Pritchard v. Blue Cross Blue Shield of Illinois

CourtDistrict Court, W.D. Washington
DecidedJanuary 22, 2024
Docket3:20-cv-06145
StatusUnknown

This text of Pritchard v. Blue Cross Blue Shield of Illinois (Pritchard v. Blue Cross Blue Shield of Illinois) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pritchard v. Blue Cross Blue Shield of Illinois, (W.D. Wash. 2024).

Opinion

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6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 C. P., by and through his parents, Patricia CASE NO. 3:20-cv-06145-RJB 11 Pritchard and Nolle Pritchard, S.L., by and through her parents, S.R. and R.L.; ORDER GRANTING 12 EMMETT JONES, individually and on DEFENDANT’S MOTION TO behalf of others similarly situated; and STAY PENDING APPEAL AND 13 PATRICIA PRITCHARD, individually, SETTING OTHER DEADLINES 14 Plaintiffs, v. 15 BLUE CROSS BLUE SHIELD OF 16 ILLINOIS, 17 Defendant. 18

19 This matter comes before the Court on Defendant Blue Cross Blue Shield of Illinois’ 20 (“Blue Cross”) Motion to Stay Pending Appeal (Dkt. 210) and on the parties’ responses to the 21 December 19, 2023 Supplemental Order (Dkts. 219 and 220). The Court has read and 22 considered all documents filed in support of, and in opposition to, the motion, as well as the 23 contents of the file and oral arguments heard on various issues throughout this litigation. The 24 Court is fully informed. 1 I. THE LAW 2 The parties agree that the basic rule governing a stay pending appeal is follows: 3 Pursuant to Fed. R. Civ. P. 62(d), “[w]hile an appeal is pending from an . . . order or 4 final judgment that grants . . . an injunction, the court may suspend, modify, restore, or grant an 5 injunction on terms for bond or other terms that secure the opposing party’s rights.” In

6 determining whether to issue a stay of an injunction, the court considers four factors: (1) whether 7 the stay applicant, Blue Cross, “has made a strong showing that [it] is likely to succeed on the 8 merits; (2) whether the applicant will be irreparably injured absent a stay; (3) whether issuance 9 of the stay will substantially injure the other parties interested in the proceeding; and (4) where 10 the public interest lies.” Nken v. Holder, 556 U.S. 418, 434 (2009). 11 The rule has some case-authorized interpretation: the requesting party, here Blue Cross, 12 has the burden of demonstrating that the facts justify a stay. Nken at 433. The first two Nken 13 factors are the most critical; the second two factors are only considered if the first two factors are 14 satisfied. Index Newspapers LLC v. United States Marshals Serv., 977 F.3d 817, 824 (9th Cir.

15 2020). The moving party is not required to show that it will win on appeal, but must show that 16 appellate success is a “reasonable probability” or a “fair prospect,” or that “serious legal 17 questions are raised.” Leiva-Perez v. Holder, 640 F.3d 962, 967-68 (9th Cir. 2011). “A stay 18 pending appeal is an extraordinary remedy that may be awarded only on a clear showing that 19 appellant is entitled to such relief.” Oracle USA, Inc. v. Rimini St., Inc., 2018 WL 4355154, at 20 *2 (D. Nev. Sept. 11, 2018). 21 It is with that background that the Court must analyze Defendant’s stay motion. 22 II. LIKELIHOOD OF SUCCESS ON THE MERITS 23 24 1 It is a challenging rule to ask a trial judge to analyze the strength of a party’s chances on 2 appeal. The undersigned is satisfied with the many rulings made in this case. Nevertheless, the 3 Court should analyze Blue Cross’s position. 4 As the Court already stated, the case “takes place in the midst of a sharply divided 5 regulatory and litigation background.” Dkt. 207 at 11. All of the key decisions in the case – and

6 there were many – were sharply litigated, and added to the background of division. Rulings were 7 spread over the order to certify the class (Dkt. 113), two additional orders amending the class 8 definition (Dkts. 143 and 203), the order denying the motion to decertify the class (Dkt. 206), the 9 order on the cross motions for summary judgment (Dkt. 146) and order on classwide relief and 10 for nominal damages (Dkt. 207)1. Although appeals were not discussed during the litigation, 11 appeals were likely due to the nature of the case in changing a long-set, and wide spread business 12 practice. Serious legal questions were raised on all of the Court’s many decisions that led to the 13 final judgment in favor of Plaintiffs. A different decision in any one of those legal questions 14 would have resulted in a different result.

15 There were substantial and serious legal questions raised on many critical issues decided 16 in the case – enough to justify a stay. 17 III. WILL DEFENDANT BE IRREPARABLY INJURED IN THE ABSENCE OF A STAY? 18 An irreparable injury is one that “cannot be easily undone should [the movant] prevail on 19 appeal.” Fed. Trade Comm'n v. Qualcomm Inc., 935 F.3d 752, 756 (9th Cir. 2019). The inquiry 20 asks the Court to “anticipate what would happen as a practical matter following the denial of a 21 22

23 1 The December 19, 2023 Order on Plaintiffs’ Motion for Classwide Relief and for Nominal Damages (Dkt. 207) included a direction to the Clerk of the Court to enter judgment (Dkt. 207 at 20-21). Erroneously, judgment was not 24 entered. Judgment is entered pursuant to that order. Dkt. 221. 1 stay.” Leiva-Perez at 968; Lair v. Bullock, 697 F.3d 1200, 1214 (9th Cir. 2012). Economic harm 2 is irreparable where a party will not be able to recover monetary losses. California v. Azar, 911 3 F.3d 558, 581 (9th Cir. 2018). 4 It is difficult to anticipate the possible actions by Blue Cross if a stay is denied. We can 5 conclude that that situation would require notice to all class members, prospective and

6 retrospective alike, and claims by class members for services arising from the denial of gender 7 affirming care. 8 The number of such retrospective claims is unknown. Blue Cross errs in concluding that 9 reprocessing retrospective claims will require it to “pay for, and reimburse its plan members for 10 certain gender-affirming care services.” Dkt. 207 at 21. Such payment and reimbursement could 11 happen, but that is beyond the scope of the injunction ordered. Dkt. 207 at 21. (Who would pay 12 such claims is not resolved in this litigation, but Defendant clearly fears that it would be 13 responsible for such payments, based on its relationship with non-party insuring plans.) 14 The bottom line on this issue is that the pending injunction will substantially change

15 Defendant’s corporate procedure which could not be readily or cheaply redone in the event of 16 action under the pending injunction followed by reversal on appeal. 17 IV. WHETHER ISSUANCE OF A STAY WILL INJURE INTERESTED PARTIES 18 The concern of third parties - retrospective class members who wish to reprocess gender- 19 affirming claims and prospective class members with such claims – will be seriously impacted. 20 On the other hand, we do not know exactly how many retrospective or prospective claims may 21 be made, how many such claims will be paid, the amount of money involved in such claims, let 22 alone the issue of who might be responsible for payment. 23 24 1 Granting Blue Cross’s motion for a stay will simply allow the status quo to remain in 2 effect pending appeal. 3 This issue does not heavily militate against Defendant’s motion. 4 V. WHERE DOES THE PUBLIC INTEREST LIE? 5 First, the most important public interest is to resolve the difficult issues raised by this

6 case. Second, is to enforce anti-discrimination law. We cannot secure the second without 7 Plaintiffs’ success on the first. The long term public interest must be delayed while these legal 8 matters are resolved. 9 VI.

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Bluebook (online)
Pritchard v. Blue Cross Blue Shield of Illinois, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pritchard-v-blue-cross-blue-shield-of-illinois-wawd-2024.