LOUISE W. FLANAGAN, District Judge.
This matter is before the court on defendants' separate motions to dismiss for lack of jurisdiction. (DE 26, 30, and 31). Also pending before the court is plaintiff's motion for temporary restraining order ("TRO"). (DE 6). In this posture, the issues raised are ripe for ruling. For the reasons that follow, defendants' motions to dismiss are granted and plaintiff's motion for TRO is denied as moot.
Plaintiff initiated this action on June 8, 2017, against defendants Trillium Health Resources ("Trillium"), Nash County, North Carolina Department of Health and Human Services ("NCDHHS"), Mandy K. Cohen, in her official capacity as Secretary of the NCDHHS, and Richard O. Brajer, in his individual and former official capacity as Secretary of the NCDHHS, alleging both North Carolina state and federal claims, all arising from defendants' involvement in the proposed disengagement of Nash County from plaintiff's catchment area. Plaintiff asserts state law claims against defendants for civil conspiracy and violation of the North Carolina Constitution. Plaintiff also asserts state law claims against defendant Nash County for breach of contract and breach of implied covenant of good faith and fair dealings and claims against defendants Brajer and Trillium for tortious interference with contract. In addition, plaintiff asserts claims against defendants for violation of 42 C.F.R. § 438.62, violation of Article I, Section 10 (the "Contracts Clause"), and violation of the Due Process Clause of the Fifth and Fourteenth Amendments to the United States Constitution.
On June 9, 2017, defendants NCDHHS and Cohen responded preliminarily in opposition to plaintiff's motion, contending that the court lacks jurisdiction over the matter as required by 28 U.S.C. § 1331. Defendant Trillium responded in a fully formed opposition memorandum to plaintiff's motion on June 12, 2017, contending that plaintiff is not entitled to injunctive relief because it cannot demonstrate success on the merits.
On June 13, 2017, the court held telephonic administrative conference.
In the midst of the court's briefing schedule, on June 20, 2017, defendant NCDHHS allegedly sent plaintiff a contract, which purports to exclude Nash County from its catchment area. Defendant requested by email dated June 20, 2017, sent at 6:02 p.m. by Lynn Fowler, a contract specialist for defendant NCDHHS to Sarah Stroud, on behalf of plaintiff, that the contract be executed and returned no later than June 23, 2017. On June 22, 2017, plaintiff filed an motion for emergency relief, seeking to preserve the status quo pending resolution of plaintiff's request for injunctive relief. By order dated June 26, 2017, the court dismissed plaintiff's motion for emergency relief as moot, reserving ruling on plaintiff's request for fees, pending disposition of the instant action.
The facts alleged in the complaint may be summarized as follows. Defendant NCDHHS is the single state agency designated to administer and supervise the administration of the state's Medicaid program under Title XIX of the Social Security Act. 42 U.S.C. § 1396(a)(5); N.C. Gen. Stat. § 108A-54. Within the NCDHHS, the Division of Medical Assistance ("DMA") is responsible for the day-to-day administration of the Medicaid program. The DMA contracts with area authorities to operate capitated Prepaid Inpatient Health Plans ("PIHPs") for Medicaid enrollees.
Plaintiff is a multi-county Local Management Entity/Managed Care Organization ("LME/MCO"), established pursuant to Chapter 122C of the North Carolina General Statutes. As an LME/MCO, plaintiff is responsible for managing the provision of Medicaid-funded mental health, developmental disability, and substance abuse benefits to residents in the following twelve counties: Bladen, Columbus, Duplin, Edgecombe, Greene, Lenoir, Nash, Robeson, Sampson, Scotland, Wayne and Wilson (together plaintiff's "catchment area"). Plaintiff operates pursuant to two Medicaid waivers in the Social Security Act,
As relevant here, sometime in 2011, the North Carolina General Assembly enacted House Bill 916, which mandated statewide expansion of certain Medicaid programs. 2011 N.C. Sess. Laws 264. Under the bill, LMEs that did not meet certain requirements by July 1, 2013, would have their management responsibilities reassigned to other LMEs. In order to meet all requirements, the bill allowed LMEs to merge through interlocal agreements.
In response to the bill, on June 7, 2012, plaintiff entered a Plan of Merger ("Merger Agreement") with Edgecombe-Nash Mental Health, Developmental Disabilities and Substance Abuse Services d/b/a the Beacon Center ("Beacon Center"), Southeastern Regional Mental Health, Developmental Disabilities and Substance Abuse Services ("Southeastern"), and the counties of Bladen, Columbus, Duplin, Edgecombe, Greene, Lenior, Nash, Robeson, Sampson, Scotland, Wayne and Wilson. (DE 1-9). The Merger Agreement, effective July 1, 2012, designated plaintiff as the single surviving LME/MCO for the combined twelve county catchment area.
The Merger Agreement requires all assets, fund balances, current real estate leases, personal property, and equipment leases of the merging entities to be transferred to plaintiff, the surviving entity. At the time of the Merger Agreement, the parties, including Nash County, agreed to use best efforts to "continue the level of funding currently budgeted, and to fund increases where the [Board of County] Commissioners deem appropriate in order to effectively provide mental health, developmental disability, and substance abuse services through [plaintiff]." (DE 1-9 ¶ 14). The Merger Agreement also requires plaintiff to "comply with all statutory and regulatory requirements applicable to multi-county LMEs, including but not limited to . . . the provisions of Chapter 122C of the North Carolina General Statutes, . . . as they exist as of the [m]erger [d]ate or may be amended in the future." (
In June 2013, the North Carolina General Assembly appended N.C. Gen. Stat. § 122C-115 to include the following subparagraph:
N.C. Gen. Stat. § 122C-115(a3).
By memorandum dated October 30, 2015, defendant Brajer, on behalf of the NCDHHS, notified state LME/MCOs that the NCDHHS would "not be acting on requests [to approve LME/MCO mergers, at [that] time," in part because the department had not yet promulgated rules for county disengagement. (Exhibit B, DE 1-10) (emphasis in original). On or around November 10, 2015, defendant Nash County gave notice to plaintiff of its intent to disengage and realign with Cardinal Innovations Healthcare ("Cardinal") by February 1, 2016. At this time, NCDHHS had not promulgated rules regarding county disengagement.
On March 17, 2016, defendant Brajer, released a memorandum, which contained a plan for LME/MCO consolidation. (Exhibit C, DE 1-11). The plan proposed merging plaintiff with defendant Trillium. The memorandum also indicated that sometime preceding, in late February, rules regarding county disengagement were "submitted to the Office of the State Budget and Management and the NCDHHS Commission for Mental Health, Developmental Disabilities and Substance Abuse Services." (
The NCDHHS gave formal notice of proposed rules regarding county disengagement on June 15, 2016. (Exhibit J, DE 1-18). The rules were allegedly available for public comment from June 16, 2016, to August 15, 2016, and were scheduled to take effect October 1, 2016.
On or about November 22, 2016, the Board of Commissioners of Nash County adopted a resolution to disengage from plaintiff and realign with defendant Trillium. Approximately one week later, on November 28, 2016, defendant Trillium passed a resolution to accept Nash County's request for realignment and forwarded the same to defendant Brajer. Plaintiff wrote to defendant Brajer on December 1, 2016, objecting to the proposed disengagement on numerous grounds. On December 5, 2016, defendant Brajer, over plaintiff's objection, approved defendant Nash County's request for disengagement, effective April 1, 2017.
In January of 2017, defendant Cohen was appointed by Governor Roy Cooper to succeed defendant Brajer as Secretary of the NCDHHS. Prior to her confirmation, defendant Cohen, purporting to act on behalf of defendant NCDHHS, wrote plaintiff regarding the planned disengagement of Nash County. Defendant Cohen requested that plaintiff submit a "comprehensive transition plan" to aid the transition of Nash County consumers to Trillium. (DE 1-22). In response to Cohen's letter, plaintiff notified Cohen of alleged unauthorized actions by the NCDHHS, Brajer and Nash County. By letter dated March 16, 2017, Cohen affirmed Brajer's approval of Nash County's disengagement, and postponed the disengagement effective date to July 1, 2017.
At plaintiff's request, plaintiff met with members of defendant NCDHSS on May 4, 2017, to discuss further the rationale for approving Nash County's disengagement. This action followed. Plaintiff contends that the proposed disengagement is in contravention of law and puts it at substantial financial risk.
A motion to dismiss under Rule 12(b)(1) challenges the court's subject matter jurisdiction. Under Rule 12(b)(1), the plaintiff bears the burden of showing that subject matter jurisdiction is appropriate.
A motion to dismiss for failure to state a claim under Rule 12(b)(6) tests the legal sufficiency of the complaint but "does not resolve contests surrounding the facts, the merits of a claim, or the applicability of defenses."
In evaluating the complaint, "[the] court accepts all well-plead facts as true and construes these facts in the light most favorable to the plaintiff, but does not consider legal conclusions, elements of a cause of action, . . . bare assertions devoid of further factual enhancement[,] . . . unwarranted inferences, unreasonable conclusions, or arguments."
The court first takes up, whether, as defendants contend, it lacks subject matter jurisdiction over plaintiff's claims. "Federal courts are courts of limited jurisdiction, possessing only that power authorized by Constitution and statute."
The asserted bases for jurisdiction in this court are plaintiff's claims that the enactment of N.C. Gen. Stat. § 122C-115(a3) violates certain federal regulations and provisions of the United States Constitution, thereby invoking this court's federal question jurisdiction. Contrary to plaintiff's suggestion, these claims fail to confer jurisdiction upon the court.
First, plaintiff's claim for violation of 42 C.F.R. § 438.62 does not confer federal question jurisdiction. Allegations of violations of federal statutes do not automatically confer federal question jurisdiction.
Here, nothing in the plain language of the regulation or the underlying statute evidences Congressional intent to create a private right of action in federal court. Plaintiff contends that 42 C.F.R. § 438.62 implements 42 U.S.C. § 1396a(a)(23) of the Medicaid Act, which allows a private right of action under 42 U.S.C. § 1983. In support of this position, plaintiff cites
Plaintiff's Constitutional claims likewise fail to confer federal question jurisdiction.
Lastly, plaintiff's Due Process claim fails to confer federal question jurisdiction upon the court. In its complaint, plaintiff asserts that the North Carolina defendants violated its Due Process rights, where they failed to provide it an "opportunity to comment on the proposed enactment of N.C. [Gen. Stat.] § 122C-115(a3)." (DE 42 ¶ 253). Where plaintiff also alleges that "[o]n June 15, 2016 . . . NCDHHS gave notice regarding proposed rules related to disengagement and realignment of counties from area authorities," (
Finding dismissal of plaintiff's federal claims appropriate for the reasons set forth herein, the court need not address the parties' alternative arguments. In light of the dismissal of plaintiff's federal claims, the court declines to exercise supplemental jurisdiction over plaintiff's remaining state-law claims. 28 U.S.C. § 1367(c)(3);
Based on the foregoing, the court GRANTS defendants' motions to dismiss. (DE 26, 30, and 31). Where the court lacks subject matter jurisdiction over the action, the court DENIES AS MOOT plaintiff's motion for temporary restraining order (DE 6). This matter is DISMISSED WITHOUT PREJUDICE for lack of subject matter jurisdiction. The clerk is DIRECTED to close this case.
SO ORDERED.