii
| Decision Date | 23 December 2009 |
| Docket Number | Civ. No. 08-00551 ACK-BMK. 09-00044 ACK-BMK. |
| Citation | 676 F. Supp.2d 1006 |
| Parties | G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. State of HAWAII, Department of Human Services, et al., Defendants. G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. United States Department of Health and Human Services, et al., Defendants. |
| Court | U.S. District Court — District of Hawaii |
Bruce F. Sherman, Honolulu, HI, Rafael G. Del Castillo, Jouxson-Meyers & Del Castillo LLLC, Wahiawa, HI, for Plaintiffs.
Charles A. Miller, Laura E. Schattschneider, Covington & Burling LLP, Michelle R. Bennett, Sheila M. Lieber, U.S. Department of Justice, Washington, DC, John F. Molay, Lee-Ann N.M. Brewer, Office of the Attorney General, State of Hawaii, Derrick K. Watson, Office of the United States Attorney, Honolulu, HI, for Defendants.
ORDER (1) GRANTING THE FEDERAL DEFENDANTS' MOTION FOR SUMMARY JUDGMENT AND THE JOINDERS THEREIN, (2) DENYING PLAINTIFFS' MOTION FOR SUMMARY JUDGMENT AGAINST THE FEDERAL DEFENDANTS BASED ON THE UNLAWFUL ISSUANCE OF A WAIVER AND APPROVALS OF MANAGED CARE CONTRACTS, AND (3) DENYING PLAINTIFFS' MOTION FOR SUMMARY JUDGMENT AGAINST THE FEDERAL DEFENDANTS BASED ON UNLAWFUL PREMIUM TAX REIMBURSEMENT
On December 8, 2008, in Civil No. 08-00551 ACK-BMK, Plaintiffs filed a complaint against the State of Hawaii, Department of Human Services ("State DHS"), and Lillian B. Koller, in her official capacity as the Director of the State DHS (collectively, "State Defendants"). At that point, the Plaintiffs were comprised of Medicaid beneficiaries who were part of the aged, blind, and disabled ("ABD") population ("ABD Plaintiffs"). Their principal allegation is that the State Defendants have violated certain provisions of Title XIX of the Social Security Act, commonly known as the Medicaid Act, 42 U.S.C. § 1396 et seq., by requiring them to enroll with one of two healthcare entities as a condition of receiving Medicaid benefits in connection with the agency's managed care program for ABD beneficiaries, the QUEST Expanded Access ("QExA") Program.
Those two entities were the only ones that received contracts to provide the medical care for ABD beneficiaries under the QExA Program ("QExA Contracts"). They are WellCare Health Insurance of Arizona, Inc. d/b/a Ohana Health Plan ("WellCare of Arizona") and United Healthcare Insurance Company d/b/a Evercare ("Evercare") (collectively, "QExA Contractors"), and they have intervened in this matter.
On January 30, 2009, in Civil No. 09-00044 ACK-BMK, Plaintiffs filed a complaint against the United States Department of Health and Human Services ("Federal DHHS") and the Secretary of the Federal DHHS (collectively, "Federal Defendants"). On February 4, 2009, Plaintiffs filed a first amended complaint against the Federal Defendants. "At the federal level, Congress has entrusted the Secretary of the Federal DHHS with administering Medicaid, and the Secretary, in turn, exercises that delegated authority through the Centers for Medicare and Medicaid Services (`CMS')." Wong v. Doar, 571 F.3d 247, 250 (2d Cir.2009). Plaintiffs contend that the CMS acted arbitrarily and capriciously by granting a waiver of the "freedom of choice" provision, 42 U.S.C. § 1396a(a)(23), for the QExA Program pursuant to 42 U.S.C. § 1315(a), and by thereafter approving the QExA Contracts.
On February 19, 2009, Civil Nos. 08-00551 and 09-00044 were consolidated. This is the third case brought in this Court challenging the QExA Program. See AlohaCare v. Hawaii, Dep't of Human Servs., 567 F.Supp.2d 1238 (D.Haw.2008), aff'd, 572 F.3d 740 (9th Cir.2009) (); Hawaii Coal, for Health v. Hawaii, Dep't of Human Servs., 576 F.Supp.2d 1114 (D.Haw.2008) ().
On May 11, 2009, the Court entered an order granting in part and denying in part a motion to dismiss filed by the State Defendants and joinders therein. G. v. Hawaii, Dep't of Human Servs., Civ. Nos. 08-00551 ACK-BMK & 09-00044 ACK-BMK, 2009 WL 1322354, 2009 U.S. Dist. LEXIS 39851 . The Court thereafter granted Plaintiffs leave to amend their complaints in certain respects. They subsequently filed a first amended complaint against the State Defendants and a second amended complaint against the Federal Defendants.
On June 2, 2009, Plaintiffs filed a motion for a preliminary injunction against the Federal Defendants. On August 7, 2009, they filed a motion for a temporary restraining order against the Federal Defendants. On August 10, 2009, Plaintiffs filed a motion for a temporary restraining order and a preliminary injunction against the State Defendants. The Court denied Plaintiffs' motions for temporary restraining orders, and Plaintiffs subsequently withdrew their motions for preliminary injunctions.
With leave of Court, on August 31, 2009, Plaintiffs filed a second amended sixty-seven-page complaint against the State Defendants and, on September 1, 2009, they filed a third amended fifty-eight-page complaint against the Federal Defendants ("Federal Third Amended Complaint" or "Fed.3d Am. Compl."). Those complaints added claims on behalf of certain Medicaid healthcare providers ("Provider Plaintiffs") and new ABD beneficiaries. The providers are physicians, pharmacists, and ancillary care providers who accepted ABD beneficiaries as patients and clients under the prior fee-for-service system and who have provided care and services to ABD beneficiaries under the QExA Program. In the action against the State Defendants, Plaintiffs have added claims under the Americans With Disabilities Act ("ADA"), the Rehabilitation Act, 42 U.S.C. § 1396a(a)(30), and the Takings Clause of the Fifth Amendment.
On September 8, 2009, the Federal Defendants filed the administrative record ("AR"), which is roughly 5,200 pages in length. At Plaintiffs' request, the administrative record includes documents from 2004 onwards. 7/18/09 Transcript of Proceedings 28:3-22. Plaintiffs did not ask for any documents that were created prior to 2004. Id.
Presently before the Court are three motions for summary judgment in the action against the Federal Defendants. The motions concern Plaintiffs' claim that the CMS acted arbitrarily and capriciously in granting the 42 U.S.C. § 1315(a) waiver and approving the QExA Contracts.
On October 14, 2009, the Federal Defendants filed a motion for summary judgment ( ), accompanied by a memorandum in support ( ) and a concise statement of facts ( ). This motion addresses both the waiver and contract-approval issues. On October 28, 2009, WellCare of Arizona filed a joinder in the motion. On November 3, 2009, Evercare filed a joinder in the motion. On November 11, 2009, the State Defendants filed a joinder in the motion.
On November 19, 2009, Plaintiffs filed an opposition to the motion ( ) and a concise statement of facts ( ).
On November 25, 2009, the Federal Defendants filed a reply ( ). On November 30, 2009, Evercare and WellCare of Arizona filed joinders in the reply.
On December 9, 2009, Plaintiffs filed a declaration of counsel.
On October 14, 2009, Plaintiffs filed a motion for summary judgment addressing both the waiver and contract approval issues ( . The motion was filed with a memorandum in support ( ) and a concise statement of facts ( ). On October 18, 2009, Plaintiffs filed an errata to their general motion for summary judgment.
On November 19, 2009, the Federal Defendants filed an opposition to the motion ( ), accompanied by a concise statement of facts ( ). On November 20, 2009, WellCare of Arizona and the State Defendants filed joinders in the Federal Defendants' opposition. On November 23, 2009, Evercare filed a joinder in the Federal Defendants' opposition.
On November 25, 2009, Plaintiffs filed a reply ( ).
On October 14, 2009, Plaintiffs filed a motion for summary judgment regarding an unlawful payment of premium tax ( . The motion was accompanied by a memorandum in support ( ) and a concise statement of facts ( ). On October 16, 2009, Plaintiffs filed an errata to their tax motion for summary judgment. The motion appears to relate to the contract-approval issue.
On November 19, 2009, the State Defendants filed an opposition to the motion ( ), along with a concise statement of facts ( ). The same day, the Federal Defendants filed an opposition to the motion ( ) and a concise statement of facts ( ). On November 20, 2009, WellCare of Arizona filed joinders in the State and Federal Defendants' oppositions. The same day, the State Defendants filed a joinder in the Federal Defendants' opposition. On November 23, 2009, Evercare filed joinders in the State and Federal Defendants' oppositions.
On November 25, 2009, Plaintiffs filed a reply (...
To continue reading
Request your trial
-
G. v. Hawaii
...is on appeal in the Circuit Court of the First Circuit, State of Hawai'i." Order on Certified Question, filed 10/28/09. On December 23, 2009, 676 F.Supp.2d 1006, the circuit court heard oral argument in the appeal and affirmed the Insurance Commissioner's decision at the 28 A participating ......
-
Parent v. State Of Haw.I
... 703 F.Supp.2d 1078 ... G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. State of HAWAII, DEPARTMENT OF HUMAN SERVICES, et al., Defendants. G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. United States Department of Health and Human Services, et al., Defendants ... Civ. Nos. 08-00551 ACK-BMK, 09-00044 ACK-BMK. United States District Court, ... D ... ...
-
Tinsley v. Faust
...among the service providers will undermine the effectiveness of the treatment that they do receive"); see G. v. Hawaii , 676 F. Supp. 2d 1006, 1017 (D. Haw. 2009) (stating a program intended to better coordinate services "further[ed] the objectives of the Medicaid Act").Plaintiff cites to r......
-
G. v. State
... 794 F.Supp.2d 1119 G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. State of HAWAII, Department of Human Services, et al., Defendants.G., Parent and Next Friend of K., A Disabled Child, et al., Plaintiffs, v. United States Department of Health and Human Services, et al., Defendants. Civ. Nos. 08–00551 ACK–BMK 09–00044 ACK–BMK. United States District Court, D. Hawai‘i ... ...