United States District Court, N.D. Illinois, Eastern Division
Doctors Nursing and Rehabilitation Center, LLC, et al., Plaintiffs,
Felicia F. Norwood, in her official capacity as the Director of the Illinois Department of Healthcare and Family Services, Defendant, and related Cases.
MEMORANDUM OPINION AND ORDER
E. Bucklo United States District Judge.
these related cases, several healthcare providers and their
patients in the State of Illinois seek declaratory and
injunctive relief against the Director of the Illinois
Department of Healthcare and Family Services
(“HFS”), Felicia Norwood, in her official
capacity. Plaintiffs allege that the defendant has failed to
process Medicaid applications and provide Medicaid benefits
with reasonable promptness to residents of long-term care
facilities in violation of Title XIX of the Social Security
Act (the “Medicaid Act”) and its implementing
regulations, the Americans with Disabilities Act
(“ADA”), the Rehabilitation Act, and the
Fourteenth Amendment. Before me is defendant's motion to
dismiss for lack of subject matter jurisdiction and for
failure to state a claim upon which relief can be granted
[Case. No. 1:16-cv-9837, ECF No. 36]. For the reasons set
forth below, I deny defendant's motion.
in these seven related cases are Illinois healthcare
providers and certain elderly and disabled patients they
serve. The healthcare provider plaintiffs are Illinois
healthcare companies owning and/or operating nursing home
facilities throughout the state of Illinois. These facilities
provide twenty-four hour, long-term nursing care to elderly
patients and patients with disabilities, some of whom are
Medicaid applicants or beneficiaries.
patient plaintiffs are residents at the healthcare provider
plaintiffs' long-term nursing care facilities. The
patient plaintiffs fall into two groups: (1) those who are
awaiting Medicaid eligibility determinations and (2) those
who, despite receiving approval, are still awaiting Medicaid
healthcare provider plaintiffs purport to serve as the
patient plaintiffs' “authorized
representatives” for the purposes of pursuing Medicaid
benefits pursuant to 42 C.F.R. § 435.923. The patient
plaintiffs also bring suit on their own behalves.
is Felicia Norwood, the Director of the Illinois Department
of Healthcare and Family Services, who is sued in her
official capacity. HFS is a state agency charged with
operating Illinois's Medicaid program. Two of the
complaints also separately list HFS as a
allege that defendant Norwood has failed to provide medical
care services to eligible Illinois residents as required by
the Medicaid Act. Specifically, plaintiffs charge that
defendant has failed to process plaintiffs' Medicaid
applications, render eligibility determinations, and provide
benefits with reasonable promptness. They allege that HFS has
exceeded the forty-five days or ninety days that the Medicaid
regulations permit to determine applicant eligibility.
Plaintiffs further allege that defendant has failed to
provide benefits to the patient plaintiffs who have had their
Medicaid applications approved. HFS's inaction on these
matters, plaintiffs allege, violates 42 U.S.C. §§
1396a(a)(10)(A), 1396d(a)(4)(A), and 1396a(a)(8).
Additionally, plaintiffs assert that these inactions
constitute violations of the ADA, Section 504 of the
Rehabilitation Act, and the Equal Protection Clause of the
Fourteenth Amendment. Plaintiffs seek injunctive and
declaratory relief to ensure the defendant's future
compliance with the Medicaid statute.
moves to dismiss the seven complaints against her because,
she argues, this court lacks subject matter jurisdiction to
hear the cases and plaintiffs fail to state claims upon which
relief may be granted. When considering motions to dismiss
for failure to state a claim or lack of subject matter
jurisdiction, I “take as true all well-pleaded factual
allegations in the complaint and make all plausible
inferences from those allegations in the plaintiffs'
favor.” Disability Rights Wisconsin, Inc. v.
Walworth Cty. Bd. of Supervisors, 522 F.3d 796, 799 (7th
Cir. 2008); see Scanlan v. Eisenberg, 669 F.3d 838,
841 (7th Cir. 2012) (applying the same standard to Rule
12(b)(1) motions). To survive a motion to dismiss under Rule
12(b)(6), a complaint must provide factual allegations that,
if taken as true, “state a claim to relief that is
plausible on its face.” Bell Atl. Corp. v.
Twombly, 550 U.S. 544, 570 (2007). Similarly, a
complaint will survive a facial challenge to jurisdiction
brought under a Rule 12(b)(1) motion to dismiss if it
“has sufficiently alleged a basis of subject matter
jurisdiction.” Apex Digital, Inc. v. Sears, Roebuck
& Co., 572 F.3d 440, 443 (7th Cir. 2009).
of Subject Matter Jurisdiction
contends that all seven complaints should be dismissed for
lack of subject matter jurisdiction. In her motion to
dismiss, defendant initially challenged this court's
jurisdiction to hear these cases on Article III standing and
Eleventh Amendment grounds. Defendant subsequently dropped
her Article III challenge in her reply brief, and I will
therefore not address it here. Def.'s Reply at 3 [ECF No.
45]. The defendant does continue to challenge the
institutional plaintiffs' authority to sue on behalf of
the patient plaintiffs, but, because the patients themselves
are plaintiffs asserting a cognizable injury, this issue does
not implicate my subject matter jurisdiction and is better
understood as a challenge arising under Rule 12(b)(6), as
discussed below. See Whelan v. Abell, 953 F.2d 663,
672 (D.C. Cir. 1992).
remaining jurisdictional argument concerns the Eleventh
Amendment. Defendant contends that plaintiffs' claims-
with the exception of those brought under the Rehabilitation
Act-are barred by the Eleventh Amendment and the doctrine of
state sovereign immunity because plaintiffs seek an order
compelling payments for services already rendered. Plaintiffs
counter that they seek only prospective injunctive and
declaratory relief to ensure defendant's future
compliance with federal law.
Eleventh Amendment states that federal jurisdiction shall not
extend to suits against a state by a citizen of another state
or foreign country. U.S. Const. amend. XI. In addition to
what it explicitly guarantees, the Eleventh Amendment also
incorporates the doctrine of sovereign immunity. See Hans
v. Louisiana, 134 U.S. 1, 13-14 (1890). Thus, the
Amendment “guarantees that ‘an unconsenting State
is immune from suits brought in federal courts by her own
citizens as well as by citizens of another State.'”
Bd. of Regents v. Phoenix Int'l Software, Inc.,
653 F.3d 448, 457 (7th Cir. 2011) (quoting Edelman v.
Jordan, 415 U.S. 651, 662-63 (1974)).
Eleventh Amendment's bar on citizens suing their state,
however, is not complete. There are several common exceptions
that allow plaintiffs to pursue claims against a state or its
agents. One such exception was first articulated in Ex
Parte Young, 209 U.S. 123 (1908). There, the Supreme
Court held that the Eleventh Amendment does not preclude
claims against state officials for prospective, injunctive
relief to stop ongoing violations of federal law. Ex
Parte Young, 209 U.S. at 159-60. While a federal court
cannot order a state to pay retrospective damages, it can
require a state officer to ...