n.b. v. district of columbia

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



N.B. v. District of Columbia 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 individualized written notice when Medicaid coverage for their prescribed medication is denied at the point-of-sale.  Plaintiffs contend that this violates the rights of Medicaid recipients guaranteed by the Due Process Clause of the Fifth Amendment to the Constitution.

The putative class currently consists of:

All current and future District of Columbia Medicaid recipients who have, or will have, District of Columbia Medicaid coverage denied for their prescribed medication at point-of-sale without timely and adequate individualized written notice.

Current Status

On March 26, 2017, the United States District Court for the District of Columbia partially denied defendants’ motion to dismiss, finding that plaintiffs have stated a claim that the District’s current system at the pharmacy for denials of Medicaid prescriptions violates the Fifth Amendment’s Due Process Clause by not providing individualized written notice to Medicaid recipients.  The case was before the district court after a second reversal from the United States Court of Appeals for the District of Columbia Circuit (“D.C. Circuit”).  On July 17, 2015, the D.C. Circuit ruled that the district court had erred in dismissing plaintiffs’ amended complaint.  The D.C. Circuit decision is reported at 794 F.3d 31.  Earlier, on June 8, 2012, the D.C. Circuit ruled that the district court had erred in dismissing the original complaint.  The 2012 decision is reported at 682 F.3d 77.

The parties will next proceed with discovery and briefing on class certification.

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