Sandefur v. Cherry

• Decision Date: 18 August 1982
• Docket Number: Civ. A. No. 80-64.
• Citation: 547 F. Supp. 418
• Parties: James D. SANDEFUR, O.D., and W. E. Marrionneaux, Jr., O.D. v. William A. CHERRY, M.D., Secretary of the Louisiana Dept. of Health & Human Resources, and Bonnie Smith, Medical Services Director of the Louisiana Dept. of Health & Human Resources.
• Court: U.S. District Court — Middle District of Louisiana

547 F. Supp. 418

James D. SANDEFUR, O.D., and W. E. Marrionneaux, Jr., O.D. v. William A. CHERRY, M.D., Secretary of the Louisiana Dept. of Health & Human Resources, and Bonnie Smith, Medical Services Director of the Louisiana Dept. of Health & Human Resources.

Civ. A. No. 80-64.

United States District Court, M. D. of Louisiana.

August 18, 1982.

Henry B. Bruser, III, Gold, Little, Simon, Weems & Bruser, Alexandria, La., for plaintiffs.

Charles L. Patin, George F. McGowin, La. Dept. of Health & Human Resources, Baton Rouge, La., for defendants.

FINDINGS OF FACT AND CONCLUSIONS OF LAW

JOHN V. PARKER, Chief Judge.

The Plaintiffs, doctors of optometry, are duly licensed to practice in Louisiana, and they are authorized providers of eye health care services under Title XIX of the Social Security Act — "Medicaid," 42 U.S.C. § 1396 et seq.

The Defendant, George Fischer, substituted by amended complaint filed July 14, 1980 for William A. Cherry, M.D., is Secretary of the Department of Health & Human Resources of the State of Louisiana and is the state official charged with the administration of the State Plan for Medical Services, and Defendant, Bonnie W. Smith, is Medical Services Director of the Louisiana Department of Health and Human Resources and is a state official charged with the administration of the State Plan for Medical Services.

Defendant, State of Louisiana, through the Department of Health & Human Resources, added by amended complaint, is the executive department charged with the formulation and administration of the State Plan for Medical Services. The Department is further charged under applicable state law with the administration of all health and human resources programs on behalf of the State, including, but not limited to, the state charity hospital system and parish public health units throughout the state.

Plaintiffs seek injunctive and declaratory relief in which they pray that the court declare the Louisiana Medical Assistance Plan, the state Medical Assistance Plan, the state Medical Assistance Program Manual, and the practices and usages thereunder unlawful under federal constitutional and statutory law and state law, and in which they seek to have the Plan and Program Manual and the practices and procedures thereunder reformed to comply with federal and state law.

Plaintiffs allege that the conflict between the state medical assistance provisions and the governing federal Medicaid statutes and regulations constitutes a violation of the Supremacy Clause of the federal Constitution, and that the substantive provisions of the state Plan and Program Manual, and the practices and usages and procedures thereunder, violate the Privileges and Immunities, Due Process, and Equal Protection Clauses. Additionally, plaintiffs argue that the state substantive provisions in dispute violate state statutory law.

Specifically, plaintiffs maintain that the defendants have unreasonably, arbitrarily, and illegally discriminated against them in the operation of the State Medicaid Plan relating to certain eye care insofar as the State Plan does not provide for reimbursement to optometrist-vendors for eye examination services which they are allegedly legally qualified and authorized to perform under Louisiana law, and for which provision for reimbursement to ophthalmologist-vendors is made.¹ Plaintiffs further allege that the Louisiana provisions are in conflict with 42 U.S.C. § 1396d(e)² and additionally maintain that the defendants' actions are in violation of L.S.A. R.S. 37:1066³ in that such actions directly and indirectly limit or restrict the freedom of categorically and medically needy persons to choose the services of optometrists, thereby depriving plaintiffs of employment and income to which they are allegedly entitled.

Assuming, arguendo, that the authorized scope of optometric practice in Louisiana is defined as broadly as plaintiffs allege, defendants deny that they are in violation of any federal constitutional or statutory provision or of any Louisiana law, and defendants particularly deny the right of plaintiffs to have the practices and usages under the Louisiana Medical Assistance Plan and Program Manual declared unlawful insofar as they relate to eye care. Alternatively, defendants assert that the services for which the plaintiff-optometrists are seeking reimbursement are not specifically included in the defined services which optometrists are legally qualified to provide under Louisiana law defining the authorized practice of optometry in the State of Louisiana. L.S.A. R.S. 37:1041(3).⁴

STANDING:

Plaintiff-optometrists have standing to raise the issues which require adjudication in the instant case. In light of the allegations that the challenged State regulations have caused or will cause economic and professional injury to them, the court concludes that plaintiffs have a significant personal stake in the outcome of the controversy, sufficient to assure that the dispute sought to be adjudicated will be presented in an adversary context. Singleton v. Wulff, 428 U.S. 106, 96 S.Ct. 2868, 49 L.Ed.2d 826 (1976); Roe v. Casey, 464 F.Supp. 487 (E.D.Penn.1978 and cases cited therein) (physicians have standing to bring class action suit and suit on their own behalf to contest state Medicaid regulations which prohibit abortions); Alabama Nursing Home Ass'n v. Califano, 433 F.Supp. 1325 (D.C.Ala.1977) (nursing homes had standing to assert their right to receive Medicaid payments calculated on a cost-related basis).

JURISDICTION:

As to all issues of law except those arising under state law, subject matter jurisdiction is sought to be grounded herein either upon 28 U.S.C. § 1331, federal question jurisdiction, or, alternatively, upon 28 U.S.C. § 1343, insofar as the cause of action arises under a civil rights statute, 42 U.S.C. § 1983. All issues which are not independently supported by a statutory grant of jurisdiction are argued to be cognizable under pendent jurisdiction theories. Hagans v. Levine, 415 U.S. 528, 94 S.Ct. 1372, 39 L.Ed.2d 577 (1974).

Jurisdiction is statutorily conferred over at least one aspect of the dispute by 28 U.S.C. § 1331, since the complaint alleges a violation of the Supremacy Clause that certain provisions of the state Plan and Program Manual are alleged to be inconsistent and incompatible with governing provisions of the Social Security Act, in particular 42 U.S.C. § 1396d(e), supra, and plaintiffs allege that the amount in controversy exceeds $10,000.00.

Shortly before trial defendants moved to dismiss but did not dispute the jurisdictional amount allegation in the complaint, choosing to rely instead on the ground of alleged "insubstantiality" of the constitutional claims raised by plaintiffs. A presumption of correctness attaches to jurisdictional amount allegations in the complaint, and the plaintiffs are not required to support these allegations in the absence of a factual attack. KVOS, Inc. & Associated Press, 299 U.S. 269, 57 S.Ct. 197, 81 L.Ed. 183 (1936) (formal jurisdictional allegation that amount in controversy is satisfied is sufficient to confer jurisdiction, unless other allegations in pleadings or particularized objections in motion to dismiss demonstrate that suit should be dismissed. Only when jurisdictional allegations are challenged in an appropriate manner must plaintiff support his conclusory jurisdictional allegations with proof).

Absent the attachment of federal question jurisdiction under 28 U.S.C. § 1331 to determine the merits of the alleged conflict between the state Medical Assistance provisions and the governing federal Medicaid statutes and regulations, with concomitant pendent jurisdiction to support the other related issues herein, the court maintains grave reservations regarding the presence of any other independent statutory basis for subject matter jurisdiction. Jurisdiction is doubtful under 28 U.S.C. § 1343 because that section, in pertinent part, confers jurisdiction only over actions in which substantial claims are made based upon alleged deprivations of constitutional or civil rights. It is settled that 28 U.S.C. § 1343 does not confer jurisdiction over disputes arising under the Social Security Act, for that Act is not classified as legislation which provides for "equal rights of citizens" or for "the protection of civil rights" as those terms are used in Section 1983. Chapman v. Houston Welfare Rights Organization, 441 U.S. 600, 99 S.Ct. 1905, 60 L.Ed.2d 508 (1979).

Consequently, it is only if the plaintiffs' constitutional claims under the due process, equal protection, or privileges and immunities clauses are not insubstantial that jurisdiction can be found pursuant to 28 U.S.C. § 1343. Although the prescribed test to determine the substantiality of constitutional claims is a rather strict one, i.e., whether "prior decisions inescapably render the claims frivolous," Hagans v. Levine, 415 U.S. 528, 94 S.Ct. 1372, 39 L.Ed.2d 577 (1974), quoting Goosby v. Osser, 409 U.S. 512, 518, 93 S.Ct. 854, 858-59, 35 L.Ed.2d 36 (1973); Curtis v. Taylor, 625 F.2d 645 (5th Cir. 1980), the court notes that there is cogent jurisprudential authority adverse to the plaintiffs which directly or analogously appears to conclusively foreclose argument on the constitutional issues raised under the due process, equal protection, and privileges and immunities clauses. This result would render these constitutional issues "insubstantial" and therefore insufficient to support jurisdiction under 28 U.S.C. § 1343. For example, with respect to the alleged violation of the Privileges and Immunities clauses of Article 4, Section 2, Clause 1, and the Fourteenth Amendment, Section 1, of the federal Constitution, the jurisprudence is clear that it is only discrimination by a State against citizens of another state in favor of its own citizens that is prohibited by the Privileges and Immunities clauses. Hague v. Committee for Industrial...