N.B., et al. v. District of Columbia, et al. is a class action lawsuit challenging the District of Columbia’s failure to provide Medicaid recipients in the District of Columbia with adequate and timely notice, the opportunity for a fair hearing, and the opportunity for reinstated coverage pending a hearing decision, when their prescription for medication is denied at the point-of-sale. Plaintiffs contend that the District of Columbia’s actions violate the rights of Medicaid recipients guaranteed by the Fifth Amendment to the Constitution and District of Columbia law.
The putative class consists of:
All current and future District of Columbia Medicaid recipients whose prescription drugs are covered by the District of Columbia Medicaid program and who have, or will have, their prescription drug coverage denied at point-of-sale without timely and adequate individualized written notice, the opportunity for a fair hearing, and/or the opportunity for reinstated drug coverage pending a hearing decision.
On July 17, 2015, the United States Court of Appeals for the District of Columbia partially reversed and remanded a March 31, 2014 decision from the district court granting defendants’ motion to dismiss the amended complaint. The decision is reported at 794 F.3d 31. This is the second reversal of the district court in this case. On June 8, 2012, the Court of Appeals for the District of Columbia Circuit reversed the district court’s grant of defendants’ motion to dismiss the original complaint. The 2012 decision is reported at 682 F.3d 77.
The parties are currently briefing the remaining motion to dismiss issues.
If you have any questions about the case or are a District of Columbia Medicaid recipient whose prescription drug coverage has been denied at point-of-sale without timely and adequate individualized written notice, an opportunity for a hearing, and/or reinstated coverage pending a hearing decision, please call Stephanie Madison at 202-204-8474.
Memorandum Opinion of Court of Appeals for the D.C. Circuit, dated June 8, 2012
Memorandum Opinion of Court of Appeals for the D.C. Circuit, Dated July 17, 2015