Deakin v. Magellan Health, Inc.

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MAUREEN DEAKIN, RACHEL CLERGE, CHERYL JOHNSON, LESLEY MITCHELL, MAY WOJCIK, DALE KESSLER, and all others similarly situated, Plaintiffs, v. MAGELLAN HEALTH, INC., and MAGELLAN HSRC, INC., Defendants.

No. 1:17-cv-00773-MLG-KK

United States District Court, D. New Mexico

August 14, 2024

MEMORANDUM OPINION AND ORDER

MATTHEW L. GARCIA UNITED STATES DISTRICT JUDGE

Plaintiff Maureen Deakin and several other individuals worked as care coordinators (“CCs”) for Defendants Magellan Health, Inc., and Magellan HSRC, Inc. (collectively “Magellan”), who provide case management and behavioral health services in New Mexico. See generally Doc. 121. Deakin claims that she and all other similarly situated CCs regularly worked more than forty hours per week without being paid overtime wages in violation of the Fair Labor Standards Act (“FLSA”), 29 U.S.C § 201 et seq., and the New Mexico Minimum Wage Act (“NMMWA”), NMSA 1978, § 50-4-19, et seq. (1955). The Court conditionally certified an FLSA collective action under 29 U.S.C. § 216(b), Doc. 62, and discovery ensued.

Magellan now moves to decertify the FLSA collective, Doc. 280, while Deakin moves for class certification under Federal Rule of Civil Procedure 23(b)(3) to pursue NMMWA claims on behalf of herself and her fellow CCs. Doc. 285. Having reviewed the parties' filings and the applicable law and having held a hearing on both motions on January 17, 2024, Doc. 340, the Court grants Deakin's motion for Rule 23(b)(3) class certification, Doc. 285, and grants in part and denies in part Magellan's motion to decertify the FLSA collective Doc. 280.

BACKGROUND

I. Magellan's Contractual Obligations

The New Mexico Human Services Department (“HSD”) has implemented several programs intended to increase access to care for our state's Medicaid recipients. Among these efforts is the implementation of a “care coordination infrastructure” whereby managed care organizations (“MCOs”) “administer a full array of services in an integrated model of care.” Doc. 286-3 at 4. Presbyterian Health Plan (“PHP”) is one of these MCOs, and it provides care coordination services pursuant to a contractual agreement known as the Medicaid Managed Care Services Agreement (the “HSD Contract”), which governs an MCO's obligations and responsibilities. Doc. 297-5 at 7. The HSD Contract requires PHP to provide care coordination services to its members,^[1] Doc. 297-5 at 7, which it accomplishes by subcontracting to outside entities like Magellan. See Doc. 297-7 at 11:18-22.

Care coordination services, as the name suggests, are the means by which PHP (and other contracting MCOs) work to ensure that members receive the full panoply of available healthcare services. The HSD Contract requires PHP, and its subcontractor Magellan, to engage with members to identify their specific health needs and then follow up with those members to implement related health practices. See generally Doc. 297-5 at 7-18. In its capacity as a subcontractor for PHP, Magellan is obligated to comply with the HSD Contract. Doc. 297-3 at 8 (requiring Magellan to comply with “all applicable Program Requirements, including those provisions of the [HSD] Contract applicable to subcontracts entered into by PHP[.]”). Magellan therefore structures its operational practices in accordance with the HSD Contract's requirements. Doc. 297-7 at 2, 12:25.

II. Care Coordination Process

The care coordination process is initiated by a CC who conducts an initial health risk assessment of a newly enrolled member or one who had a change in health care condition to obtain “basic health and demographic information.” Doc. 286-4 at 8, ¶ 4.4.2.1. The CC completes this initial assessment through the administration of a survey tool, which is comprised of a series of pre-determined questions. Id at 9, ¶ 4.4.2.5. If the member's responses to that questionnaire indicate certain health risks, then the CC administers a second survey tool, referred to as a Comprehensive Needs Assessment (“CNA”). See id. at 7, 11. Like the initial health risk assessment, the CNA is a standardized questionnaire, and all CCs utilize the same CNA survey tool. Id. at 12, ¶ 4.4.5.4; see also Doc. 297-7 at 7, 33:11-34:11 (testimony of Magellan's Chief Operating Officer (“COO”) Sarah Lopez that CCs all used the same CNA tool); Doc. 297-9 at 5, 91:13-21 (testimony of Magellan supervisor Lauren Tyler affirming that the questions on the CNA were “primarily, ‘yes,' ‘no,' multiple choice, or fill in the blank”); Doc. 280-1 at 385, 20:25-21:2 (testimony of CC Katherine Potts that CNAs were “all the same”); id. at 53, 25:18-19 (testimony of CC Carlos Campos that the CNA is “all multiple choice, yes or no”); id. at 66, 32:21-33:1 (testimony of Maureen Deakin that the CNA was “mostly . . . yes, no, multiple choice” but had limited options for “some free text that could be put in it”); id. at 333, 16:8-13 (testimony of CC Janice Jones that the CNA was “fill in the blank, yes-or-no questions, multiple choice”). The HSD Contract prohibits modifications of the CNA questionnaire without prior approval from HSD. Doc. 285 at 6; see also Doc. 286-4 at 12 ¶ 4.4.5.4 (“In performing the CNA [Magellan] shall use a tool that has been approved by HSD . . . Any changes to the assessment tool must be approved by HSD thirty (30) [c]alendar [d]ays prior to use by [Magellan].”).

While the CNA is formulaic, not all members will be presented with identical sets of questions. Variations may arise from members' individual responses about their particular health needs, but queries are nonetheless pre-populated and part of the CNA questionnaire.^[2] Doc. 297 at 8; see also Doc. 280-1 at 208, 22:9-23:2 (testimony of CC Orlando Garcia that the CNA prepopulated questions and care plans for clients).

After completing the CNA, the CC enters the member's responses into a computer and an algorithm assigns a “Care Coordination Level” of 1, 2, or 3. Doc. 297 at 6; Doc. 297-5 at 10 ¶ 4.4.3.1. At Levels 2 and 3, the CC generates a care plan based on the CNA and then follows up with “Touchpoint” evaluations. Doc 297 at 6; Doc. 297-5 at 17 ¶ 4.4.9.1. These Touchpoints are simply phone calls or in-person visits to check on the member's compliance and comfort with the care plan. Doc. 280-1 at 231, 30:18-31:12 (testimony of CC Coshele Clitso that Touchpoints involve direct contact with members to evaluate progress in their care plans); Doc. 297 at 9; see also Doc. 280-1 at 212, 52:12-18; id. at 231, 29:25-30:4. The frequency of these contacts is directly related the member's level of need. Doc. 297 at 9; Doc. 280-1 at 70, 66:21-67:13 (Deakin's testimony that CCs could decide to have more frequent check-ins with a member based on the member's need and the CC's clinical judgment).

To ensure that CCs carry out their duties in accordance with the HSD Contract, Magellan requires uniform training on how to conduct home visits, interview clients, and how to perform CNAs, care plans, and Touchpoints. Doc 297 at 12; Doc. 297-7 at 7-8, 36:12-37:6 (COO Lopez's testimony that Magellan provides uniform training to new CCs). CCs are also subject to close supervision and continual auditing to make sure that they do not deviate from the HSD Contract or Magellan's policies. See Doc. 297-7 at 11, 61:21-62:10 (COO Lopez's testimony detailing the extensive audit process for Magellan's care coordination services); Doc. 297-8 at 6, 49:25-50:9 (testimony of Magellan supervisor Danielle Guerrero that she monitors and audits CCs to ensure that CNAs are produced within established timelines); Doc. 297-9 at 3, 59:7-13 (supervisor Tyler's testimony that care plans are reviewed to ensure compliance with the HSD Contract).

III. Magellan's Alleged Overtime Violations

This case arises from Deakin's claim that as a CC she regularly worked more than forty hours per week and that she was not compensated for this additional labor. Doc. 121 at 2 ¶¶ 3-7. Deakin, on behalf of herself and other Magellan employees, sued for unpaid overtime wages and other damages pursuant to the NMMWA and FLSA. See generally id. She now moves for class certification of her NMMWA claims pursuant to Rule 23(a) and 23(b)(3). Doc. 285 at 1.

DISCUSSION

I. Class Definition and Certification

Deakin seeks certification of her NMWWA claims and defines the proposed class as follows:

All current and former Care Coordinators employed by Defendants in New Mexico from October 1, 2013 to the final date of judgment (the “Class”). The term “Care Coordinators” refers to individuals that provided care coordination services pursuant to the HSD Contract (and any amendments or restatements thereof) and held a job title that included the term “care coordinator,” including the job titles “Care Coordinator,” “Care Coordinator-Unlicensed,” and “Care Coordinator-Licensed.” The term “Care Coordinator” also includes individuals that performed the foregoing care coordination services under the HSD Contract and held the title “Senior Care Worker” prior to December 2016.

Id. at 1-2.

As the moving party, Deakin bears the burden of meeting the strictures of Rule 23, and this Court must conduct a rigorous analysis to ensure she has met those requirements. DG ex rel. Stricklin v. Devaughn, 594 F.3d 1188, 1194 (10th Cir. 2010). To that end, the Court begins by assessing whether Deakin has met Rule 23(a)'s threshold requirements of numerosity, commonality, typicality,^[3] and adequacy. Specifically, Deakin must demonstrate that:

(1) the class is so numerous that joinder of all members is impracticable;

(2) there are questions of law or fact common to the class;

(3) the claims or defenses of the representative parties are typical of the claims or defenses of the class; and

(4) the representative parties will fairly and

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