Minnesota R-80 Medical Transportation Coalition v. Piper

CourtDistrict Court, D. Minnesota
DecidedAugust 29, 2018
Docket0:17-cv-04539
StatusUnknown

This text of Minnesota R-80 Medical Transportation Coalition v. Piper (Minnesota R-80 Medical Transportation Coalition v. Piper) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Minnesota R-80 Medical Transportation Coalition v. Piper, (mnd 2018).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA

Minnesota R-80 Medical Civil No. 17-4539 (DWF/LIB) Transportation Coalition, and Minnesota Ambulance Association,

Plaintiffs,

v. MEMORANDUM OPINION AND ORDER Commissioner of the Minnesota Department of Human Services, Emily Johnson Piper, in her official capacity; and Secretary of the United States Department of Health and Human Services, Don Wright, in his official capacity,

Defendants.

Anthony D. Johnson, Esq., Christopher J. Heinze, Esq., and Kirsten J. Libby, Esq., Libby Law Office, P.A., counsel for Plaintiffs.

James H. Clark III, Assistant Attorney General, Minnesota Attorney General’s Office, counsel for Defendant Emily Johnson Piper.

David W. Fuller, Assistant United States Attorney, United States Attorney’s Office, counsel for Defendant Don Wright.

INTRODUCTION

This matter is before the Court on Motions to Dismiss brought by Defendants Emily Johnson Piper, Commissioner of the Minnesota Department of Human Services, and Don Wright, Secretary of the United States Department of Health and Human Services. (Doc. Nos. 15, 20.) For the reasons set forth below, the Court grants the Commissioner’s motion and dismisses this case.

BACKGROUND I. The Parties Plaintiffs, Minnesota R-80 Medical Coalition (“R-80”) and Minnesota Ambulance Association (“MAA”), are organizations whose members provide non-emergency medical transportation (“NEMT”) to Medicaid recipients throughout the State of Minnesota. (Doc. No. 14 (“Am. Compl.”) ¶¶ 1, 2, 14.) Plaintiffs assert claims against

Emily Johnson Piper (the “Commissioner”) in her official capacity as Commissioner of the Minnesota Department of Human Services (“DHS”) and Don Wright (the “Secretary”) in his official capacity as Secretary of the U.S. Department of Health and Human Services (“HHS”).1 (See id. ¶¶ 3, 7.) R-80’s organizational “purpose is to advocate for its members by promoting and strengthening transportation medical services

by advancing policy and practice in the State of Minnesota.” (Id. ¶ 28.) Similarly, “MAA is an organization with numerous medical transportation members that advocates for its members by promoting and strengthening transportation medical services by advancing policy and practice in the State of Minnesota.” (Id. ¶ 34.) Both Plaintiff

1 The parties’ briefing and the Court’s independent review of the U.S. Department of Health and Human Services website indicates that Don Wright no longer serves as Secretary of this agency. (See Doc. No. 17 at 2 n.2; Doc. No. 23 at 1 n.1; Doc. No. 25 at 1; see also U.S. Department of Health and Human Services, HHS Leadership, https://www.hhs.gov/about/leadership/index.html (last visited Aug. 20, 2018).) Pursuant to Federal Rule of Civil Procedure 25(d), Don Wright’s “successor is automatically substituted as a party” in his absence. See Fed. R. Civ. P. 25(d). For simplicity, the Court shall refer to this Defendant as “the Secretary” throughout this order. organizations are members of the state’s NEMT Advisory Committee. (Id. ¶¶ 29, 37.) In this capacity, Plaintiffs “advise[] [the Commissioner] on the administration of nonemergency medical transportation covered under Medical Assistance [(“MA”)].”2

(Id. ¶¶ 30, 39.) II. The Commissioner’s Delegation of NEMT Administration According to Plaintiffs, Minnesota law “requires [the Commissioner] and DHS to ‘implement a single administrative structure and delivery system for [NEMT].’” (Id. ¶ 63 (quoting Minn. Stat. § 256B.0625, subd. 18e); see also id. ¶¶ 74-76.) Plaintiffs contend

that “[t]his single administrative structure ensures that [NEMT] claims are being administered consistently and in a uniform manner.” (Id. ¶ 77.) Plaintiffs also assert that Minnesota law obligates DHS to “administer and reimburse [NEMT] providers for services provided . . . unless and until [the Commissioner] has ‘developed, made available, and funded the single administrative structure.’” (Id. ¶ 80 (quoting Minn. Stat.

§ 256B.0625, subd. 17(j)).) Specifically, Plaintiffs contend that local counties should be permitted to administer and reimburse NEMT services “[o]nly once that single administrative structure and delivery system is developed, available, and funded by [the Commissioner] and DHS.” (Id. ¶ 83.) Plaintiffs allege that the Commissioner has improperly failed to develop a statewide administrative system for coordinating NEMT

and has delegated responsibility for approving payments to Minnesota counties as well as

2 “Medical Assistance” is the state of Minnesota’s Medicaid program. (See Doc. No. 14 (“Am. Compl.”) ¶ 5.) a private brokerage firm located in Missouri known as Medical Transportation Management, Inc. (“MTM”).3 (See id. ¶¶ 87-90, 130, 132, 135-37, 150.) According to

Plaintiffs, the decision “to relegate all of DHS’ duties concerning the administration of [NEMT] services to the 87 Minnesota counties” took place following a 5-4 vote at a NEMT Advisory Committee meeting inappropriately convened in the absence of a quorum and with the improper participation of DHS employees. (Id. ¶¶ 144-50.) Plaintiffs also generally assert that the Commissioner unlawfully “restructured reimbursement payments without advice and counsel from the Nonemergency Medical

Transportation Committee.” (Id. ¶ 232.) Plaintiffs allege that a number of “inconsistencies” have resulted from the delegation of oversight to Minnesota’s 87 counties. (Id. ¶ 92.) In particular, Plaintiffs discuss “a number of varying protocols and administrative procedures for the administration and reimbursement of [NEMT].” (Id. ¶ 94.) Examples include

differences in whether a county utilizes a web-based or paper-based claim submission process, varying lengths of time to obtain reimbursement, and differing information provided along with reimbursements. (See id. ¶¶ 95-99.) Plaintiffs allege that slower reimbursement rates and varying reimbursement protocols impose an undue burden on

3 According to the Complaint, Medicaid covers seven separate “Modes” of transportation, and only Modes 1-4 have thus far been delegated to Minnesota counties for administration. (Id. ¶¶ 79, 92-93.) The allegations in the Complaint center primarily on the delegation of Mode 4 administration to Minnesota counties. The distinctions between the various modes, however, are irrelevant to the Court’s analysis of the pending motions, and the Court omits reference to the specific modes at issue for simplicity throughout this order. NEMT providers. (Id. ¶ 100.) Thus, Plaintiffs explain, some NEMT providers have discontinued providing certain services in counties with complicated and slow

reimbursement processes, leaving Medicaid “recipients in those counties with little to no options for needed [NEMT] services.” (Id. ¶ 101.) Plaintiffs also allege various inconsistences relating to “determinations of level of need for MA recipients,” the “requirements for [NEMT] providers to be reimbursed for services provided,” and which entity actually administers reimbursements in each county. (Id. ¶¶ 102-21.) Plaintiffs particularly allege that the varying reimbursement requirements have placed an undue

burden on NEMT providers and Medicaid recipients. (Id. ¶ 117.) In addition, Plaintiffs contend that the Commissioner’s delegation of administration over NEMT has created confusion over which counties should be responsible for claims, resulting in some “uncollectable claim[s] for services provided” and an undue burden on NEMT providers. (Id. ¶¶ 122-28.)

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