Aelen Unan v. Nick Lyon

853 F.3d 279, 2017 WL 1192906, 2017 U.S. App. LEXIS 5623
CourtCourt of Appeals for the Sixth Circuit
DecidedMarch 31, 2017
Docket16-1185
StatusPublished
Cited by60 cases

This text of 853 F.3d 279 (Aelen Unan v. Nick Lyon) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aelen Unan v. Nick Lyon, 853 F.3d 279, 2017 WL 1192906, 2017 U.S. App. LEXIS 5623 (6th Cir. 2017).

Opinions

MOORE, J., delivered an opinion in which WHITE, J., joined in part. WHITE, J. (pp. 293-94), delivered a separate opinion concurring in all but Part II.B.1 of the lead opinion. SUTTON, J. (pp. 294-98), delivered a separate dissenting opinion.

OPINION

KAREN NELSON MOORE, Circuit Judge.

In the course of implementing certain changes required by the Patient Protection and Affordable Care Act of 2010 (“ACA”), the State of Michigan experienced a systemic computer problem that erroneously assigned thousands of non-citizens, who may have been eligible for comprehensive Medicaid coverage, to Emergency Services Only (“ESO”) Medicaid. Plaintiffs Aelen Unan and Patricia Quintino, two eligible non-citizen residents of Michigan who were erroneously assigned ESO coverage, filed a class action complaint against Nick Lyon, Director of the Michigan Department of Health and Human Services (“DHHS”), alleging violations of the Medicaid statute and the Due Process Clause of the Fourteenth Amendment. On cross-motions for summary judgment, the district court found that actions taken by the State since the complaint was filed had resolved all systemic errors. Finding plaintiffs’ claims to be moot, the district court [283]*283granted defendant’s motion for summary judgment, denied plaintiffs’ motion for the same, and dismissed as moot plaintiffs’ motions for preliminary injunction and class certification. Plaintiffs now appeal the district court’s judgment. For the reasons set forth below, we hold that the plaintiffs’ claims are not moot, and REVERSE the district court’s grant of defendant’s motion for summary judgment. On the basis of grounds other than those relied upon by the district court, we AFFIRM the denial of plaintiffs’ motion for summary judgment as to their claims that defendant failed to provide comprehensive Medicaid coverage and a reasonable opportunity to verify immigration status, and hold that there are fact issues,precluding summary judgment for both plaintiffs and defendant. We hold that defendant is entitled to judgment as a matter of law on the remaining notice claims, and we REMAND the case for further proceedings.

I. BACKGROUND

In 1986, Congress made comprehensive Medicaid benefits available to eligible non-citizens who attest to having “satisfactory immigration status.” Pub. L. No. 99-603, § 121(a)(1), 100 Stat. 3359 (codified as amended at 42 U.S.C. § 1320b-7(d)(4)(A)). Non-citizen applicants are required to present verified documentation to prove their immigration status. 42 U.S.C. § 1320b-7(d)(2). If an individual attests to his or her status, but does not submit or verify the required documentation, state Medicaid agencies are required to provide that individual with a “reasonable opportunity” to provide documents verifying their eligible status. 42 U.S.C. § 1320b-7(d)(4)(A). In Michigan, DHHS1 administers the state Medicaid program, which is known as the Healthy Michigan Plan. Ap-pellee’s Br. at 3.

On January 25, 2014, DHHS implemented various system changes required by the ACA. R. 22-6 (Hundley Aff. at 2) (Page ID #837). In the course of implementation, a systemic computer problem caused a number of applicants to be assigned automatically to ESO Medicaid, although they might otherwise be eligible for comprehensive coverage. Specifically, non-citizen applicants who attested to, but failed to verify, their immigration status were automatically denied comprehensive coverage, and approved for ESO coverage only. Id. at 3 (Page ID #838). Denial of comprehensive coverage occurred without a reasonable opportunity to provide documents verifying an applicant’s eligible status. Id.

Among these applicants- were named plaintiffs Unan and Quintino. Their cases are nearly identical. Unan, a refugee, applied for Medicaid on April 2, 2014. Quinti-no, who became a legal permanent resident in 1998, applied for Medicaid on April 1, 2014. Neither Unan nor Quintino was asked for documentation of her immigration status, although each had previously provided such proof of status for her food assistance case. Each received a Health Coverage Determination Notice indicating that she had been approved for ESO Medicaid. The letters did not include any language regarding denial of comprehensive Medicaid coverage. R. 28-3 (Health Care Determination Notices) (Page ID #976-83).

On September 8, 2014, Unan and Quinti-no filed a class-action lawsuit for declarato[284]*284ry and injunctive relief against Nick Lyon, the Director of DHHS,2 alleging that defendant (1) failed promptly to provide comprehensive Medicaid to plaintiffs pursuant to 42 U.S.C. § 1396a(a)(8), 10(A) (Count I); (2) failed to provide comprehensive Medicaid to plaintiffs pending a reasonable opportunity to verify plaintiffs’ immigration status pursuant to 42 U.S.C. §§ 1396a(a)(8), 1320b-7(d)(4)(A) (Counts II and III); and (3) failed to provide plaintiffs with adequate notice and a meaningful opportunity to be heard regarding the denial of comprehensive Medicaid pursuant to 42 U.S.C. § 1396a(a)(3) and the Due Process Clause of the Fourteenth Amendment (Counts IV and V). On the same date, plaintiffs filed a motion for preliminary injunction and a motion for class certification.

Two days after the complaint was filed, Unan and Quintino were both determined by DHHS to be eligible for comprehensive Medicaid coverage retroactive to April 1, 2014. On August 2, 2014, DHHS, while working to correct the systemic computer problem, began approving for full Medicaid individual applicants who attested to eligible immigration status. R. 22-6 (Hund-ley Aff. at 3) (Page ID #838). DHHS applied other temporary fixes throughout November, and by the end of December, had reprocessed well over 16,000 cases in addition to those corrected manually. R. 69-10 (Woods Aff., Exh. B at 2-3) (Page ID #1755-56). Defendant claims that a “permanent correction for the ESO issue” was implemented by December 30, 2014. R. 45 (Def. Reply in Support of First Mot. to Dismiss and/or for Summ. J. at 2) (Page ID #1216).

On March 24, 2015, the district court ordered the parties to prepare revised notices for Medicaid applicants, and held in abeyance plaintiffs’ motions for preliminary injunction and class certification. R. 46 (Dist. Ct. Order Denying Mot. to Dismiss) (Page ID #1247-48). On July 23, 2015, the district court stayed discovery pending resolution of dispositive motions. Both parties filed cross-motions for summary judgment3 on August 31, 2015, and a hearing was held on October 8, 2015. R. 69 (Def. Second Mot. to Dismiss and/or for Summ. J.) (Page ID #1624-73); R. 70 (Pis. Mot. for Summ. J.) (Page ID #1780-826). On January 11, 2016, the district court granted defendant’s motion for summary judgment,, denied plaintiffs’ motion for summary judgment, and entered judgment for defendant. R. 83 (Dist. Ct. Order at 33) (Page ID #2443). Plaintiffs’ motions for class certification and preliminary injunction were dismissed as moot.

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Cite This Page — Counsel Stack

Bluebook (online)
853 F.3d 279, 2017 WL 1192906, 2017 U.S. App. LEXIS 5623, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aelen-unan-v-nick-lyon-ca6-2017.