Case: Lankford v. Sherman

2:05-cv-04285 | U.S. District Court for the Western District of Missouri

Filed Date: Aug. 29, 2005

Closed Date: Jan. 23, 2008

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Case Summary

On August 29, 2005, seven low-income Missouri residents who received health coverage through Medicaid filed this lawsuit in the U.S. District Court for the Western District of Missouri. The plaintiffs sued the State of Missouri under the Medicaid Act, pursuant to 42 U.S.C. 1983 and the Supremacy Clause. The plaintiffs, represented by an array of public interest organizations, sought declaratory and injunctive relief, asking the court to enjoin Missouri from enforcing an emergency Medicaid regulation that would deny plaintiffs access to durable medical equipment (DME). The plaintiffs claimed that the emergency regulation, eliminating coverage of DME for most categorically-needy Medicaid recipients in the state, violated the Medicaid Act's comparability requirements and reasonable standards provisions.

As background, DME includes a wide variety of medical devices and equipment, including wheelchairs, prosthetics, orthopedic devices and hospital beds. Before 2005, Missouri provided DME as a stand-alone benefit to all recipients of Medicaid in the state. However, due to budget constraints, Missouri eliminated coverage of DME except for residents who are needy children, blind, or pregnant. In September 2005, the state promulgated an emergency regulation that reinstated coverage of certain DME items for all Medicaid recipients -- while at the same time extended coverage of additional items only to recipients who are blind, pregnant, needy children or those receiving home health care. The plaintiffs, who did not fall into those categories, were unable to obtain coverage for previously covered DME. Rather than challenging the statute, the plaintiffs argued that the emergency regulation impermissibly extended DME coverage to blind recipients but not others -- in violation of federal law.

On September 13, 2005, the court (Judge Whipple) denied the plaintiffs' motion for a preliminary injunction. In evaluating the plaintiff's argument, Judge Whipple reasoned that the Missouri emergency regulations likely did not violate the comparability requirement of the Medicaid Act. Judge Whipple concluded that the plaintiffs had other ways of obtaining DME through the state's Medicaid program. Further, he noted that Missouri had filed for a waiver from the Department of Health and Human Services (HHS) and the Center for Medicare and Medicaid Services (CMS) to permit it to provide DME services to the blind (but not other categorically need persons such as the plaintiffs). The plaintiffs appealed the District Court's decision to the Eighth Circuit Court of Appeals.

On June 22, 2006, the Eighth Circuit (Judge Benton) vacated and remanded the District Court's decision, finding that the state DME regulation was likely preempted by the Supremacy Clause. (Lankford v. Sherman, 451 F.3d 496 (8th Cir. 2006)). The Eighth Circuit determined, in line with the District Court's conclusion, that Missouri's provision of DME did not violate the Medicaid Act's comparability requirement. After HHS/CMS denied the waiver, Missouri decided to cover DME for the blind using solely state (and no federal) funds, meaning that it need not comply with the federal requirement. For the same reasons, the court concluded that the provision of DME services did not violate the reasonable standards requirement. The court further concluded that the plaintiffs did not have a private right of action under 1983 to enforce Medicaid's reasonable-standards provision.

The Eighth Circuit concluded that Missouri's DME regulations conflicted with the federal regulations that implement Medicaid's reasonable-standards requirement; thus, the regulations violated the Supremacy Clause. The plaintiffs had argued that the state regulation was unreasonable because it failed to provide sufficient DME services to meet Medicaid's basic objectives and the state's proposed alternatives to obtain the necessary DME were insufficient. The court agreed, concluding that the plaintiffs established a likelihood that they would prevail on the merits of their preemption claim pertaining to the reasonable-standards requirement. The court explained that because likelihood of success on the merits is only one of the four factors in determining whether to grant a preliminary injunction and the district court failed to address the other facts, the case should be remanded.

On March 2, 2007, Judge Whipple, on remand, granted the plaintiffs' motion for summary judgment and for a preliminary injunction to enjoin enforcement of Missouri's emergency Medicaid regulations that essentially eliminated the plaintiffs' access through Medicaid of DME. Judge Whipple ordered the state to amend its current DME program to comply with Medicaid's reasonable-standards requirement, thus remedying the preemption problem that the Eighth Circuit found.

On June 1, 2008, the defendants informed the court that on May 18, 2007, the Missouri General Assembly had passed a bill that covered all medically necessary DME. As such, defendants asked the court to declare that they were in compliance with the court's March 2 order.

On January 23, 2008, Judge Whipple declared that the defendants were in compliance with that order. He noted, however, that the only issue before the court was the legality of Missouri's 2005 emergency regulations. By eliminating that proposed regulatory scheme, Missouri complied with the order. However, the court was not deciding whether the state's subsequent legislative action in May 2007 conformed with the reasonable-standards requirement.

	Document
2:05-cv-04285	Docket [PACER]	Feb. 11, 2008	Feb. 11, 2008 Docket
1 2:05-cv-04285	Complaint	Aug. 29, 2005	Aug. 29, 2005 Complaint
17 2:05-cv-04285	Order	Sept. 13, 2005	Sept. 13, 2005 Order/Opinion
43 05-03587	Judgment [From Court of Appeals] U.S. Court of Appeals for the Eighth Circuit	July 21, 2006	July 21, 2006 Order/Opinion
64 2:05-cv-04285	Order [Granting Plaintiffs' Motion for Preliminary Injunction]	March 2, 2007	March 2, 2007 Order/Opinion
76 2:05-cv-04285	Order	Jan. 23, 2008	Jan. 23, 2008 Order/Opinion

ECF Number	Description	Date	Link Date / Link
1	COMPLAINT against Gary Sherman (Filing fee $250 receipt number 1073976) Service due by 12/27/2005, filed by Michael H. Finkelstein on behalf of Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse.(Finkelstein, Michael) Additional attachment(s) added on 8/30/2005 (Bax, Laura). (Entered: 08/29/2005)	Aug. 29, 2005	Aug. 29, 2005 PACER
2	MOTION for temporary restraining order and preliminary injunction filed byMichael H. Finkelstein on behalf of all plaintiffs Suggestions in opposition/response due by 9/13/2005 unless otherwise directed by the court (Attachments: # 1 Attachment - Vogelpohl# 2 Attachment - Brown# 3 Attachment - Ely# 4 Attachment - Everett# 5 Attachment - Lankford# 6 Attachment - Thomason# 7 Attachment - Greathouse)(Finkelstein, Michael) (Entered: 08/29/2005)	Aug. 29, 2005	Aug. 29, 2005 PACER
3	SUGGESTIONS in support re 2 MOTION for temporary restraining order and preliminary injunction filed by Michael H. Finkelstein on behalf of Plaintiffs Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse. (Related document(s) 2 ) (Finkelstein, Michael) (Entered: 08/29/2005)	Aug. 29, 2005	Aug. 29, 2005 PACER
4	DISCLOSURE OF CORPORATE INTERESTS filed by Michael H. Finkelstein on behalf of Plaintiffs Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse.(Finkelstein, Michael) (Entered: 08/29/2005)	Aug. 29, 2005	Aug. 29, 2005 PACER
	SUMMONS ISSUED as to Gary Sherman. (Bax, Laura)	Aug. 29, 2005	Aug. 29, 2005 PACER
5	NOTICE of appearance by Victorine R. Mahon on behalf of Gary Sherman (Mahon, Victorine) (Entered: 08/30/2005)	Aug. 30, 2005	Aug. 30, 2005 PACER
6	SUGGESTIONS in opposition re 2 MOTION for temporary restraining order and preliminary injunction filed by Victorine R. Mahon on behalf of Defendant Gary Sherman. Reply suggestions due by 9/15/2005 unless otherwise directed by the court (Attachments: # 1 # 2 # 3 # 4 # 5 # 6)(Related document(s) 2 ) (Mahon, Victorine) (Entered: 08/31/2005)	Aug. 31, 2005	Aug. 31, 2005 PACER
7	Motion to allow Martha Jane Perkins to appear pro hac vice (Pro Hac fee $50 receipt number 237503) filed byJane Perkins on behalf of Kimberly Vogelpohl, Joseph Everett, Donald Eugene Brown (James, Carrie) (Entered: 08/31/2005)	Aug. 31, 2005	Aug. 31, 2005 PACER
	ORDER granting 7 motion to appear pro hac vice approved by Clerk of Court. Attorney Jane Perkins for Plaintiffs. This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. . Signed by Judge Dean Whipple on 8/31/05. (James, Carrie)	Aug. 31, 2005	Aug. 31, 2005 PACER
8	Motion to allow Edward King to appear pro hac vice (Pro Hac fee $50 receipt number 237504) filed byEd King on behalf of all plaintiffs (James, Carrie) (Entered: 08/31/2005)	Aug. 31, 2005	Aug. 31, 2005 PACER
	ORDER granting 8 motion to appear pro hac vice approved by Clerk of Court. Attorney Ed King for plaintiffs. This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. . Signed by Judge Dean Whipple on 8/31/05. (James, Carrie)	Aug. 31, 2005	Aug. 31, 2005 PACER
9	Motion to allow Eugene Coffey to appear pro hac vice (Pro Hac fee $50 receipt number 237504) filed byEugene Coffey on behalf of all plaintiffs (James, Carrie) (Entered: 08/31/2005)	Aug. 31, 2005	Aug. 31, 2005 PACER
	ORDER granting 9 motion to appear pro hac vice approved by Clerk of Court. Attorney Eugene Coffey for plaintiffs. This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. . Signed by Judge Dean Whipple on 8/31/05. (James, Carrie)	Aug. 31, 2005	Aug. 31, 2005 PACER
10	Motion to allow Michael Ferry to appear pro hac vice (Pro Hac fee $50 receipt number 237505) filed by Michael A. Berry on behalf of all plaintiffs (James, Carrie) Modified on 9/2/2005 to correct docket text (Bax, Laura). (Entered: 08/31/2005)	Aug. 31, 2005	Aug. 31, 2005 PACER
	ORDER granting 10 motion to appear pro hac vice approved by Clerk of Court. Attorney Michael A. Ferry for Plaintiffs. This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. . Signed by Judge Dean Whipple on 8/31/05. (James, Carrie)	Aug. 31, 2005	Aug. 31, 2005 PACER
11	ORDER - denying plaintiff's 2 motion for TRO. A Preliminary Injunction hearing is set for Sept. 7, 2005 at 2:30 p.m. in Courtroom 8B. Signed by Judge Dean Whipple on 9/1/2005. (Johnson, Yvonne) (Entered: 09/01/2005)	Sept. 1, 2005	Sept. 1, 2005 PACER
12	RETURN OF SERVICE of complaint executed by plaintiffs. Gary Sherman served on 8/30/2005, answer due 9/19/2005. (Bax, Laura) (Entered: 09/02/2005)	Sept. 2, 2005	Sept. 2, 2005 PACER
13	Plaintiffs' Reply to Defendants' Suggestions in Opposition to Motion for Temporary Restraining Order and Preliminary Injunction filed byMichael H. Finkelstein on behalf of all plaintiffs Suggestions in opposition/response due by 9/21/2005 unless otherwise directed by the court (Attachments: # 1 # 2 Exhibit # 3 Exhibit # 4 Exhibit # 5 Exhibit # 6 Exhibit # 7 Exhibit # 8 Exhibit # 9 Exhibit # 10 Exhibit # 11 Exhibit)(Finkelstein, Michael) 2 Modified on 9/7/2005 to correct docket text and terminate motion(Bax, Laura). (Entered: 09/06/2005)	Sept. 6, 2005	Sept. 6, 2005 PACER
14	SUGGESTIONS in opposition re 2 MOTION for temporary restraining order and preliminary injunction filed by Victorine R. Mahon on behalf of Defendant Gary Sherman. Reply suggestions due by 9/22/2005 unless otherwise directed by the court (Attachments: # 1)(Related document(s) 2 ) (Mahon, Victorine) (Entered: 09/07/2005)	Sept. 7, 2005	Sept. 7, 2005 PACER
	NOTICE OF DOCKET MODIFICATION. A modification has been made to the document filed on 9/6/05 as Motion for TRO 13 . Docket text changed to correctly reflect document filed. Motion terminated as this document was not a motion. This document was not deleted and will not be refiled as a hearing is being held in regard to this document today. This is a text entry only - no document is attached. (Bax, Laura)	Sept. 7, 2005	Sept. 7, 2005 PACER
27	JOINT EXHIBIT INDEX (Kee, Georgia) (Entered: 09/21/2005)	Sept. 7, 2005	Sept. 7, 2005 PACER
29	Minute Entry for proceedings held before Judge Dean Whipple : PRELIMINARY INJUNCTION HEARING held on 9/7/2005. All parties present. In favor of defendant. (Court Reporter Denna Lamken.) (Kee, Georgia) (Entered: 09/27/2005)	Sept. 7, 2005	Sept. 7, 2005 PACER
15	MOTION for leave to file Letter of September 1, 2005 from Centers for Medicare and Medicaid Services as a Supplement to the Record filed byVictorine R. Mahon on behalf of Gary Sherman Suggestions in opposition/response due by 9/26/2005 unless otherwise directed by the court (Attachments: # 1)(Mahon, Victorine) (Entered: 09/09/2005)	Sept. 9, 2005	Sept. 9, 2005 PACER
16	RESPONSE to motion re 15 MOTION for leave to file Letter of September 1, 2005 from Centers for Medicare and Medicaid Services as a Supplement to the Record filed by Joel Ferber on behalf of Plaintiffs Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse. Reply suggestions due by 9/26/2005 unless otherwise directed by the court (Related document(s) 15 ) (Ferber, Joel) (Entered: 09/09/2005)	Sept. 9, 2005	Sept. 9, 2005 PACER
17	ORDER - denying plaintiff's 2 MOTION for temporary restraining order and preliminary injunction. Signed by Judge Dean Whipple on 9/13/2005. (Johnson, Yvonne) (Entered: 09/14/2005)	Sept. 13, 2005	Sept. 13, 2005 PACER
18	ORDER - granting defendant's 15 motion for leave to supplement the record. Signed by Judge Dean Whipple on 9/15/2005. (Johnson, Yvonne) (Entered: 09/16/2005)	Sept. 15, 2005	Sept. 15, 2005 PACER
19	MOTION to dismiss case filed byVictorine R. Mahon on behalf of Gary Sherman Suggestions in opposition/response due by 10/3/2005 unless otherwise directed by the court (Mahon, Victorine) (Entered: 09/16/2005)	Sept. 16, 2005	Sept. 16, 2005 PACER
20	SUGGESTIONS in support re 19 MOTION to dismiss case filed by Victorine R. Mahon on behalf of Defendant Gary Sherman. (Related document(s) 19 ) (Mahon, Victorine) (Entered: 09/16/2005)	Sept. 16, 2005	Sept. 16, 2005 PACER
21	TRANSCRIPT of Telephone Conference held on 8/31/05 before Judge Dean Whipple. Court Reporter: Sandra Lamken. (Kee, Georgia) Modified on 7/13/2010 - Transcript added to event & paper document purged(Bax, Laura). (Entered: 09/20/2005)	Sept. 19, 2005	Sept. 19, 2005 PACER
22	TRANSCRIPT of Temporary Injunction Hearing held on 9/7/05 before Judge Dean Whipple. Court Reporter: Sandra Lamken. This is a text entry only - no document is attached. The transcript is available for review in the Clerk's Office. Please contact the court reporter listed above for copies. (Kee, Georgia) (Entered: 09/20/2005)	Sept. 19, 2005	Sept. 19, 2005 PACER
23	NOTICE OF APPEAL as to 17 Order by Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse. Filing fee $ 255, receipt number 1089091. (Attachments: # 1 Exhibit)(Ferber, Joel) (Entered: 09/20/2005)	Sept. 20, 2005	Sept. 20, 2005 PACER
24	Motion to allow Rochelle Bobroff to appear pro hac vice (Pro Hac fee $50 receipt number 237577) filed byMichael H. Finkelstein on behalf of all plaintiffs (Bax, Laura) (Entered: 09/20/2005)	Sept. 20, 2005	Sept. 20, 2005 PACER
	ORDER granting 24 motion to appear pro hac vice approved by Clerk of Court. Attorney Rochelle Bobroff for plaintiffs. This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. (Bax, Laura)	Sept. 20, 2005	Sept. 20, 2005 PACER
25	Motion to allow Dorothy Siemon to appear pro hac vice (Pro Hac fee $50 receipt number 237577) filed byMichael H. Finkelstein on behalf of plaintiffs (Bax, Laura) (Entered: 09/20/2005)	Sept. 20, 2005	Sept. 20, 2005 PACER
	ORDER granting 25 motion to appear pro hac vice approved by Clerk of Court. Attorney Dorothy Siemon for plaintiffs This is a text only entry and will serve as authorization for the pro hac participation by the attorney. No document is attached. (Bax, Laura)	Sept. 20, 2005	Sept. 20, 2005 PACER
26	MOTION for order Injunction re 23 Notice of Appeal, filed byJoel Ferber on behalf of all plaintiffs Suggestions in opposition/response due by 10/5/2005 unless otherwise directed by the court (Related document(s) 23 ) (Ferber, Joel) (Entered: 09/20/2005)	Sept. 20, 2005	Sept. 20, 2005 PACER
28	TRANSMISSION of Notice of Appeal and docket sheet to US Court of Appeals re 23 Notice of Appeal, (Price, Jackie) (Entered: 09/21/2005)	Sept. 21, 2005	Sept. 21, 2005 PACER
	***Appeal Receipt of Notice of Appeal and supporting documents received by USCA on: Wed Sep 21 15:16:57 CDT 2005 (Price, Jackie)	Sept. 21, 2005	Sept. 21, 2005 PACER
	US COURT OF APPEALS 8th Circuit CASE NUMBER 05-3587 for 23 Notice of Appeal. (Bax, Laura)	Sept. 22, 2005	Sept. 22, 2005 PACER
30	SUGGESTIONS in opposition re 19 MOTION to dismiss case filed by Michael H. Finkelstein on behalf of Plaintiffs Kimberly Vogelpohl, Adam Daniel Thomason, Rachel Ely, Susan Lavon Lankford, Joseph Everett, Donald Eugene Brown, Laura Lee Greathouse. Reply suggestions due by 10/18/2005 unless otherwise directed by the court (Related document(s) 19 ) (Finkelstein, Michael) (Entered: 10/03/2005)	Oct. 3, 2005	Oct. 3, 2005 PACER

Case: Lankford v. Sherman

2:05-cv-04285 | U.S. District Court for the Western District of Missouri

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