Elsa Maldonado v. DC

United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued January 27, 2023 Decided March 10, 2023

No. 22-7060

ELSA MALDONADO, ET AL.,

APPELLANTS

v.

DISTRICT OF COLUMBIA, A MUNICIPAL CORPORATION,

APPELLEE

Appeal from the United States District Court

for the District of Columbia

(No. 1:10-cv-01511)

Michael L. Huang argued the cause for appellants. With

him on the briefs were Martha Jane Perkins, Kathleen L.

Millian, Nicholas F. Soares, and Stephanie A. Madison.

Richard S. Love, Senior Assistant Attorney General,

Office of the Attorney General for the District of Columbia,

argued the cause for appellee. With him on the brief were Karl

A. Racine, Attorney General, at the time the brief was filed,

Caroline S. Van Zile, Solicitor General, Ashwin P. Phatak,

Principal Deputy Solicitor General, and Thais-Lyn Trayer,

Deputy Solicitor General.

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Before: PAN, Circuit Judge, and SENTELLE and TATEL,

Senior Circuit Judges.

Opinion for the Court filed by Senior Circuit Judge TATEL.

TATEL, Senior Circuit Judge: More than a decade ago,

Medicaid recipients filed this suit alleging that in violation of

the Due Process Clause, the District of Columbia is failing to

provide them notice and an opportunity to be heard when

denying them prescription coverage. The case is now before us

for the third time. In the first two appeals, we reversed the

district court’s dismissals for lack of standing and for failure to

state a claim, respectively. On remand, the district court once

more dismissed the case, this time for mootness. For the

reasons set forth below, we again reverse and remand with

instructions to proceed expeditiously with discovery and allow

plaintiffs to make their case.

I.

We described the background of this case in our two

previous opinions. See NB ex rel. Peacock v. District of

Columbia, 682 F.3d 77 (D.C. Cir. 2012); NB ex rel. Peacock v.

District of Columbia, 794 F.3d 31 (D.C. Cir. 2015). For

purposes of this appeal, readers need know only the following.

Medicaid-eligible individuals typically do not learn whether

their prescriptions are eligible for Medicaid coverage until they

attempt to fill them at a pharmacy. But when pharmacies

determine that a prescription is ineligible for Medicaid

coverage, they often fail to explain why the prescription was

denied or how the Medicaid recipient can appeal. In 2010,

plaintiffs, Medicaid-eligible individuals, filed this putative

class action alleging that the District’s “policies, procedures,

and practices of failing to provide individualized written

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notice” when Medicaid benefits are denied “violate[s] the Due

Process Clause.” Second Am. Compl. ¶ 1.

The district court first dismissed the case for lack of

standing. We reversed. NB ex rel. Peacock, 682 F.3d at 87. The

district court then dismissed for failure to state a claim. Again,

we reversed. NB ex rel. Peacock, 794 F.3d at 44.

On remand, plaintiffs sought to proceed with discovery,

which the district court had stayed ever since the District filed

its first motion to dismiss in 2010. Although the district court

did set a discovery schedule, it soon stayed it because the

District issued a memorandum to all pharmacies (the

“transmittal memorandum”) requiring them to explain to

Medicaid recipients why a prescription is denied and how to

appeal.

Based on this memorandum, the district court again

dismissed, this time on mootness grounds. According to the

district court, the transmittal memorandum “provides complete

relief to all potential plaintiffs” by enacting a new District-wide

policy “specifically designed to provide the notice to which

plaintiffs are entitled under the Constitution.” Maldonado v.

District of Columbia, No. 10-1511 (RJL), 2022 WL 910512, at

*3, *4 (D.D.C. Mar. 29, 2022). Because the policy, if

“implemented correctly,” would “lead to the exact form of

individualized notice that [plaintiffs] seek,” the district court

concluded that it could not “provide the plaintiffs with any

further relief.” Id. at *4.

Plaintiffs again appeal, arguing that their case is not moot

because, notwithstanding the transmittal memorandum, some

number of Medicaid recipients are still not informed why their

prescriptions are denied or how they can appeal. Plaintiffs also

urge us to reassign the case to a different district judge. The

District defends the district court’s decision. Our review is de

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novo. True the Vote, Inc. v. IRS, 831 F.3d 551, 555 (D.C. Cir.

2016).

II.

A case becomes moot when the court “can grant no

meaningful relief.” McByrde v. Committee to Review Circuit

Council Conduct, 264 F.3d 52, 55 (D.C. Cir. 2001). Indeed,

“[o]nly when it is impossible for a court to grant any effectual

relief” is a case moot. Decker v. Northwest Environmental

Defense Center, 568 U.S. 597, 609 (2013) (emphasis added)

(internal quotation marks and citation omitted). The “heavy

burden” of proving mootness falls “with the party asserting a

case is moot.” Honeywell International v. NRC, 628 F.3d 568,

576 (D.C. Cir. 2010) (internal quotation marks omitted).

In order to assess mootness, we must first define the

“wrong” alleged in the complaint “in terms of the precise

controversy it spawns.” PETA v. Gittens, 396 F.3d 416, 422

(D.C. Cir. 2005) (internal quotation marks omitted). According

to the district court, the “wrong” alleged in the complaint was

the lack of a policy and the “entirety of the relief” plaintiffs

were seeking was a new “notice policy.” Maldonado, 2022 WL

910512, at *3, *4. This is wrong.

The amended complaint challenges not only the District’s

policies (or lack thereof), but also “procedures [] and practices

of failing to provide individualized written notice.” Second

Am. Compl. ¶ 1 (emphasis added). Plaintiffs objected to not

only the District’s “actions,” but also its “inactions” and asked

the court to “requir[e] the District of Columbia to give them

timely and adequate individualized written notice.” Second

Am. Compl. ¶ 3. Thus, the wrong the complaint alleges is, in

addition to the absence of a policy, the actual failure to provide

notice. And the relief plaintiffs sought was, in addition to a

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change in policy, a “permanent injunction ordering [the District

and its agents] to comply with the Due Process Clause.”

Second Am. Compl. at 35.

Our court has likewise described the alleged wrong as the

failure to provide notice. In our decision reversing the district

court’s dismissal for lack of standing, we characterized the

harm as a “systematic[] deni[al]” of plaintiffs’ constitutional

rights to “timely and adequate written notice.” NB ex rel.

Peacock, 682 F.3d at 80, 81. And we grounded plaintiffs’

constitutional standing not on the absence of policy, but on the

District’s “procedural violations that threaten an individual’s

ability to obtain Medicaid coverage of prescription

medications.” Id. at 83.

The District insists that the case is nonetheless moot

because the transmittal memorandum has been “largely

successful.” Appellee’s Br. 32. In support, it cites an even more

equivocal declaration: “As far as the District is aware, the

notification policy is largely successful.” Joint Appendix 497,

Supp. Byrd. Decl. ¶ 12 (emphasis added). This is hardly

sufficient to meet the District’s “heavy burden” of

demonstrating mootness, True the Vote, 831 F.3d at 561,

especially given that plaintiffs introduced evidence that

pharmacies are in fact failing to provide notice. Plaintiffs

surveyed sixteen pharmacies and discovered that thirteen,

spread across all eight wards, were failing to comply with the

transmittal memorandum. And when one named plaintiff

sought prescription coverage over a year after the transmittal

memorandum circulated, her Medicaid coverage was denied

without any notice of why or how she could challenge the

denial. The District challenges none of this evidence.

For its part, the district court dismissed plaintiffs’ evidence

as a “small handful of individualized instances of alleged

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noncompliance with the new policy.” Maldonado, 2022 WL

910512, at *4. But having denied plaintiffs any opportunity for

discovery, the district court would have had no way of knowing

the extent to which Medicaid recipients are being denied

notice. In any event, the “heavy burden of establishing

mootness is not carried by proving that the case is nearly moot,

or is moot as to a ‘vast majority’ of the parties.” True the Vote,

831 F.3d at 561.

To sum up, plaintiffs challenge the District’s failure to

give Medicaid recipients reasons for denying their

prescriptions and an explanation of how to appeal, and

uncontested evidence demonstrates that, notwithstanding the

transmittal memorandum, some number of plaintiffs are still

not receiving the information they claim they are entitled to

under the Due Process Clause. Because it is not “impossible for

[the district] court to grant any effectual relief,” the case is not

moot. Decker, 568 U.S. at 609 (internal quotation marks and

citation omitted). Indeed, the case is no more moot than Brown

v. Board of Education would have been if, in the wake of the

Supreme Court’s 1954 decision, the Topeka Board of

Education had issued a memorandum directing its schools to

desegregate and record evidence demonstrated that Black

children were still attending segregated schools.

III.

For the foregoing reasons, we reverse and remand. Given

this case’s advanced age and our repeated reversals, we expect

the district court to proceed swiftly to lift the stay on discovery,

and to schedule briefing on class certification and dispositive

motions. We thus see no reason to reassign the case to a

different judge. See In re Kellogg Brown & Root, Inc., 756 F.3d

754, 763 (D.C. Cir. 2014) (reassigning cases is appropriate

“only in the exceedingly rare circumstance that a district

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judge’s conduct is ‘so extreme as to display clear inability to

render fair judgment’” (citation omitted)).

So ordered.