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Montpelier v. Green Mountain Care

United States District Court, D. Vermont

October 11, 2019

GREEN MOUNTAIN CARE and CORY GUSTAFSON, Commissioner Department of Vermont Health Access, Defendants.


          William K. Sessions, III District Court Judge.

         Plaintiff Princess C. Montpelier, proceeding pro se, claims the Defendants wrongfully denied her funding for transportation to out-of-state medical providers. Defendants now move to dismiss, arguing that Plaintiff's claims are barred by res judicata, that the Complaint fails to state a claim under 42 U.S.C. § 1983, and that Plaintiff has not alleged personal involvement by Defendant Cory Gustafson. The motion to dismiss is unopposed.

         For the reasons set forth below, Defendants' motion to dismiss is granted. Plaintiff may amend her Complaint within 30 days. Failure to file a timely Amended Complaint will result in the dismissal of Plaintiff's claims with prejudice.

         Factual Background

         Plaintiff alleges that Green Mountain Care has repeatedly denied her the funding she requires to travel to certain medical providers. According to Defendants, Green Mountain Care is a Division of the Department of Vermont Health Access (“DVHA”). DVHA apparently reviews, and can either grant or deny requests from Medicaid recipients for funding to subsidize health care-related transportation.

         In this case, Plaintiff cites denials of her requests for transportation to two out-of-state providers. She first claims that Defendants denied her funding for transportation to Dartmouth Hitchcock Medical Center, which is located in New Hampshire. DVHA has allegedly approved funds for Plaintiff to receive care at the University of Vermont Medical Center (“UVMC”) in Burlington, Vermont, but Plaintiff claims the providers at UVMC have “discriminated horrendously against [her] in the past, ” including a refusal to see her in 2009. ECF No. 3 at 1.

         Plaintiff similarly claims that she has been denied funding to travel to New York City for care. The Complaint alleges that Dr. Themistocles Phopsaltis was the primary surgeon on a team that performed Plaintiff's surgery on December 14, 2018. Defendants have allegedly denied Plaintiff's request for transportation to a post-operative appointment with Dr. Phopsaltis in New York.

         The Complaint asserts that this Court has jurisdiction because “the Federal government contributes to Medicaid of each state. And currently the State of Vermont is not delivering.” Id. at 3. For relief, Plaintiff asks the Court to (1) order Green Mountain Care to provide her with the transportation needed to attend appointments at Dartmouth Hitchcock Medical Center and the office of Dr. Phopsaltis, and (2) reimburse her for transportation and hotel expenses as necessary.


         I. Legal Standards

         “To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.'” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)); see Fed. R. Civ. P. 12(b)(6). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Iqbal, 556 U.S. at 678. When interpreting a pro se plaintiff's complaint, a court should construe the complaint liberally and interpret it to raise the strongest arguments that it suggests. See Weixel v. Bd. of Educ. of City of N.Y., 287 F.3d 138, 146 (2d Cir. 2002).

         In this case, the pending motion to dismiss is unopposed. The lack of opposition does not mean, however, that the motion must be granted. See Haas v. Commerce Bank, 497 F.Supp.2d 563, 564 (S.D.N.Y. 2007). “In deciding an unopposed motion to dismiss, a court is to ‘assume the truth of a pleading's factual allegations and test only its legal sufficiency. . . .'” Id. (quoting McCall v. Pataki, 232 F.3d 321, 322-23 (2d Cir. 2000)).

         II. Res Judicata

         Defendants' first argument is that Plaintiff's claims are barred by res judicata. This is not the first lawsuit in which Plaintiff has alleged violation of a federal right to Medicaid-funded transportation. In 2006, under her former name Esther Avila, Plaintiff sued State of Vermont officials and others claiming a right to Medicaid funding for transportation to medical appointments. See Avila v. Smith, No. 2:05-cv-309, 2006 WL 1519420, at *1 (D. Vt. May 26, 2006). In that case, the Court granted Defendants' motion to dismiss ...

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