United States District Court, M.D. Alabama, Northern Division
JEAN C. MAY, by and through Isaac W. May, her next friend and attorney-in-fact, et al. Plaintiff,
STEPHANIE AZAR, in her official capacity as Commissioner of the Alabama Medicaid Agency, Defendant.
MEMORANDUM OPINION AND ORDER
F. MOORER UNITED STATES DISTRICT JUDGE
before the Court is Defendant Stephanie Azar's Motion
to Dismiss or, in the Alternative Motion to Stay or, in the
Alternative Motion for a More Definite Statement. Doc.
6, filed November 6, 2018. Pursuant to Fed.R.Civ.P. 12(b)(1)
and (b)(6), Defendant Azar requests the Court dismiss
Plaintiff Jean C. May's Complaint for injunctive and
declaratory relief; or in the alternative, requests the Court
stay this matter pursuant to the Colorado River
abstention doctrine while related proceedings that are on
appeal before the Alabama Court of Civil Appeals conclude; or
in the alternative, requests the Court order a more definite
statement pursuant to Fed.R.Civ.P. 12(e). Id. at 1.
Having considered the motion and relevant law, the Court
finds the motion to dismiss is due to be GRANTED in part and
DENIED in part.
the Court will refer to the parties to this action as
follows: Plaintiff Jean C. May will be referred to as
“Jean May, ” Plaintiff Isaac W. May will be
referred to as “Isaac May, ” and they will be
collectively referred to as “Plaintiffs” or the
“Mays.” Defendant Stephanie Azar will be referred
to as either “Defendant” or the
“Commissioner, ” and the Alabama Medicaid Agency
will be referred to as the “AMA.”
JURISDICTION AND VENUE
district court has subject matter jurisdiction over the
claims in this action pursuant to 28 U.S.C. § 1331
(federal question) as Plaintiffs bring claims pursuant to 42
U.S.C. § 1983 for violations of the Medicaid Act and
violation of 42 U.S.C. § 1396a(a)(8).
district court has personal jurisdiction over the claims in
this action because Jean May and Isaac May, Jean's
husband, next friend, and attorney-in-fact, are alleged to be
citizens of Montgomery County, Alabama, and Stephanie Azar is
the Commissioner of the Alabama Medicaid Agency, and are
within the Court's district. Daimler AG v.
Bauman, 571 U.S. 117, 137, 134 S.Ct. 746, 760, 187
L.Ed.2d 624 (2014) (“‘For an individual, the
paradigm forum for the exercise of general jurisdiction is
the individual's domicile; for a corporation, it is an
equivalent place, one in which the corporation is fairly
regarded as at home.' [Goodyear Dunlop Tires
Operations, S.A. v. Brown, ] 564 U.S. [915, ] 924, 131
S.Ct. 2846, 2854, 180 L.Ed.2d 796, 806 (citing [Lea]
Brilmayer et al., A General Look at General
Jurisdiction, 66 Tex. L. Rev. 721, 728 (1988)). With
respect to a corporation, the place of incorporation and
principal place of business are ‘paradig[m] . . . bases
for general jurisdiction.' Id. at 735; see
also [Mary] Twitchell, The Myth of General
Jurisdiction, 101 Harv. L. Rev. [610, ] 633.”).
is proper in this Court pursuant to 28 U.S.C. §
1391(b)(1) because the events that are described in the
Complaint occurred in this district.
parties do not contest either personal jurisdiction or venue.
Defendant contests subject matter jurisdiction because she
brings her instant motion pursuant to Fed.R.Civ.P. 12(b)(1),
but as the Court has already discussed, the Court has subject
matter jurisdiction over this matter and Defendant does not
distinguish in her motion between Fed.R.Civ.P. 12(b)(1) and
FACTUAL AND PROCEDURAL BACKGROUND
relevant times, Jean May was married to Isaac May. Doc. 1
¶ 12. On January 13, 2016, Jean May was admitted to a
nursing home, John Knox Manor. Id. ¶ 11. The
Mays paid out of pocket for Jean May to be admitted to the
nursing home. Id. ¶ 13. After the Mays
“spent-down” their resources to what they
understood to be the required limit for Medicaid, a Medicaid
application was filed for Jean May on February 28, 2017.
Id. ¶ 14. Issac May, along with his son and
daughter-in-law, assisted Jean May with the Medicaid benefits
process. Id. ¶ 15. On March 2, 2017, Medicaid
supplied Isaac May with a pre-filled “Agreement to
Sell” form in regard to a junkyard that is jointly
owned by the Mays. Id. ¶ 32. The
“Agreement to Sell” form states, “If this
agreement is made by and with respect to an individual who is
not filing for or receiving benefits but whose resources
effect the eligibility of another individual for benefits,
this agreement is required by regulations (20 C.F.R.
§§ 416.1240, 416.1202, 416.1203).”
Id. After Isaac May received the “Agreement to
Sell” form, he completed it and returned it signed on
March 20, 2017. Id. ¶ 35. On June 9, 2017,
Medicaid denied Jean May's application for “failure
to provide information.” Id. ¶ 17.
May's attorney requested an informal conference with
Medicaid after Jean May's Medicaid application was
denied. Id. ¶ 18. The conference was held on
June 29, 2017, after which Medicaid continued to process Jean
May's Medicaid application. Id. However, as of
June 29, 2017, Medicaid had not issued a “spousal
assessment” for the Mays. Id. ¶ 19. For
Medicaid eligibility purposes, a spousal assessment
determines the total combined resources of an applicant and
her community spouse and states Medicaid's calculation of
how much of those joint assets may be preserved for the
community spouse, pursuant to the applicable spousal
improverishment rules. Id. ¶ 20. The spousal
assessmenet is required under 42 U.S.C. §
1396r-5(c)(1)(B). Id. ¶ 21.
30, 2017, Jean May's attorney emailed Medicaid to inquire
about the status of the spousal assessment and submitted a
“re-application” to preserve the maximum benefits
for Jean May in the event the first denial stood.
Id. ¶ 22. On July 5, 2017, Medicaid issued the
first spousal assessment. Id. ¶ 23. On the same
date, Medicaid notified Jean May's attorney a second
denial of Jean May's Medicaid application because of
“excess resources” would issue. Id.
May's attorney again requested an informal conference
with Medicaid to discuss the spousal assessment. Id.
¶ 25. The conference was held on July 7, 2017, with the
Medicaid District Office Manager and the case worker who was
assigned the relevant file. Id. As a result of the
conference, the Montgomery District Office Manager requested
an “interpretation request” from the Medicaid
central office. Id. ¶ 26. On August 4, 2017,
Medicaid issued a second denial letter, in which Jean May was
denied Medicaid benefits for excess resources. Id.
¶ 30. Medicaid's position in the second denial
letter was Jean May was ineligible due to excess resources
because her husband, Isaac May, owned an undivided one-half
interest in a junkyard, which was listed for sale since March
2, 2016. Id. ¶ 31. It is Medicaid's
position that the “bona fide effort to sell”
exclusion is not available to a married applicant
and that was the reason Jean May's Medicaid application
May appealed the second denial of her Medicaid application
and an administrative fair hearing was conducted on October
13, 2017, before an Administrative Law Judge (the
“ALJ”) as the designee of the Commissioner of the
AMA. Id. ¶ 40. On December 14, 2017, the ALJ
issued her Recommendation to the Commissioner of the AMA, in
which she recommended both of the decisions to deny Jean
May's Medicaid application be reversed. Id.
¶ 41. On January 12, 2018, the Commissioner accepted the
ALJ's recommendation as to the denial of Jean May's
Medicaid application for “failure to provide
information.” Id. ¶ 42. However, the
Commissioner declined to accept the ALJ's recommendation
as to the second denial of Jean May's Medicaid
application. Id. ¶ 43.
January 29, 2018, pursuant to the Alabama Administrative
Procedures Act, a petition for judicial review of the
Commissioner's decision was filed with the Circuit Court
of Montgomery County, Alabama. Id. ¶ 44. On
August 30, 2018, the circuit court issued an order in which
it reversed the ALJ's decision. Id. ¶ 45.
The circuit court's order was appealed to the Alabama
Court of Civil Appeals on September 27, 2018. Id.
October 15, 2018, Jean May, by and through Isaac May, her
next friend and attorney-in-fact, and Isaac May,
individually, filed this instant action against the AMA
Commissioner, in her official capacity. Id. The Mays
bring against the Commissioner two claims: (1) a claim for
violation of 42 U.S.C. § 1983 because the Mays allege
they were deprived of rights that are secured to them by the
Medicaid Act, 42 U.S.C. §§ 1396-1396w; 42 C.F.R.
§ Part 435; the Social Security Act, 42 U.S.C.
§§ 1381-1385; and 20 C.F.R. Part 416 and (2) a
claim for violation of 42 U.S.C. § 1396a(a)(8) because
the Mays claim the Commissioner failed to furnish Medicaid
assistance to Jean May with “reasonable
promptness.” Id. ¶¶ 90-101.
November 6, 2018, Defendant filed her Motion to Dismiss or,
in the Alternative Motion to Stay or, in the Alternative
Motion for a More Definite Statement. Doc. 6. Plaintiffs
timely responded in opposition, to which Defendant replied.
Docs. 13-14. The Court finds oral argument unnecessary for
resolution at this time. Therefore, the motion is fully
briefed and ripe for adjudication.
31, 2019, the Court entered an Order for the parties to file
a joint status report to inform the Court about the status of
the related matter that was before the Alabama Court of Civil
Appeals. Doc. 17. According to the parties' joint status
report, the appeals court issued its opinion on Jean
May's appeal on August 2, 2019, in which it upheld the
circuit court's decision to deny Jean May's
application for Medicaid benefits. Doc. 18-1.
STANDARD OF REVIEW
Fed.R.Civ.P. 12(b)(1) motion directly challenges the district
court's subject matter jurisdiction. McElmurray v.
Consol. Gov't of Augusta-Richmond Cty., 501 F.3d
1244, 1251 (11th Cir. 2007); Gilmore v. Day, 125
F.Supp.2d 468, 470 (M.D. Ala. 2000). The burden of proof for
a Fed.R.Civ.P. 12(b)(1) motion is on the party averring
jurisdiction. Gilmore, 125 F.Supp.2d at 471 (citing
Thomson v. Gaskill, 315 U.S. 442, 446, 62 S.Ct. 673,
86 L.Ed. 951 (1942)). A motion to dismiss for lack of subject
matter jurisdiction may occur either facially or factually.
Makro v. Capital of Am., Inc. v. UBS AG, 543 F.3d
1254, 1258 (11th Cir. 2008) (citing Morrison v. Amway
Corp., 323 F.3d 920, 925 n.5 (11th Cir. 2003));
Stalley v. Orlando Reg'l Healthcare Sys., Inc.,
524 F.3d 1229, 1232 (11th Cir. 2008) (citing
McElmurray, 501 F.3d at 1251).
“facial attack” is based solely on the pleadings
and requires the court to assess whether the plaintiff has
alleged a sufficient basis for subject matter jurisdiction.
Stalley, 524 F.3d at 1232-33; Morrison, 323
F.3d at 925 n.5; Lawrence v. Dunbar, 919 F.2d 1525,
1529 (11th Cir. 1990). “On a facial attack, a plaintiff
is afforded safeguards similar to those provided in opposing
a [Fed. R. Civ. P.] 12(b)(6) motion -- the court must
consider the allegations of the complaint to be true.”
Lawrence, 919 F.2d at 1529 (citing Williamson v.
Tucker, 645 F.2d 404, 412 (5th Cir. 1981)); see also
Houston v. Marod Supermarkets, 733 F.3d 1323, 1335 (11th
Cir. 2013) (evaluating whether the plaintiff “has
sufficiently alleged a basis of subject matter
jurisdiction” in the complaint and employing standards
similar to those that govern a Fed.R.Civ.P. 12(b)(6) review).
The Court is “not required to accept mere conclusory
allegations as true, nor are we required to accept as true
allegations in the complaint that are contrary to factual
details presented in the exhibits.” Griffin Indus.,
Inc. v. Irvin, 496 F.3d 1189, 1205-06 (11th Cir. 2007).
“[W]hen the exhibits contradict the general and
conclusory allegations of the pleading, the exhibits
govern.” Id. at 1206. When discussing exhibits
on a facial attack, the Court may consider exhibits that are
attached to the complaint as well as those attached to a
motion to dismiss. Lawrence v. United States, 597
Fed.Appx. 599, 602 (11th Cir. 2015). Exhibits attached to the
complaint are considered part of the complaint for all
purposes. Id. Further, exhibits attached to a motion
to dismiss may be considered for a facial attack if the
documents are central to the plaintiff's claim and their
authenticity is not disputed. Id.
other hand, a “factual attack” challenges
“subject matter jurisdiction in fact, irrespective of
the pleadings.” Morrison, 323 F.3d at 925. On
a Fed.R.Civ.P. 12(b)(1) factual attack, the court “may
proceed as it never could under 12(b)(6) or Fed.R.Civ.P. 56.
Lawrence, 919 F.2d at 1529. Further, in resolving a
factual attack, the court “may consider extrinsic
evidence such as testimony and affidavits.”
Makro, 543 F.3d at 1258 (quoting Morrison,
323 F.3d at 925 n.5); accord Stalley, 524 F.3d at
1233; Miccosukee Tribe of Indians of Fla. v. U.S.,
E.P.A., 105 F.3d 599, 603 (11th Cir. 1997) [hereinafter
Miccosukee Tribe]. “[A] trial court is free to
weigh the evidence and satisfy itself as to the existence of
its power to hear the case without presuming the truthfulness
of the plaintiff's allegations.” Makro,
543 F.3d at 1528 (citation and internal quotation marks
omitted); see also Willett v. United States, 24
F.Supp.3d 1167, 1173 (M.D. Ala. 2014) ...