Edmonds v. Levine

233 F.R.D. 638, 2006 U.S. Dist. LEXIS 9661, 2006 WL 453911
CourtDistrict Court, S.D. Florida
DecidedFebruary 14, 2006
DocketNo. 05-21215-CIV
StatusPublished
Cited by2 cases

This text of 233 F.R.D. 638 (Edmonds v. Levine) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Edmonds v. Levine, 233 F.R.D. 638, 2006 U.S. Dist. LEXIS 9661, 2006 WL 453911 (S.D. Fla. 2006).

Opinion

ORDER GRANTING PLAINTIFFS’ AMENDED MOTION FOR CLASS CERTIFICATION

KLEIN, United States Magistrate Judge.

This cause came before the Court on Plaintiffs’ Amended Motion for Class Certification (D.E. No. 13) filed May 5, 2005. For the reasons discussed below, Plaintiffs’ Motion is GRANTED.

BACKGROUND

Plaintiffs are a group of Medicaid recipients who had been prescribed Neurontin, or [640]*640its generic equivalent “Gabepentin”1 by their physicians. The proposed class consists of individuals who were denied reimbursement coverage for Neurontin on approximately 6000 occasions by the Florida Agency for Health Care Administration (“AHCA”). The class that Plaintiffs seek to certify is defined as:

Florida Medicaid recipients whose doctors prescribed Neurontin for a therapeutic use cited in one or more of the drug compendia specified at 42 U.S.C. 1396r-8(g)(l)(B)(i) and whose requests for Medicaid coverage of their Neurontin prescriptions have been or will be denied by the Defendant.

Plaintiffs allege that AHCA has denied coverage to numerous individuals who have been prescribed Neurontin by qualified physicians for certain therapeutic uses listed in drug compendia designated by 42 U.S.C. § 1396r-8(g)(l)(B)(i), and further allege that this practice is a violation of the federal Medicaid statute 42 U.S.C. §§ 1396a(a)(10), 1396d(a)(12), and 1396r-8r.

According to Plaintiffs, 54 therapeutic uses for Neurontin are listed in DrugDex, one of the drug compendia designated by the statute; AHCA, however, covers prescriptions for only two of those 54 therapeutic uses, as well covering two uses for which the drug has received FDA approval. The parties disagree on the issue of whether the 50 uncovered uses fall within the definition of “medically accepted indication” which would require coverage under the statute.2 Plaintiffs allege that this practice of denial of coverage contravenes the reimbursement procedures established in the Medicaid statute, and seek to certify a class of all plaintiffs who have been denied coverage of Neurontin for those uses which appear in the listed compendia.

ANALYSIS

Plaintiffs seeking class certification bear the burden to show that the requirements of Rule 23 have been satisfied. However a court, in determining whether to certify a class, will accept plaintiffs’ substantive allegations as true. In re Carbon Dioxide Antitrust Litigation, 149 F.R.D. 229, 232 (M.D.Fla.1993). Moreover, a court’s determination regarding certification of a class must be based upon whether the class satisfies the requirements of Rule 23, and not based upon an inquiry into the merits of the plaintiffs’ claim. Eisen v. Carlisle & Jacquelin, 417 U.S. 156, 178, 94 S.Ct. 2140, 40 L.Ed.2d 732 (1974).

The Federal Rules of Civil Procedure designate the requirements for class certification. Fed.R.Civ.P. 23(a) sets forth certain prerequisites concerning the class members, as follows:

One or more members of a class may sue or be sued as representative parties on behalf of all only if (1) the class is so numerous that joinder of all members is impracticable; (2) there are questions of law or fact common to the class; (3) the claims or defenses of the representative parties are typical of the claims or defenses of the class; and (4) the representative parties will fairly and adequately protect the interests of the class.

Once all of the requirements of 23(a) are satisfied, a class must satisfy one of the provisions of Fed.R.Civ.P. 23(b). Klay v. Humana, Inc., 382 F.3d 1241 (11th Cir.2004). Plaintiffs are seeking certification based upon 23(b)(2), which provides that a class action may be maintained when

the party opposing the class has acted or refused to act on grounds generally applicable to the class, thereby making appropriate final injunctive relief or corresponding declaratory relief with respect to the class as a whole.

1. Numerosity

There is no question that Plaintiffs have satisfied the numerosity requirement. Plaintiffs estimate that thousands of individuals in the state of Florida have been denied prescriptions for Neurontin. This Circuit [641]*641has repeatedly held that the numerosity requirement is satisfied with numbers far lower than those at issue here. See, e.g., Cox v. American Cast Iron Pipe Co., 784 F.2d 1546, 1553 (11th Cir.1986); Phillips v. Joint Legilative Comm’n, 637 F.2d 1014 (5th Cir.1981).

Defendant claims that Plaintiffs have failed to satisfy the numerosity requirement, arguing that many of the patients who were denied Neurontin have since switched to another drug, and Defendant further suggests that Plaintiffs’ estimate of the total number of potential class members is unsupported. These arguments are entirely without merit. Whether patients have begun using a different drug after being denied coverage for Neurontin is not at issue, and that fact would not preclude class certification based on lack of numerosity. Plaintiffs’ class action claims are based upon the improper denial of coverage to all of the proposed class members for uses of a particular drug which the state has improperly excluded from coverage in violation of the Medicaid Act. The Plaintiffs’ claims are not based on whether any alternative drugs might be substituted.

Moreover, Plaintiffs have substantial support for their estimate of class size; Defendant’s own records reveal that between July 1. 2004 and March 22, 2005, the Defendant denied coverage for Neurontin on 6482 occasions. Although the actual number of patients who were denied the drug is not clear, for some of the 6482 denials may have been repeated denials to the same patient, the class is surely numerous enough to satisfy Eleventh Circuit standards. See Cox v. American Cast Iron Pipe Co., 784 F.2d 1546, 1553 (11th Cir.1986)(“generally less than twenty-one is inadequate, more than forty adequate, with numbers in between varying according to other factors”).

2. Commonality

The commonality requirement requires simply that there be questions of law or fact common to the class. Plaintiffs maintain that the class easily meets this requirement, and describes the common questions at issue as follows:

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Related

Kuehn v. Cadle Co.
245 F.R.D. 545 (M.D. Florida, 2007)

Cite This Page — Counsel Stack

Bluebook (online)
233 F.R.D. 638, 2006 U.S. Dist. LEXIS 9661, 2006 WL 453911, Counsel Stack Legal Research, https://law.counselstack.com/opinion/edmonds-v-levine-flsd-2006.