Maldonado v. District of Columbia

(Formerly Known as n.b. v. District of Columbia)

D.D.C., Civ. No. 10-1511



Maldonado v. District of Columbia is a class action lawsuit challenging the District of Columbia’s failure to provide individualized written notice to persons whose prescriptions are denied Medicaid payment at the point-of-sale.  Plaintiffs contend that this violates their right to due process guaranteed by the Fifth Amendment to the Constitution.

The putative class currently consists of:

All persons who have applied for, received, or are receiving DC Medicaid that present a prescription to a participating pharmacy for a covered medication, and who do not, or will not, receive timely, adequate individualized written notice when the prescription is denied or is not filled as written.

Current Status

On April 4, 2019, the United States District Court for the District of Columbia granted plaintiffs leave to file a second amended complaint.  In plaintiffs’ Second Amended Complaint, plaintiffs added a class representative and descriptions of recent denials of Medicaid coverage experienced by class representatives.  Plaintiffs also modified the class definition to track the Court of Appeals’ language in its 2015 decision and made other necessary changes.

Most recently, on May 31, 2019, the District of Columbia filed a partial motion to dismiss plaintiffs’ Second Amended Complaint – its fourth motion to dismiss in the case. On June 28, 2019, plaintiffs opposed the motion to dismiss and filed a cross-motion for partial summary judgment.  The parties are currently completing the briefing on the motions.

Plaintiffs have two other motions pending:  a Renewed Motion for Class Certification, filed on October 22, 2018, and a Motion for Summary Judgment and Permanent Injunction, or in the Alternative, for a Preliminary Injunction filed on November 16, 2018.  The briefing on those two motions is being delayed until after the Court decides the District of Columbia’s fourth motion to dismiss. 

If you have any questions about the case or are a District of Columbia Medicaid recipient who has had problems obtaining Medicaid coverage for your prescribed drugs at the pharmacy, please call Stephanie Madison at 202-204-8474.

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