Eddy v. BlueCross BlueShield of Tennessee, Inc.

CourtDistrict Court, E.D. Tennessee
DecidedSeptember 20, 2021
Docket3:19-cv-00376
StatusUnknown

This text of Eddy v. BlueCross BlueShield of Tennessee, Inc. (Eddy v. BlueCross BlueShield of Tennessee, Inc.) is published on Counsel Stack Legal Research, covering District Court, E.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Eddy v. BlueCross BlueShield of Tennessee, Inc., (E.D. Tenn. 2021).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF TENNESSEE KNOXVILLE DIVISION

DAREN KATHRYN EDDY, ) ) Plaintiff, ) 3:19-CV-00376-DCLC ) vs. ) ) BLUECROSS BLUESHIELD OF ) TENNESSEE, INC., ) ) Defendant. )

MEMORANDUM OPINION AND ORDER

Plaintiff Daren Kathryn Eddy (“Eddy”) filed this action against her former employer Blue Cross Blue Shield of Tennessee, Inc. (“BCBS”) alleging discrimination, failure to accommodate, and retaliation in violation of the Americans with Disabilities Act (“ADA”), 42 U.S.C. § 12101, et seq., the Tennessee Human Rights Act1 (“THRA”), Tenn. Code Ann. § 4-21-101, et seq., the Tennessee Disabilities Act2 (“TDA”), Tenn. Code. Ann. § 8-50-103, et seq., and the Tennessee Public Protection Act (“TPPA”), Tenn. Code Ann. § 50-1-304 [Doc. 28]. Eddy also alleges intentional infliction of emotional distress (“IIED”). BCBS filed a motion for summary judgment on all claims [Docs. 43-45], to which Eddy responded [Docs. 47-57] and BCBS replied [Docs. 58,

1 Eddy claims discrimination, retaliation, and failure to accommodate under both the TDA and the THRA [Doc. 28, ¶¶ 72-80]. When a plaintiff alleges disability discrimination under the TDA, “there is no separate claim of disability discrimination under the THRA.” Whited v. Community Bank of the Cumberlands, Inc., 2010 WL 605280 at *8 (M.D. Tenn. 2010); see also Thompson v. UGL Unicco Service Co., 750 F. Supp. 2d 907, 912-13 (W.D. Tenn. 2010) (“[THRA disability claims] have been treated as being alleged under the TDA.”) (internal citations omitted). Accordingly, any separate claims alleged under the THRA are dismissed.

2 “A claim brought under the [TDA] is analyzed under the same principles as those utilized for the [ADA].” White v. Interstate Distributor Co., 438 F. App’x 415, 418, n. 1 (6th Cir. 2011). Therefore, unless stated otherwise, the Court will use the same analysis for both. 59]. For the reasons stated herein, BCBS’s motion for summary judgment [Doc. 43] is GRANTED in part and DENIED in part. I. FACTUAL BACKGROUND

Eddy is a pharmacist licensed by the state of Tennessee, and BCBS is a Medicare Part D plan sponsor that provides health insurance benefits for Medicare-covered patients [Doc. 28, ¶¶ 15, 16]. On May 7, 2018, BCBS hired Eddy to work as a Coverage Review Pharmacist (“CRP”) on its “newly formed” Coverage Determination Team (“CDT”) [Doc. 28, ¶ 18; Doc. 48, ¶ 1]. The CDT was comprised of licensed pharmacists whose job responsibilities included deciding prescription drug coverage issues for Medicare members, responding to prescriber and member appeals, and ensuring that coverage decision letters met regulatory compliance [Doc. 48, ¶¶ 1, 2]. Eddy had performed similar coverage review work for Cigna and Aetna companies before joining BCBS [Doc. 59, ¶¶ 23, 24]. Eddy and the other members of the CDT worked remotely, handling prescription requests online and through phone calls as they came in [Doc. 50-9, pg. 1]. BCBS scheduled the CDT to start making coverage decisions beginning July 2, 2018 [Doc. 59, ¶ 9]. In

preparation, BCBS trained the CDT pharmacists on the software used to make coverage determinations and gave them permission to copy and record the training [Doc. 48, ¶ 5]. BCBS also gave them time to review and study the applicable Medicare rules and regulations that pertained to coverage issues [Doc. 48, ¶ 5]. Before and after the team went live, BCBS developed several “job aids” to assist the CDT in its work [Doc. 43-1, pgs. 48-105]. At all times relevant to this action, Eddy suffered from Post-Traumatic Stress Disorder (“PTSD”), anxiety disorder and depression, and the effects of a Traumatic Brain Injury (“TBI”) [Doc. 59, ¶¶ 1, 2]. Early in her employment at BCBS, Eddy advised her supervisor, Dr. Portia Moss (“Moss”), that she suffered from anxiety [Doc. 59, ¶ 33]. While Eddy appears initially to have done well at BCBS, problems soon surfaced with her work performance [Docs. 50-2; 50-7; 50-8]. On July 13, 2018, Moss emailed Eddy to inform her that she had improperly modified a case without informing her supervisors [Doc. 50-3, pg. 2]. On July 26, 2018, Moss provided Eddy with “verbal coaching” to help improve her performance [Doc. 48, ¶ 6; Doc. 59, ¶ 6]. Soon after, Eddy emailed Moss that she had been “having acute anxiety over my work performance since my last verbal formal written coaching,” and stated, “I hope you will let me know more about what I

am doing right and wrong.” [Doc. 50-4]. The verbal coaching did not resolve the issues BCBS had with Eddy’s work performance, so on September 14, 2018, Moss set up a telephone conference between herself, Eddy, and BCBS Human Resources Business Partner Shonnie Scruggs (“Scruggs”) to address those concerns [Doc. 48, ¶ 7; Doc. 43-1, pg. 110]. Moss read from a prepared memorandum which noted Eddy’s inability to “remain focused” and that she had “caused disruptions to the business.” [Doc. 43-1, pg. 110]. In addition, Moss identified four problems with Eddy’s job performance: (1) constructing work outside of [her] job requirements, (2) failure to follow processes and procedures, (3) excessively soliciting coworkers for information, and (4) lack of focus on the content of management communication.

[Doc. 43-1, pg. 110]. Moss advised Eddy that “[i]f significant improvement in your performance/behavior is not shown in the next 30 days, your employment will be terminated.” [Id.]. Eddy did not receive the criticism well and immediately “had a severe anxiety attack and began crying and gasping for breath.” [Doc. 59, ¶ 92; Doc. 48, ¶ 8]. Scruggs advised Eddy to contact BCBS’s Accommodations Administrator Andrew Eldridge (“Eldridge”) if she believed she needed a medical accommodation [Doc. 59, ¶ 92; Doc. 48, ¶ 8]. Eddy followed Scruggs’ advice and contacted Eldridge, who provided her with the ADA medical accommodation forms around September 17, 2018 [Doc. 59, ¶ 37]. Eddy never completed the ADA forms, but she advised Eldridge, Moss and Scruggs of her continued efforts to obtain a medical provider’s recommendation for what accommodations might be available to her [Doc. 48, ¶ 11; Doc. 59, ¶ 38]. More than a week later, on September 25, 2018, Eddy contacted the “compliance investigator” Don Provoshna (“Provoshna”) and complained about “the lack of detailed written procedures addressing the review and use of prior cases and claims history.” [Doc. 59, ¶ 125; Doc.

55, pg. 55]. Eddy outlined her issues in an email to Provoshna, who forwarded it to BCBS Compliance Monitoring Consultant Julie Moses (“Moses”) and asked her to review Eddy’s concerns to “determine if we are within CMS Guidelines”3 [Doc. 55, pgs. 52-53]. Two days later, on September 27, 2018, Moss met with Eddy again to discuss her job performance [Doc. 48, ¶ 12]. At this meeting, Moss brought several issues to Eddy’s attention, including that Eddy “missed a meeting with Dr. Moss, failed to make more than one coverage determination on September 14th, and 17th, approved a case without the required documentation, failed to document her rationale in the decision tree, and did not follow proper procedures with respect to at least three other cases.” [Doc. 48, ¶ 12].4 That same day, Moss drafted a

memorandum recommending Eddy’s termination. Moss noted that Eddy’s work performance had not improved since Moss warned her of these problems on September 14, 2018 [Doc. 43-1, pg. 115]. The Director of Clinical Pharmacy, Dr. Crescent Moore (“Moore”), reviewed Moss’ recommendation and approved the termination [Doc. 48, ¶ 13; Doc. 43-1, pg. 115].

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Eddy v. BlueCross BlueShield of Tennessee, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/eddy-v-bluecross-blueshield-of-tennessee-inc-tned-2021.