Community Health Center Alliance for Patient Access v. Lightbourne

8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA COMMUNITY HEALTH CENTER FOR No. 2:20-cv-02171-JAM-KJN PATIENT ACCESS, et al., Plaintiffs, 13 ORDER DENYING PLAINTIFFS’ EX v. PARTE MOTION FOR TEMPORARY 14 RESTRAINING ORDER WILLIAM LIGHTBOURNE, Director of the California Department of Health Care Services, and CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES, Defendants.

19 This matter is before the Court on a Motion for Temporary Restraining Order (“TRO”) filed by Community Health Center Alliance for Patient Access, Avenal Community Health Centers, Community Health Centers of the Central Coast, Family Health Centers of San Diego, Imperial Beach Community Clinic, La Maestra Family Clinic, Omni Family Health, Open Door Community Health Centers, Shasta Community Health Center, and South County Community Health Center, Inc. (“Plaintiffs”). TRO, ECF No. 6.

27 Will Lightbourne and the California Department of Health Care Services (“Defendants”) oppose the motion. Opp’n, ECF No. 13.

1 Plaintiffs have replied to Defendants’ opposition. Reply, ECF No. 18.

3 Plaintiffs seek to enjoin Defendants from implementing the Medi-Cal Rx Transition, which carves out the pharmacy benefit from California’s Medi-Cal managed care program, or, in the alternative, the Defendants’ waiver extension request, on the grounds that (1) Defendants’ request for federal approval for the carve out was untimely and improperly made; (2) Defendants do not have an alternative method for reimbursing Plaintiffs for their pharmacy benefit outside of managed care that is compliant with federal law; and (3) Defendants’ proposed methodology for reimbursing Plaintiffs post-transition would improperly give Defendants the benefit of the drug discount program that is intended to benefit Plaintiffs and other safety net providers under federal law. See generally TRO.

16 However, temporary restraining orders are emergency measures, intended to preserve the status quo pending a fuller hearing on the injunctive relief requested, and the irreparable harm must therefore be clearly immediate. Fed. R. Civ. Proc.

20 65(b)(1). Here, Plaintiffs failed to adequately prove they face an immediate risk of irreparable harm as Defendants have publicly stated the transition to Medi-Cal RX will not be effective until April 1, 2021. See Opp’n at 9-13. From the parties’ briefing, it is clear to the Court that there are numerous factual and legal disputes. It would be inappropriate to grant the ultimate relief sought at the earliest stage in the proceeding, prior to a more deliberative investigation of the claims’ merits. See Senate of State of Cal. v. Mosbacher, 968 F.2d 974, 978 (9th Cir. nee enn meee ne nn nnn en en enn EN OS ISI I ED EEO 1992) (finding that it is inappropriate to grant preliminary relief that results in the non-moving party essentially losing the whole case).

5 I. ORDER 6 After careful consideration of all papers filed by both parties, the Court DENIES Plaintiffs’ Ex Parte Motion for a Temporary Restraining Order.

9 Plaintiffs may, of course, file a motion for a preliminary 10 injunction which would allow the Court to consider their 11 arguments regarding the merits, or lack thereof, of their claims.

12 In denying their motion for a TRO, the Court has not reached the 13 issue of the Plaintiffs’ likelihood of success on the merits. A 14 motion for a preliminary injunction, if filed within the next 15 thirty days, could be heard and decided by the Court prior to the 16 date the Medi-Cal Rx Transition is scheduled to be implemented.

17 IT IS SO ORDERED.

18 Dated: November 24, 2020 19 ke Me 20 teiren staves odermacr 7008