Case: M.V. v. Lyon

2:17-cv-11184 | U.S. District Court for the Eastern District of Michigan

Filed Date: April 14, 2017

Case Ongoing

Clearinghouse coding complete

Case Summary

On April 14, 2017, plaintiff, a Medicaid eligible individual who had been diagnosed with hepatitis C Virus, filed this class action complaint against Nick Lyon, in his capacity as executive director of the Michigan Department of Health and Human Services (MDHHS). The complaint was filed in the United States District Court for the Eastern District of Michigan, and it alleged that the MDHHS violated several provisions of the Medical Assistance Program, Title XIX of the Social Security Act, 42 U.S…

On April 14, 2017, plaintiff, a Medicaid eligible individual who had been diagnosed with hepatitis C Virus, filed this class action complaint against Nick Lyon, in his capacity as executive director of the Michigan Department of Health and Human Services (MDHHS). The complaint was filed in the United States District Court for the Eastern District of Michigan, and it alleged that the MDHHS violated several provisions of the Medical Assistance Program, Title XIX of the Social Security Act, 42 U.S.C. § 1396 by its then existing prior-authorization criteria for hepatitis C treatment.

The complaint alleged that the criteria's requirement that individuals suffer certain levels of measurable liver damage before they could become eligible for direct-acting antiviral medications. More specifically, this practice violated three separate provisions of 42 U.S.C. § 1396 by: (1) excluding qualified Medicaid recipients from "medically necessary" treatment as required by 42 U.S.C. § 1396a(a)(10)(A); (2) discriminating among similarly situated Medicaid recipients in violation of 42 U.S.C. § 1396a(a)(10)(B); and (3) failing to provide medically necessary treatment with "reasonable promptness" as required by 42 U.S.C. § 1396a(a)(8).

The defendants initially filed a motion to dismiss the claim, but in October of 2017 the parties began discussing settlement possibilities and agreed to mediation. The parties then reached an agreement after a formal mediation with Magistrate Judge R. Steven Whalen on January 27, 2018.

On May 29, 2018, the court granted preliminary approval of the proposed class action settlement and set a date for a fairness hearing. The court granted final approval of the settlement on August 31, 2018, and awarded plaintiff's counsel $199,000 in attorney fees, an amount the defendants had agreed not to contest in the settlement.

The settlement class was defined as: All individuals that: are or will be enrolled in Michigan's Medicaid Program at the time of class certification; have been or will be diagnosed with a chronic infection of Hepatitis C virus; are 18 years or older; and require or in the future will require treatment for Hepatitis C with direct-acting antiviral medication and who do not meet the MDHHS current treatment criteria, which restricts direct-acting antiviral treatment to individuals with a minimum metavir fibrosis score criteria of F-2.

The defendants denied any liability in the settlement, but agreed to replace the MDDHS prior-authorization criteria and institute amended criteria to provide coverage for direct-acting antiviral treatment to all Eligible Michigan Medicaid beneficiaries diagnosed with chronic hepatitis C. The schedule for expanding direct-acting antiviral treatment coverage was set as follows: (a) defendant will provide coverage for all eligible beneficiaries with a metavir fibrosis score of F-1 and above on October 1, 2018; (b) defendant will provide coverage for all beneficiaries with a metavir fibrosis score of F-0 and above on October 1, 2019.

The court issued a stipulated order dismissing the case on April 15, 2019 and an amended order on stipulation of dismissal on May 17, 2019.

Summary Authors

Chris Pollack (3/20/2019)

People

For PACER's information on parties and their attrorneys, see: https://www.courtlistener.com/docket/6947656/parties/jv-on-behalf-of-herself-and-all-others-similarly-situated-v-lyon-in/


Judge(s)

Hood, Denise Page (Michigan)

Whalen, R. Steven (Michigan)

Attorneys(s) for Plaintiff

Burrell, Aaron V. (Michigan)

Estes, Morris Reid Jr. (Tennessee)

Holmes, Martin D. (Tennessee)

Traylor, John M. (Michigan)

Young, Robert P. Jr. (Michigan)

Attorneys(s) for Defendant

McLean, Kelley Turnock (Michigan)

Smith, Joshua S (Michigan)

Judge(s)

Hood, Denise Page (Michigan)

Whalen, R. Steven (Michigan)

Attorneys(s) for Plaintiff

Burrell, Aaron V. (Michigan)

Estes, Morris Reid Jr. (Tennessee)

Holmes, Martin D. (Tennessee)

Traylor, John M. (Michigan)

Young, Robert P. Jr. (Michigan)

Attorneys(s) for Defendant

McLean, Kelley Turnock (Michigan)

Smith, Joshua S (Michigan)

Documents in the Clearinghouse

Document

2:17-cv-11184

Docket [PACER]

J.V. v. Lyon

May 17, 2019

May 17, 2019

Docket
1

2:17-cv-11184

Complaint

J.V. v. Lyon

April 14, 2017

April 14, 2017

Complaint
42

2:17-cv-11184

Motion for Approval of Settlement and Attached Settlement Agreement

M.R. v. Lyon

2018 WL 6975002

Aug. 15, 2018

Aug. 15, 2018

Settlement Agreement
43

2:17-cv-11184

Order Approving Class Settlement

M.R. v. Lyon

2018 WL 4179635

Aug. 31, 2018

Aug. 31, 2018

Order/Opinion

Resources

Docket

See docket on RECAP: https://www.courtlistener.com/docket/6947656/jv-on-behalf-of-herself-and-all-others-similarly-situated-v-lyon-in/

Last updated Aug. 2, 2022, 3:26 a.m.

ECF Number Description Date Link Date / Link
1

COMPLAINT − Class Action filed by J.V., on behalf of herself and all others similarly situated against Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services with Jury Demand. Plaintiff requests summons issued. Fee Required − Fee Not Paid. County of 1st Plaintiff: Macomb − County Where Action Arose: Macomb − County of 1st Defendant: Macomb. [Previously dismissed case: No] [Possible companion case(s): None] (Burrell, Aaron) (Entered: 04/14/2017)

April 14, 2017

April 14, 2017

31

Order on Motion to Certify Class

May 29, 2018

May 29, 2018

PACER
32

Appear*

May 30, 2018

May 30, 2018

PACER
2

MOTION to Proceed Under A Pseudonym by J.V., on behalf of herself and all others similarly situated. (Burrell, Aaron) (Entered: 04/14/2017)

April 14, 2017

April 14, 2017

33

Withdrawal of Attorney

June 4, 2018

June 4, 2018

PACER
3

Notice of Filing Fee Not Paid. Correction due by 4/24/2017 (SOso) (Entered: 04/17/2017)

April 17, 2017

April 17, 2017

FILING FEE Received in the amount of $400.00 by All Plaintiffs − Receipt No. DET103030 [No Image Associated with this docket entry] (Huff, W.) (Entered: 04/19/2017)

April 19, 2017

April 19, 2017

34

Order

June 6, 2018

June 6, 2018

PACER
35

Stipulation and Order

1 Exhibit

View on PACER

June 8, 2018

June 8, 2018

PACER
4

SUMMONS Issued for *Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services* (Huff, W.) (Entered: 04/19/2017)

April 19, 2017

April 19, 2017

36

Appearance

June 15, 2018

June 15, 2018

PACER
5

NOTICE OF HEARING on 2 MOTION to Proceed Under A Pseudonym . Motion Hearing set for 7/26/2017 02:30 PM before District Judge Denise Page Hood (LSau) (Entered: 04/21/2017)

April 21, 2017

April 21, 2017

37

Motion - Free

1 Index of Exhibits Index of Exhibits

View on PACER

2 Exhibit Exhibit A

View on PACER

3 Exhibit Exhibit B

View on PACER

June 15, 2018

June 15, 2018

PACER
6

ATTORNEY APPEARANCE: Joshua S. Smith appearing on behalf of Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services (Smith, Joshua) (Entered: 04/27/2017)

April 27, 2017

April 27, 2017

7

ATTORNEY APPEARANCE: Kelley Turnock McLean appearing on behalf of Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services (Turnock McLean, Kelley) (Entered: 04/27/2017)

April 27, 2017

April 27, 2017

38

Hearing on Motion*

June 21, 2018

June 21, 2018

PACER
39

Objection - Free

July 5, 2018

July 5, 2018

PACER
8

CERTIFICATE of Service/Summons Returned Executed. Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services served on 4/21/2017, answer due 5/12/2017. (Burrell, Aaron) (Entered: 05/08/2017)

May 8, 2017

May 8, 2017

9

CERTIFICATE of Service/Summons Returned Executed.. (Burrell, Aaron) (Entered: 05/08/2017)

May 8, 2017

May 8, 2017

42

Motion - Free

1 Index of Exhibits

View on PACER

2 Exhibit A-Class Action Settlement Agreement and Release

View on PACER

Aug. 15, 2018

Aug. 15, 2018

PACER
10

STIPULATION AND ORDER to Extend Time for Defendant to File Responsive Pleadings and Response to Motion to Proceed Under A Pseudonym as to 2 :( Response due by 6/9/2017 ) Signed by District Judge Denise Page Hood. (LSau) (Entered: 05/09/2017)

May 9, 2017

May 9, 2017

11

STIPULATED ORDER Granting Plaintiff's Motion to Proceed Under A Pseudonym. Signed by District Judge Denise Page Hood. (LSau) (Entered: 05/19/2017)

May 19, 2017

May 19, 2017

TEXT−ONLY NOTICE: Motion Hearing on July 26, 2017 is Cancelled re 5 Notice of Hearing on Motion. (LSau) (Entered: 05/19/2017)

May 19, 2017

May 19, 2017

12

NOTICE of Appearance by Robert P. Young, Jr on behalf of J.V., on behalf of herself and all others similarly situated. (Young, Robert) (Entered: 05/24/2017)

May 24, 2017

May 24, 2017

14

STIPULATION AND ORDER to Extend Page Limitations re 1 Complaint,, Set Motion and R&R Deadlines/Hearings as to 1 Complaint, :( Responsive Pleading due by 6/23/2017 ) Signed by District Judge Denise Page Hood. (TMcg) (Entered: 06/06/2017)

June 6, 2017

June 6, 2017

15

MOTION to Dismiss and/or for Summary Judgment by Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services. (Attachments: # 1 Index of Exhibits, # 2 Exhibit 1 − Quarter Watch, # 3 Exhibit 2 − CEP Report, # 4 Exhibit 3 − Kabiri, et al., # 5 Exhibit 4 − Treatment Action Group v FDA−Complaint, # 6 Exhibit 5 − Annals of Internal Medicine−HCV, # 7 Exhibit 6 − Ahmed, et al., # 8 Exhibit 7 − Senate Finance Committee Executive Summary, # 9 Exhibit 8 − National Governors Assn, # 10 Exhibit 9 − SFC Report−Appendix F, # 11 Exhibit 10 − SFC Full Report, # 12 Exhibit 11 −SFC Report−Appendix A, # 13 Exhibit 12 − Express Scripts, # 14 Exhibit 13 − Neff Affidavit, # 15 Exhibit 14 − B.E. v Teeter, # 16 Exhibit 15 − Jackson Order Denying Mtn to Dismiss, # 17 Exhibit 16 − Jackson Docket Sheet, # 18 Exhibit 17 − CMS Release No. 172, # 19 Exhibit 18 − B.E. v Teeter Docket Sheet, # 20 Exhibit 19 − Cunningham v Birch, # 21 Exhibit 20 − J.E.M. v Tidball−Order, # 22 Exhibit 21 − Smith v Capots, # 23 Exhibit 22 − Chart of Private Insurance DAA Coverage, # 24 Exhibit 23 − Fernanders v Dept of Military and Vet Affairs, # 25 Exhibit 24 − MDHHS Prior Authorization Criteria, # 26 Exhibit 25 − Medicaid Provider Manual−Pharmacy, # 27 Exhibit 26 − Hepatitis C Prior Authorization Form, # 28 Exhibit 27 − Denial Letters) (Smith, Joshua) (Entered: 06/23/2017)

June 23, 2017

June 23, 2017

16

NOTICE of Appearance by Randall L. Tatem on behalf of All Plaintiffs. (Tatem, Randall) (Entered: 06/26/2017)

June 26, 2017

June 26, 2017

17

NOTICE OF HEARING on 15 MOTION to Dismiss and/or for Summary Judgment . Motion Hearing set for 9/6/2017 03:00 PM before District Judge Denise Page Hood (LSau) (Entered: 07/07/2017)

July 7, 2017

July 7, 2017

18

STIPULATION AND ORDER to Extend Time to File Responsive Pleading to Defendant's 15 MOTION to Dismiss and/or for Summary Judgment and for Defendant to File a Reply Brief :( Response due by 8/25/2017 , Reply due by 9/15/2017 , Motion Hearing REset for 10/4/2017 at 3:30 PM before District Judge Denise Page Hood. ) Signed by District Judge Denise Page Hood. (TMcg) (Entered: 07/17/2017)

July 17, 2017

July 17, 2017

19

RESPONSE to 15 MOTION to Dismiss and/or for Summary Judgment filed by All Plaintiffs. (Attachments: # 1 Index of Exhibits Index of Exhibits, # 2 Exhibit Exhibit 1, # 3 Exhibit Exhibit 2, # 4 Exhibit Exhibit 3, # 5 Exhibit Exhibit 4, # 6 Exhibit Exhibit 5, # 7 Exhibit Exhibit 6, # 8 Exhibit Exhibit 7, # 9 Exhibit Exhibit 8, # 10 Exhibit Exhibit 9, # 11 Exhibit Exhibit 10, # 12 Exhibit Exhibit 11, # 13 Exhibit Exhibit 12, # 14 Exhibit Exhibit 13, # 15 Exhibit Exhibit 14, # 16 Exhibit Exhibit 15, # 17 Exhibit Exhibit 16, # 18 Exhibit Exhibit 17, # 19 Exhibit Exhibit 18, # 20 Exhibit Exhibit 19, # 21 Exhibit Exhibit 20, # 22 Exhibit Exhibit 21) (Burrell, Aaron) (Entered: 08/25/2017)

Aug. 25, 2017

Aug. 25, 2017

20

REPLY to Response re 15 MOTION to Dismiss and/or for Summary Judgment filed by Nick Lyon, in his official capacity only as Executive Director of the Michigan Department of Health and Human Services. (Smith, Joshua) (Entered: 09/15/2017)

Sept. 15, 2017

Sept. 15, 2017

TEXT−ONLY NOTICE: Motion Hearing on October 4, 2017 is Cancelled. (LSau) (Entered: 10/04/2017)

Oct. 4, 2017

Oct. 4, 2017

21

STIPULATION AND ORDER for Mediation and to Adjourn Oral Argument. Signed by District Judge Denise Page Hood. (LSau) (Entered: 10/05/2017)

Oct. 5, 2017

Oct. 5, 2017

22

ORDER REFERRING OTHER MATTERS to Magistrate Judge Whalen : Settlement Conference. Signed by District Judge Denise Page Hood. (LSau) (Entered: 10/05/2017)

Oct. 5, 2017

Oct. 5, 2017

23

NOTICE TO APPEAR: Settlement Conference set for 11/30/2017 at 01:30 PM before Magistrate Judge R. Steven Whalen . Please see Notice for additional information. (THac) (Entered: 10/06/2017)

Oct. 6, 2017

Oct. 6, 2017

24

AMENDED NOTICE TO APPEAR: Settlement Conference reset for 1/17/2018 at 01:30 PM before Magistrate Judge R. Steven Whalen . SEE NOTICE FOR ADDITIONAL INFORMATION. (THac) (Entered: 12/05/2017)

Dec. 5, 2017

Dec. 5, 2017

Minute Entry for proceedings before Magistrate Judge R. Steven Whalen: Settlement Conference held on 1/17/2018 − Disposition: Settlement reached/Notice of Settlement will be submitted to District Judge. (Court Reporter: Digitally Recorded) (CCie) (Entered: 01/17/2018)

Jan. 17, 2018

Jan. 17, 2018

25

STIPULATION AND ORDER for In−Person Status Conference, ( Status Conference set for 3/29/2018 03:00 PM before District Judge Denise Page Hood ) Signed by District Judge Denise Page Hood. (LSau) (Entered: 03/07/2018)

March 7, 2018

March 7, 2018

26

ORDER Dismissing Motion Without Prejudice 15 . Signed by District Judge Denise Page Hood. (LSau) (Entered: 03/23/2018)

March 23, 2018

March 23, 2018

Minute Entry for proceedings before District Judge Denise Page Hood: Status Conference held on 3/29/2018, [Motion for Preliminary Approval to be filed by 4/30/18] (LSau) (Entered: 03/29/2018)

March 29, 2018

March 29, 2018

27

Joint MOTION to Certify Class , Appoint Class Counsel, Approve Notice to Class Members, Grant Preliminary Approval of Proposed Class Action Settlement and Set Date for Fairness Hearing by J.V., on behalf of herself and all others similarly situated. (Attachments: # 1 Index of Exhibits, # 2 Exhibit A−Settlement and Release Agreement, # 3 Exhibit B−Proposed Settlement Notice, # 4 Exhibit C−Order for Notice to the Class, # 5 Exhibit D−Stipulated Order to Certify Class) (Burrell, Aaron) (Entered: 04/16/2018)

April 16, 2018

April 16, 2018

28

NOTICE OF HEARING on 27 Joint MOTION to Certify Class , Appoint Class Counsel, Approve Notice to Class Members, Grant Preliminary Approval of Proposed Class Action Settlement and Set Date for Fairness Hearing . Motion Hearing set for 5/1/2018 03:30 PM before District Judge Denise Page Hood (LSau) (Entered: 04/18/2018)

April 18, 2018

April 18, 2018

29

NOTICE TO APPEAR: Status Conference set for 5/1/2018 03:30 PM before District Judge Denise Page Hood (LSau) (Entered: 04/18/2018)

April 18, 2018

April 18, 2018

30

NOTICE by J.V., on behalf of herself and all others similarly situated re 27 Joint MOTION to Certify Class , Appoint Class Counsel, Approve Notice to Class Members, Grant Preliminary Approval of Proposed Class Action Settlement and Set Date for Fairness Hearing Notice of Corrected Exhibit (Burrell, Aaron) (Entered: 04/26/2018)

April 26, 2018

April 26, 2018

Set/Reset Deadlines as to 27 Joint MOTION to Certify Class , Appoint Class Counsel, Approve Notice to Class Members, Grant Preliminary Approval of Proposed Class Action Settlement and Set Date for Fairness Hearing . Motion Hearing set for 5/24/2018 03:00 PM before District Judge Denise Page Hood (LSau) (Entered: 04/27/2018)

April 27, 2018

April 27, 2018

Set Deadlines/Hearings: Status Conference RESET for 5/24/2018 03:00 PM before District Judge Denise Page Hood (LSau) (Entered: 04/27/2018)

April 27, 2018

April 27, 2018

Minute Entry for proceedings before District Judge Denise Page Hood: Motion Hearing held on 5/24/2018 re 27 Joint MOTION to Certify Class , Appoint Class Counsel, Approve Notice to Class Members, Grant Preliminary Approval of Proposed Class Action Settlement and Set Date for Fairness Hearing filed by J.V., on behalf of herself and all others similarly situated Disposition: Motion taken under advisement (Court Reporter: Cheryl Daniel) (LSau) (Entered: 05/24/2018)

May 24, 2018

May 24, 2018

41

Letter from Lisa Ferrise. (NAhm) (Entered: 07/19/2018)

July 3, 2018

July 3, 2018

40

Letter from Patricia Kelly. (NAhm) (Entered: 07/06/2018)

July 5, 2018

July 5, 2018

Minute Entry for proceedings before District Judge Denise Page Hood: Motion Hearing held on 8/8/2018 re 37 MOTION for An Award of Attorneys' Fees and Reimbursemenet of Expenses filed by J.V., on behalf of herself and all others similarly situated Disposition: Motion taken under advisement (Court Reporter: Darlene May) (LSau) (Entered: 08/09/2018)

Aug. 8, 2018

Aug. 8, 2018

Minute Entry for proceedings before District Judge Denise Page Hood: Fairness Hearing held on 8/8/2018. (Court Reporter: Darlene May) (LSau) (Entered: 08/09/2018)

Aug. 8, 2018

Aug. 8, 2018

43

ORDER Granting Final Approval of Class Settlement 42 and Addressing Objections. Signed by District Judge Denise Page Hood. (LSau)

Aug. 31, 2018

Aug. 31, 2018

RECAP
44

ORDER Granting Plaintiff's Motion for an Award of Attorneys' Fees and Reimbursement of Expense 37 . Signed by District Judge Denise Page Hood. (LSau)

Aug. 31, 2018

Aug. 31, 2018

RECAP
45

Dismissing Case - Stipulated Order

April 15, 2019

April 15, 2019

PACER
46

Stipulation and Order

May 17, 2019

May 17, 2019

PACER

Case Details

State / Territory: Michigan

Case Type(s):

Prison Conditions

Special Collection(s):

Multi-LexSum (in sample)

Key Dates

Filing Date: April 14, 2017

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

All individuals that: are or will be enrolled in Michigan's Medicaid Program at the time of class certification; have been or will be diagnosed with a chronic infection of Hepatitis C virus; are 18 years or older; and require or in the future will require treatment for Hepatitis C with direct-acting antiviral medication and who do not meet the MDHHS current treatment criteria, which restricts direct-acting antiviral treatment to individuals with a minimum metavir fibrosis score criteria of F-2.

Plaintiff Type(s):

Private Plaintiff

Public Interest Lawyer: No

Filed Pro Se: No

Class Action Sought: Yes

Class Action Outcome: Granted

Defendants

Michigan, State

Defendant Type(s):

Jurisdiction-wide

Case Details

Causes of Action:

42 U.S.C. § 1983

Constitutional Clause(s):

Cruel and Unusual Punishment

Availably Documents:

Trial Court Docket

Complaint (any)

Monetary Relief

Injunctive (or Injunctive-like) Relief

Outcome

Prevailing Party: Plaintiff

Nature of Relief:

Injunction / Injunctive-like Settlement

Attorneys fees

Source of Relief:

Settlement

Form of Settlement:

Court Approved Settlement or Consent Decree

Amount Defendant Pays: 199000

Issues

Medical/Mental Health:

Hepatitis