LITIGATION
In addition to representing individuals, TJC also uses litigation as a tool to make widespread impact and improve the lives of Tennesseans across the state.
Please find more information about some of our current and past cases below:
AMC v. Smith, Civil Action No. 3:20-cv-00240 (M.D. Tenn.)
AMC v. Smith is an ongoing lawsuit filed in 2020 involving the administration of Tennessee’s Medicaid program, known as TennCare. Following a five-day trial, a federal court ruled that TennCare violated the Constitution, Medicaid Act, and the Americans with Disabilities Act. Thirty-five children and adults from across Tennessee originally brought a class action on behalf of the hundreds of thousands of individuals challenging the state’s wrongful termination of people’s health insurance. The plaintiffs allege that TennCare’s system for reevaluating eligibility is defective and fails to provide the notice and opportunity for hearing required by the Medicaid Act and the Constitution. They also claim that TennCare’s eligibility redetermination process discriminates against people with disabilities. While the case is not over and appeals may follow, the district court agreed with the Plaintiffs following the trial. The Tennessee Justice Center filed this case in partnership with the National Health Law Program, National Center for Law and Economic Justice, and Selendy and Gay, PLLC.
McCutchen v. Becerra, Civil Action No. 1:21−cv−01112 (D.D.C.)
McCutchen v. Becerra is a case of national significance filed in 2021 in the United States District Court for the District of Columbia. The lawsuit, filed by TennCare enrollees, a physician who treats TennCare patients, and the Tennessee Justice Center, challenged an unprecedented waiver granted Tennessee by federal officials during the last days of the Trump Administration. That waiver incentivized the state to drastically cut prescription drug coverage and divert federal Medicaid funds to unrelated state activities. Health policy experts warned that the waiver established a precedent that posed an existential threat to the national Medicaid program. The lawsuit prompted the withdrawal of the financial incentives and the cuts in prescription drug benefits. The plaintiffs continue to challenge other features of the waiver that unlawfully deprive TennCare patients of protections established by Congress. This case was filed by TJC, the National Health Law Program and King & Spalding LLP.
Click HERE to read the complaint.
Click HERE for press inquiries.
Wilson v. Gordon, 822 F.3d 934 (6th Cir. 2016)
Wilson v. Gordon was a class action filed in 2014 in the United States District Court for the Middle District of Tennessee. Eleven named plaintiffs challenged Tennessee’s systemic delays in approving applications and extending health coverage to eligible families, many of whom had urgent medical needs. The lawsuit compelled the state to process applications timely and afford an appeal to any applicant who might experience a delay in the future. TJC was assisted by co-counsel from the Southern Poverty Law Center and the National Health Law Program.
Click to read the complaint HERE and the courts’ decisions HERE.
Daniels v. Wadley, 926 F. Supp. 1305 (M.D. Tenn. 1996), vacated in part and remanded Daniels v. Menke, 145 F.3d 1330 (6th Cir. Tenn. 1998) Binta B. v. Gordon, 262 F.3d 559 (6th Cir. 2001) Tenn. Assoc. of Health Maintenance Organizations, Inc. v. Grier, 262 F.3d 559 (6th Cir. 2001); Grier v. Goetz, 402 F. Supp. 2d 876 (M.D. Tenn. 2005; Grier v. Goetz, 424 F. Supp. 2d 1052(M.D. Tenn 2006).
Known by a series of different case names over its 37 year history, the case was a nationally significant class action on behalf of Tennessee Medicaid patients. As managed care came to dominate Medicaid patients’ access to care, the lawsuit established landmark patient protections against HMOs’ arbitrary refusal to cover necessary medical care. Originally filed by the Legal Aid Society in 1979 and transferred to the Tennessee Justice Center in 1996, TJC was assisted by co-counsel from the National Center for Law and Economic Justice, AARP Legal Foundation and Kirkland & Ellis LLP.
Click to read landmark appellate ruling HERE against Medicaid HMOs.
John B. v. Menke, 176 F. Supp. 2d 786 (M.D. Tenn. 2001); John B. v. Goetz, 626 F.3d 356 (6th Cir. Tenn., 2010); John B. v. Emkes, 852 F.Supp. 2d 944 (M.D. Tenn. 2012); John B. v. Emkes, 852 F. Supp. 2d 957 (M.D. Tenn. 2012); John B. v.
Emkes, 710 F.3d 394 (6th Cir. 2013).
John B. was a class action brought on behalf of the 500,000 children (half of all children in Tennessee) who receive health coverage through TennCare. The trial court found after a protracted trial that TennCare fell far short of meeting federal health quality and access standards, and that essential care was often delayed or denied. The parties developed a comprehensive remedial plan governing all aspects of the delivery of medical and behavioral health care to children and youth. The parties also developed additional protections to meet the special needs of children in, or at risk of entering, foster care. After a decade of monitoring by TJC and oversight by a court-appointed special master, the court found that TennCare had achieved compliance with federal standards. TJC was assisted by co-counsel from Sonnenschein Nath & Rosenthal (now Dentons LLP).
Click to read the complaint HERE and court findings HERE.
Newberry v. Goetz, Civil Action No.3-98-1127 (M.D. Tenn.)
Newberry v. Goetz was a class action filed in 1998 on behalf of several young TennCare enrollees with disabilities. The plaintiffs were told by their TennCare HMOs that they could no longer receive the nursing care they needed while living in the community but would have to move to nursing homes, requiring them to abandon college studies and career plans. The lawsuit raised the same arguments under the Americans with Disabilities Act that were subsequently accepted by the Supreme Court in Olmstead v. L.C. The Newberry plaintiffs regained their home nursing care. A favorable 2003 settlement required the state to rebalance its spending on long term services and supports, resulting in a shift of hundreds of millions of dollars of services from institutional to home and community-based settings. TJC was assisted by co-counsel from Burr & Forman LLP, and the U.S. Justice Department took the unusual step of submitting an amicus brief in the district court in support of TJC’s position.
Click to read the complaint HERE.
Winkler v. Interim Health, 36 F. Supp. 2d 1026 (M.D. Tenn. 1999)
Winkler was brought on behalf of several medically fragile Medicare patients who faced the loss of their in-home nursing care after a change in federal reimbursement rules. TJC obtained a preliminary injunction barring the home health company from reducing their care, and the case was settled on favorable terms. Winkler produced a landmark ruling recognizing the right of Medicare patients to enforce Medicare quality standards against a health care provider. TJC was assisted by co-counsel from Justice in Aging.
Click to read the complaint HERE and court ruling HERE.
League of Women Voters v. McPeak, No. 13-1365 (Davidson County, TN Chancery)
In 2013, as federally subsidized health insurance was about to become available under the Affordable Care Act (“Obamacare”), Tennessee officials adopted regulations that effectively barred anyone other than a licensed insurance broker from helping individuals sign up for the new coverage. The rules hamstrung a statewide effort to train and deploy the hundreds of volunteers that would be needed to help uninsured Tennesseans access the new coverage. TJC brought the League of Women Voters case to challenge the state rules on First Amendment grounds. The lawsuit prompted the state to revise the rules, clearing the way for successful implementation of the new law.
Click to read the complaint HERE.
Doe v. Word, Civ. Action No 3-84-1260 (M.D. Tenn.)
This class action was filed in 1984 by the Legal Aid Society of Middle Tennessee and the Cumberlands on behalf of applicants seeking nursing home care through Tennessee’s Medicaid program. A 1987 settlement produced an order that established important appeal protections for applicants who are denied coverage. In 1996, Legal Aid transferred the case to TJC to monitor and enforce compliance with the order. In 1999, the state refused to enforce a provision in the 1987 order that bars nursing homes from evicting residents while their Medicaid coverage appeals are pending. TJC filed contempt of court proceedings and obtained an injunction against further violations. The parties settled later that year with an agreement strengthening the protections of the 1987 order. The orders remain in effect and protect the more than 30,000 Tennesseans each year who apply for Medicaid nursing home care.
Click to read the 1987 order and 1999 stipulation and order.
Doe v. Henderson, No. A-7980-I (Davidson County, TN Chancery)
This case was filed in 1976 by the Legal Aid Society on behalf of a class of juvenile offenders with intellectual disabilities who are committed to state custody. The lawsuit challenged dangerous conditions and degrading treatment prevailing in state juvenile detention facilities. A series of orders entered in the 1980s established comprehensive safeguards protecting all juvenile detainees in state custody. In 1996, Legal Aid transferred the case to TJC for continued monitoring and enforcement. Between 2015 and 2020, TJC negotiated several state policy changes that improved security, limited the use of segregation and improved education services.
Rosen v. Tenn. Comm'r of Fin. & Admin., 204 F. Supp. 2d 1061 (M.D. Tenn. 2001), rev’d in part and affirmed in part, 288 F.3d 918 (6th Cir. 2002); Rosen v. Tenn. Comm'r of Fin. & Admin., 280 F. Supp. 2d 743 (2002); Rosen v. Goetz, 410 F.3d 919 (6th Cir. 2005). This class action established notice and hearing protections for 300,000 individuals eligible for health coverage under a special Medicaid waiver and won reinstatement for those whose coverage was wrongfully terminated. Among other things, orders established uniquely stringent requirements protecting people with disabilities. Those included a requirement that the state review patient billing records to identify beneficiaries with diagnosed disabilities and provide them special assistance in renewing their coverage. TJC was assisted by co-counsel from Kirkland & Ellis, LLP and the National Center for Law & Economic Justice.
Click to read the 2001 and 2002 trial court rulings and the 2002 appellate decision.
Doe v. HCA Health Services of Tennessee, Inc., 46 S.W. 3d 191 (Tenn. 2001) This class action challenged the then-common hospital industry practice of charging uninsured patients as much as 2-3 times the discounted prices paid by commercial insurers and government programs. The Tennessee Supreme Court ruling established a national precedent benefiting uninsured patients, prompting hospitals to give those patients the same discounts they extend to insurance companies. TJC was assisted by co-counsel from the Law Offices of John Day, PLLC, and Doffermyre Shields Canfield & Knowles, LLC.
Click to read the Tennessee Supreme Court ruling.
Linton v. Commissioner, 779 F. Supp. 925 (M.D. Tenn. 1990), affd. on other grounds 65 F3d 508 (6th Cir. 1995), cert. den. sub. nom. St. Peter Villa v. Linton, 517 U.S 1155, 134 L.Ed.2d 646 (1996)
Linton was a class action challenging state policies that enforced racial and economic discrimination by nursing homes that receive Medicaid funding. The case was filed in 1989 by the Legal Aid Society and successfully prosecuted over several years to a successful conclusion. In 1996, the Legal Aid Society transferred the case to TJC, which filed a brief successfully opposing the Supreme Court’s review of the case. The orders in the case remain in effect and provide consumer protections that are unique to Tennessee. The NAACP Legal Defense & Educational Fund participated as co-counsel in this case.
Click links to read the trial court ruling, the appeals court decision, state implementation plan, and orders adopting the plan.
