DERRICK K. WATSON, District Judge.
On December 1, 2016, Plaintiff Brian Shaughnessy, proceeding pro se, filed a Complaint against WellCare Health Insurance, Inc., dba Ohana Health Plan ("Ohana"), alleging claims for violation of 42 U.S.C. § 1983 and breach of contract based on the denial of medical services and benefits under his Medicaid plan administered by Ohana. Shaughnessy also filed a Motion for Temporary Restraining Order and Preliminary Injunction ("Motion for TRO"), seeking a court order directing Ohana to provide the services and benefits ordered by his doctor and to award him costs in the amount of $25,000.00. Because Shaughnessy's conclusory assertions are insufficient to establish a likelihood of success on the merits of his claims or that the balance of relevant factors weighs in his favor, the Motion for TRO is DENIED.
The standard for issuing a temporary restraining order is identical to the standard for issuing a preliminary injunction. See, e.g., Hawaii v. Gannett Pac. Corp., 99 F.Supp.2d 1241, 1247 (D. Haw. 1999). A "plaintiff seeking a preliminary injunction must establish that he is likely to succeed on the merits, that he is likely to suffer irreparable harm in the absence of preliminary relief, that the balance of equities tips in his favor, and that an injunction is in the public interest." Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7, 20 (2008) (citation omitted). "That is, `serious questions going to the merits' and a balance of hardships that tips sharply towards the plaintiff can support issuance of a preliminary injunction, so long as the plaintiff also shows that there is a likelihood of irreparable injury and that the injunction is in the public interest." Alliance for the Wild Rockies v. Cottrell, 632 F.3d 1127, 1135 (9th Cir. 2011). Winter emphasized that plaintiffs seeking preliminary relief must demonstrate that "irreparable injury is likely in the absence of an injunction." 555 U.S. at 22; see also Stormans, Inc. v. Selecky, 586 F.3d 1109, 1127 (9th Cir. 2009).
Shaughnessy fails to set forth sufficient supporting facts or legal argument demonstrating that he is likely to succeed on the merits, that the balance of equities tips in his favor, and that an injunction is in the public interest. The Court acknowledges that he alleges the likelihood of suffering irreparable harm in the absence of the preliminary relief requested. On balance, however, the Motion for TRO fails to establish that Shaughnessy is entitled to the requested TRO, an "extraordinary remedy that may only be awarded upon a clear showing that the plaintiff is entitled to such relief." Winter, 555 U.S. at 22.
Shaughnessy seeks, on an expedited basis,
Motion for TRO at 3.
According to Shaughnessy, Ohana manages Medicaid benefits for Hawaii's aged, blind, and disabled residents. Shaughnessy is a quadriplegic, and under his plan, he is entitled to certain aides, medical equipment and prescription medicines. For over six months, Ohana has failed to provide aides for 130-plus hours allotted per week, as needed. Motion for TRO at 1. He alleges that two aides were recently hired after waiting weeks for approval by Ohana, but Ohana has not paid them because of "coding" mistakes by healthcare providers. According to Shaughnessy, Ohana is, in fact, "lying and blaming agencies to keep money indefinitely. As a result, either the Plaintiff has to spend money from his limited resources or go without the services." Motion for TRO at 1-2.
Shaughnessy's doctor wrote prescriptions for the following equipment: shower chair; sling for lift; hospital bed; and specialized mattress. Motion for TRO at 2. Although Shaughnessy's doctor provided manufacturer and model numbers associated with these items, Ohana refused to provide the requested, prescribed equipment. Instead, it provided equipment that was "not usable" and "not the items in photos sent by plaintiff and Plaintiff's Doctor," according to Shaughnessy. Motion for TRO at 2.
Ordinarily, a threshold requirement for granting temporary injunctive relief is that the moving party make some showing of irreparable harm. Sampson v. Murray, 415 U.S. 61, 88 (1974). Shaughnessy states:
Motion for TRO at 4. The Motion for TRO establishes a plausible likelihood of irreparable injury.
Turning to the merits of his claims, Shaughnessy fails to set forth sufficient factual content in the Motion for TRO to allow the Court to determine that he is likely to succeed on his Section 1983 and breach of contract claims at this time.
Beyond the lack of evidentiary support in the Motion for TRO, Shaughnessy's bare legal allegations are similarly deficient, and state purely legal conclusions. Count I alleges that a "Medicaid recipient has a private cause of action to enforce his right to treatments and services. Defendant has failed to provide prescriptions by the doctor to the plaintiff." Complaint at 3. Section 1983 imposes liability on anyone who under color of state law deprives a person of "rights, privileges, or immunities" secured by the laws or the Constitution of the United States. 42 U.S.C. § 1983. First, Shaughnessy does not identify the Medicaid provision(s) allegedly violated that he contends give rise to his private cause of action. Without scrutinizing the Medicaid law at issue, the Court cannot determine whether he, in fact, has a private cause of action or is likely to succeed on the merits of that claim. See J.E. v. Wong, 125 F.Supp.3d 1099, 1106 n.3 (D. Haw. 2015) ("[W]hether a private right of action exists under a certain provision of the Medicaid law is highly dependent upon the language and nature of the particular provision at issue."). Second, Shaughnessy fails to allege how he has a private cause of action against Ohana — a private health insurer
Count II, entitled "Breach of Agreement," alleges that Ohana failed to provide aides, medical equipment, and prescription medicines to Shaughnessy and "is in breach of the agreement under Medicaid between the parties." Complaint at 3. Liberally construed, Count II attempts to allege a breach of contract claim. The Court, however, cannot determine with any certainty whether Shaughnessy is likely to succeed on the merits of this claim because the terms of the purported agreement are not before the Court. Generally, a breach of contract claim must set forth (1) the contract at issue; (2) the parties to the contract; (3) whether plaintiff performed under the contract; (4) the particular provision of the contract allegedly violated by defendants; and (5) when and how defendants allegedly breached the contract. See Evergreen Eng'rg, Inc. v. Green Energy Team LLC, 884 F.Supp.2d 1049, 1059 (D. Haw. 2012); see also Otani v. State Farm Fire & Cas. Co., 927 F.Supp. 1330, 1335 (D. Haw. 1996) ("In breach of contract actions, . . . the complaint must, at minimum, cite the contractual provision allegedly violated. Generalized allegations of a contractual breach are not sufficient . . . the complaint must specify what provisions of the contract have been breached to state a viable claim for relief under contract law."); Kaar v. Wells Fargo Bank, N.A., 2016 WL 3068396, at *1 (N.D. Cal. June 1, 2016) ("To claim a breach of contract in federal court the complaint must identify the specific provision of the contract allegedly breached by the defendant.").
Although Shaughnessy conclusorily states that he "has a substantial likelihood of success on the merits of the case" because his "rights to due process will be violated as Defendant has failed to provide the prescriptions of the doctor and Aides under Medicaid," the Court has no independent means of determining whether that is the case. The Motion for TRO points to no statute, regulation, or other provision of Medicaid law violated by Ohana, nor does it point to any contract or contract provision that was breached. Nor does Shaughnessy provide a copy of the relevant health plan or contract, specifying the provisions at issue. The failure to provide this basic information makes it impossible for the Court to determine that Plaintiff's claims are substantially likely to succeed.
Based upon the specific circumstances of this case and how they weigh upon the balancing of the equities between the parties and whether an injunction is in the public interest, the Court finds that Shaughnessy has failed to carry his burden at this time. The current, undeveloped record weighs against any finding of the propriety of an award of preliminary relief.
Nothing in the Complaint or Motion for TRO demonstrates any past or imminent future injury caused by Ohana that is sufficient to justify the relief sought. The allegations in the Complaint are unsupported and therefore present no serious question that the balance of equities tips in favor of Ohana or that an injunction is not in the public interest. Alliance for the Wild Rockies, 632 F.3d at 1135. The Court acknowledges the gravity of Shaughnessy's allegations of imminent harm. However, without sufficient factual details, Shaughnessy leaves the Court with nothing more than speculation as to whether defendant breached any legal duty or Medicaid agreement. Accordingly, Shaughnessy's Motion for TRO is DENIED.
IT IS SO ORDERED.