Midkiff v. The Anthem Companies, Inc.

CourtDistrict Court, E.D. Virginia
DecidedNovember 10, 2022
Docket3:22-cv-00417
StatusUnknown

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

Bluebook
Midkiff v. The Anthem Companies, Inc., (E.D. Va. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF VIRGINIA Richmond Division WINIFRED MIDKIFF, on behalf of +) herself and all others similarly situated, ) ) Plaintiff, ) ) Vv. ) Civil Action No. 3:22-cv-417-HEH ) THE ANTHEM COMPANIES, INC., ) et al., ) ) Defendants. ) MEMORANDUM OPINION (Granting in Part and Denying in Part Plaintiff’s Motion for Court-Authorized Notice) This matter is before the Court on Plaintiff Winifred Midkiff’s (“Plaintiff”) Motion for Court-Authorized Notice Under the Fair Labor Standards Act (“FLSA”) (the “Motion,” ECF No. 26), filed on September 15, 2022. Plaintiff filed the initial Complaint on June 3, 2022 (Compl., ECF No. 1), followed by an Amended Complaint on August 24, 2022 (Am. Compl., ECF No. 19). Plaintiff seeks to represent a putative collective of medical management nurses who were allegedly denied proper overtime compensation during the past three years while employed by The Anthem Companies, Inc., Anthem Health Care Plans of Virginia, Inc. d/b/a Anthem Blue Cross and Blue Shield, and Amerigroup Corporation (collectively, “Defendants” or “Anthem’”).' (Pl.’s

' The Court notes that The Anthem Companies, Inc. recently rebranded as The Elevance Health Companies, Inc. However, for ease of reference, the Court will use the name “Anthem.”

Mem. in Supp. at 1, ECF No. 27.) Plaintiff's claim is asserted as a state-wide collective action under 29 U.S.C. § 216(b). Ud.) Defendants filed their Response in Opposition on October 13, 2022, asserting multiple arguments against Plaintiff's Motion. (Defs.’ Resp. in Opp’n, ECF No. 38.) First, Defendants argue that the timing of Plaintiff's Motion warrants pausing the case here because there are other nearly identical lawsuits filed in district courts in other states that are further along in proceedings. (/d. at 1-2.) Defendants argue that other district courts’ decisions might influence this Court’s determination of Plaintiff's claim in this case. (/d. at 2.) Second, Defendants contend that if this Court chooses not to stay proceedings, the Court should instead deny Plaintiff's Motion and direct the parties to

pursue limited discovery regarding the merits of Plaintiff's and opt-in plaintiffs’ claims as to whether they both are “similarly situated.” (id.) Third, Defendants maintain even if the Court applies Plaintiff's lenient standard, Plaintiff still fails to carry her burden of establishing she is entitled to court-authorized notice under the FLSA. (/d. at 3.) Fourth, Defendants assert that Plaintiff has not established that she or the putative collective were subject to a common unlawful policy. (/d. at 14.) Finally, Defendants object to both the substance of Plaintiff's proposed notice and her suggested distribution method. (/d. at 15.) The parties have submitted memoranda in support of their respective positions. The Court heard oral argument on November 3, 2022. For the reasons that follow, Plaintiff's Motion will be granted in part and denied in part.

I BACKGROUND Defendants are all subsidiaries of Anthem, Inc., which is incorporated in and has its principal place of business in Indiana. (Am. Compl. Ff 10-18.) Plaintiff and the putative collective work or worked for Anthem or its subsidiaries across Virginia.? (Am. Compl. 27, 51.) Plaintiff worked for Defendants from approximately June 2014 to July 2017, performing primarily medical necessity reviews as a “Medical Management Nurse II.” (Am. Compl. 750.) Since the filing of Plaintiff's Complaint, eleven opt-in plaintiffs have consented to joining in this action.’ Plaintiff, opt-in plaintiffs, and the declarants assert that they and others work or worked for Anthem as “Medical Management Nurses, Utilization Management Nurses, Utilization Review Nurses, Nurse Reviewers, Nurse Reviewer Associates, or in similar job titles” during the last three years. (PI.’s Mem. in Supp. at 6.)

Plaintiff initially opted-in to the case Canaday v. The Anthem Companies, Inc., No. 1:19-cv- 01084-STA-jay (W.D. Tenn.), on August 19, 2019. (Am. Compl. 9 50.) However, the Canaday court limited the scope of the conditionally certified collective to only individuals who worked for Anthem within the state of Tennessee. Jd Because Plaintiff worked in Virginia, Plaintiff ultimately withdrew as a plaintiff from Canaday after filing her claim in this Court on June 3, 2022. (Compl. at 1.) 3 Plaintiff attached four declarations to her Motion by former employees of Anthem. (See Ex. A, Decl., ECF No. 27-2.) In pertinent part, these declarations state that Plaintiff and the declarant employees worked for Anthem in Virginia, were either Medical Management Nurses or Utilization Review Nurses, had a primary job responsibility of conducting medical necessity reviews, were salaried and classified as exempt, and routinely worked over forty-hour weeks without overtime compensation. (Midkiff Decl. §{ 1-14; Adams Decl. ff 1-15; Elmore Decl. 1-15; Vialpando Decl. JJ 1-15.) 4 (ECF Nos. 1-3, 10-1, 10-2, 15-1, 15-2, 15-3, 16-1, 17-1, 18-1.)

The primary responsibility of the nurses in each of these roles was to perform “utilization reviews, also known as medical necessity reviews.” (/d.) When conducting a review, these nurses analyze “medical authorization requests submitted by healthcare providers against pre-determined guidelines and criteria for insurance coverage and payment purposes.” (/d.) These reviews involved the use of Defendants’ “electronic case management system, standardized guidelines and criteria, and Defendants’ policies and procedures.” (/d.) If the authorization request meets the applicable criteria in the guidelines and policies, then Plaintiff and the other nurses may approve the requested service or benefit. (/d.) Ifthe criteria are not met, however, the “medical management nurses must send the authorization request on to Defendants’ ‘Medical Director,’ who is a doctor, for their review and determination.” (/d.) Based on the affidavit declarations, these nurses were not permitted to deny any authorization on their own. (/d.) Plaintiff also asserts that Anthem provides these nurses “with the skills necessary to do their jobs through similar training.” (P1l.’s Mem. in Supp. at 7.) Anthem subjects the nurses performing these reviews to “similar production requirements, expecting them to review a certain number of authorizations within specific timeframes.” (/d.) Anthem also “measures the nurses’ performance through quality audits and regular knowledge tests to ensure that they are applying [Anthems’] established criteria.” (/d.) Plaintiff alleges that in order to complete assigned medical necessity reviews, Plaintiff and the putative collective routinely worked over forty hours during a workweek. (U/d.) However, Plaintiff and the other nurses did not receive overtime compensation for the work completed over forty hours. (Am. Compl. {J 5—6, 57, 73.)

Instead, Anthem “compensated medical management nurses with a salary, did not require them to record their actual hours worked, and uniformly classified them as exempt from the overtime requirements of the FLSA.” (Pl.’s Mem. in Supp. at 7.) Based on their “common job duties and shared experiences,” Plaintiff and the other opt-in plaintiffs believe they are similarly situated to the putative collective they seek to represent.

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Bluebook (online)
Midkiff v. The Anthem Companies, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/midkiff-v-the-anthem-companies-inc-vaed-2022.