Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caDC-11-07084/USCOURTS-caDC-11-07084-0/pdf.json

Nature of Suit Code: 444
Nature of Suit: Civil Rights Welfare
Cause of Action: 

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United States Court of Appeals 

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued April 16, 2012 Decided June 8, 2012 

No. 11-7084 

NB, BY HER PARENT AND NEXT FRIEND, MICHELLE PEACOCK,

ET AL., 

APPELLANTS

v. 

DISTRICT OF COLUMBIA, A MUNICIPAL CORPORATION, ET AL., 

APPELLEES

Appeal from the United States District Court 

for the District of Columbia 

(No. 1:10-cv-01511) 

Bruce J. Terris argued the cause for appellants. With him 

on the briefs were Kathleen L. Millian, Jane M. Liu, and Jane 

Perkins. 

Rochelle Bobroff was on the brief for amicus curiae 

Legal Aid Society of the District of Columbia, et al., in 

support of appellants. 

Richard S. Love, Senior Assistant Attorney General, 

Office of the Attorney General for the District of Columbia, 

argued the cause for appellees. With him on the brief were 

Irvin B. Nathan, Attorney General, Todd S. Kim, Solicitor 

USCA Case #11-7084 Document #1377734 Filed: 06/08/2012 Page 1 of 15
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General, and Donna M. Murasky, Deputy Solicitor General.

Before: TATEL and KAVANAUGH, Circuit Judges, and 

GINSBURG, Senior Circuit Judge. 

Opinion for the Court filed by Circuit Judge TATEL. 

TATEL, Circuit Judge: Five Medicaid recipients filed this 

class action against the District of Columbia, alleging that the 

District systematically denies Medicaid coverage of 

prescription medications without providing the written notice 

required by federal and D.C. law. The district court dismissed 

the case on the pleadings, concluding that plaintiffs lacked 

standing to pursue their claims for injunctive and declaratory 

relief. Because we believe that the facts alleged in the 

complaint are sufficient to establish standing, we reverse. 

I. 

 Medicaid is a “cooperative federal-state program that 

provides federal funding for state medical services to the 

poor.” Frew v. Hawkins, 540 U.S. 431, 433 (2004). States 

electing to participate in Medicaid must comply with 

requirements imposed by federal law. Id. As relevant here, 

federal regulations mandate procedural protections for 

Medicaid recipients, including provision of written notice 

“[a]t the time of any action affecting [a Medicaid recipient’s] 

claim.” 42 C.F.R. § 431.206(b), (c)(2). Such notice must 

contain a statement of what action the state intends to take, 

the reasons for that action, the specific regulations supporting 

the action, the individual’s right to a hearing, and an 

explanation of the circumstances under which coverage will 

be continued if a hearing is requested. Id. § 431.210. District 

of Columbia law imposes the same requirements. D.C. Code 

§ 4-205.55. 

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 In the District, the Department of Health Care Finance 

(DHCF) implements much of the Medicaid program, 

including prescription drug coverage. As permitted under 

federal law, DHCF places restrictions on the medications 

covered by Medicaid. In particular, for certain medications—

including medications not on DHCF’s Preferred Drug List, 

medically necessary brand-name medications with generic 

equivalents, and medications with quantity limits—DHCF 

imposes a prior authorization requirement, meaning that the 

prescribing physician must obtain approval from DHCF 

before it will cover the prescription. See ACS Solutions 

Center, District of Columbia Pharmacy Benefits Management 

Prescription Drug Claims System (X2) Provider Manual 

Version 0.09, at 8, 11–12, 15 (2012), available at 

http://www.dcpbm.com/documents/DC%20MAA%20Provide

r%20Manual%20v9.pdf; see also 42 U.S.C. § 1396r8(d)(1)(A), (d)(5) (permitting prior authorization programs, 

subject to certain requirements). According to the allegations 

in the complaint, DHCF contracts with a company called 

Affiliated Computer Services, Inc. (ACS) to process claims 

for prescription drug coverage using an electronic claims 

management system. Compl. ¶ 29. Under this system, when a 

Medicaid recipient presents a prescription to a pharmacy, the 

pharmacy submits an electronic claim to ACS, and ACS 

immediately provides an automatic reply indicating whether 

Medicaid will cover the prescription. If coverage is denied, 

ACS gives the pharmacy a “rejection code” identifying the 

reason for the denial. Id. at ¶ 30. 

 Plaintiffs allege that the District, in violation of both 

federal and D.C. law, systematically fails to provide Medicaid 

recipients with timely and adequate written notice of the 

reasons for prescription coverage denials or reductions, the 

right to request a hearing, and the circumstances under which 

coverage will be reinstated if a hearing is requested. Deprived 

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of these procedural protections, plaintiffs claim they have no 

opportunity to prevent or challenge denials or reductions of 

coverage or to obtain reinstated coverage pending appeal. 

This, they argue, leaves them with two choices: (1) forego 

medically necessary prescriptions, at least temporarily, or (2) 

pay for the prescriptions with money needed for other life 

necessities. In their complaint, plaintiffs recount multiple 

instances in which they were denied prescription coverage 

without written notice of either the reason for the denial or 

their procedural rights. In some cases, plaintiffs allege, they 

had to pay out-of-pocket in order to obtain necessary 

medications; in other cases, they were eventually able to 

obtain their medication at a different pharmacy or at a later 

date. Plaintiffs seek no compensation for either the expense or 

inconvenience caused by DHCF’s failure to provide adequate 

notice. Instead, they request declaratory and injunctive relief 

requiring the District to provide the procedural protections 

that they claim are mandated by statute and by the Due 

Process Clause. 

 The district court dismissed the complaint, finding 

plaintiffs lacked standing to seek such relief. In its view, 

because “in many of the instances alleged by plaintiffs, they 

were, in fact, ultimately able to obtain their prescriptions at no 

cost,” there was “no injury.” NB v. District of Columbia, 800 

F. Supp. 2d 51, 56 (D.D.C. 2011). And though acknowledging 

that “plaintiffs may have suffered a cognizable injury based 

on the various out-of-pocket expenses incurred after being 

denied coverage,” the district court concluded that these 

injuries were neither traceable to defendants nor likely to be 

remedied by a favorable ruling. Id. at 57. Our review is de 

novo. LaRoque v. Holder, 650 F.3d 777, 785 (D.C. Cir. 2011) 

(“We review de novo the district court’s dismissal for lack of 

standing[.]”). 

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II. 

 Several well-accepted principles of standing govern our 

review of the district court’s decision. As we have explained, 

“[t]he mere violation of a procedural requirement . . . does not 

permit any and all persons to sue to enforce the requirement.” 

Fla. Audubon Soc’y v. Bentsen, 94 F.3d 658, 664 (D.C. Cir. 

1996) (en banc). Our jurisdiction is limited to “actual cases or 

controversies between proper litigants,” and if this suit is to 

proceed, plaintiffs must demonstrate that they have 

“constitutional standing to invoke the authority of an Article 

III court.” Id. at 661. As the Supreme Court explained in 

Lujan v. Defenders of Wildlife, to establish constitutional 

standing, plaintiffs must satisfy three elements: (1) they must 

have suffered an injury in fact that is “concrete and 

particularized” and “actual or imminent, not conjectural or 

hypothetical”; (2) the injury must be “fairly traceable to the 

challenged action of the defendant”; and (3) “it must be 

likely, as opposed to merely speculative, that the injury will 

be redressed by a favorable decision.” 504 U.S. 555, 560–61 

(1992) (alteration, omission, and internal quotation marks 

omitted). Where, as here, plaintiffs seek to enforce procedural 

(rather than substantive) rights, they must establish that “the 

procedures in question are designed to protect some 

threatened concrete interest of [theirs] that is the ultimate 

basis of [their] standing.” Id. at 573 n.8. Once plaintiffs 

establish that a law “accord[s] a procedural right to protect 

[their] concrete interests,” however, they “can assert that right 

without meeting all the normal standards for redressability 

and immediacy.” Id. at 572 n.7; see also Ctr. for Law & Educ. 

v. Dep’t of Educ., 396 F.3d 1152, 1157 (D.C. Cir. 2005) 

(“Where plaintiffs allege injury resulting from violation of a 

procedural right afforded to them by statute and designed to 

protect their threatened concrete interest, the courts relax—

while not wholly eliminating—the issues of imminence and 

redressability[.]”). In assessing plaintiffs’ standing, “we must 

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assume they will prevail on the merits” of their claims, 

LaRoque, 650 F.3d at 785—in this case, that the Constitution, 

federal regulations, and D.C. law require written notice when 

DHCF denies coverage of prescription medications. 

Moreover, because the district court dismissed the complaint 

at the pleadings stage, “the burden imposed” on plaintiffs to 

establish standing “is not onerous,” Equal Rights Ctr. v. Post 

Props., Inc., 633 F.3d 1136, 1141 n.3 (D.C. Cir. 2011), and 

“general factual allegations of injury resulting from the 

defendant’s conduct may suffice.” Lujan, 504 U.S. at 561. 

 This case turns primarily on the injury element of 

standing. Because plaintiffs seek only forward-looking 

injunctive and declaratory relief, “past injuries alone are 

insufficient to establish standing,” and plaintiffs must show 

that they “suffer[] an ongoing injury or face[] an immediate 

threat of injury.” Dearth v. Holder, 641 F.3d 499, 501 (D.C. 

Cir. 2011). As the District points out, none of the plaintiffs 

expressly allege an imminent threat of future injury in the 

complaint. This failure, however, is not by itself fatal. In 

reviewing a motion to dismiss, we “treat the complaint’s 

factual allegations as true . . . and must grant [plaintiffs] the 

benefit of all inferences that can be derived from the facts 

alleged.” In re Interbank Funding Corp. Sec. Litig., 629 F.3d 

213, 216 (D.C. Cir. 2010) (omission in original) (internal 

quotation marks omitted). The question, then, is whether the 

complaint contains facts that, viewed in the light most 

favorable to plaintiffs, establish an imminent threat of injury. 

At least with regard to one plaintiff, John Doe, the facts 

alleged satisfy this standard. See Comcast Corp. v. FCC, 579 

F.3d 1, 6 (D.C. Cir. 2009) (“[I]f one party has standing in an 

action, a court need not reach the issue of the standing of 

other parties when it makes no difference to the merits of the 

case.” (internal quotation marks omitted)). 

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 As an initial matter, Doe alleges past injuries that quite 

clearly constitute injury in fact. The procedural rights at issue 

are undoubtedly “designed to protect some threatened 

concrete interest of his,” Lujan, 504 U.S. at 573 n.8, namely 

his interest in timely receiving the Medicaid prescription drug 

benefits to which he is entitled. As amici curiae explain, 

DHCF’s alleged failure to provide adequate notice describing 

the reasons for coverage denials, the right to a hearing, and 

the potential for reinstatement of coverage pending appeal 

“can prevent a beneficiary from receiving essential 

medications indefinitely, or at least for some period of time 

while the individual tries to remedy the cause of denial 

without adequate information.” Legal Aid Soc’y et al. Amicus 

Br. 12. Moreover, even if recipients are able to pay out-ofpocket for medications, such payments “can result in financial 

harm to a population acutely vulnerable to such injury.” Id.

Alleging just such an injury, Doe explains that when DHCF 

denies coverage, his mother has to pay out-of-pocket for his 

medications, “typically” causing her to “forego paying a bill 

or another necessary living expense in order to buy the 

medication.” Compl. ¶ 74. Doe also alleges instances in 

which his mother paid for medications in response to 

coverage denials made without adequate notice and in 

circumstances where notice of the reasons for the denial 

would likely have enabled him to remedy the problem and 

obtain coverage. See id. ¶ 73 (explaining that Doe’s mother 

paid $75.99 for a prescribed nasal spray because she was 

never informed that the prior authorization previously 

obtained by Doe’s physician had expired, triggering the 

coverage denial); id. ¶¶ 63, 65 (describing repeated denials, 

without explanation, of Doe’s prescription for a second 

inhaler, causing his mother to pay out-of-pocket). We have no 

doubt that injuries of this sort—that is, procedural violations 

that threaten an individual’s ability to obtain Medicaid 

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coverage of prescription medications—satisfy the injury 

element of constitutional standing. 

 Nor do we doubt that Doe’s allegations are sufficient to 

establish an ongoing or imminent threat of injury. For one 

thing, the complaint alleges that Doe “continues to be denied 

refills of inhalers” without adequate notice. Id. at ¶¶ 69–70 

(emphasis added). And even if this ongoing harm were 

insufficient, Doe also alleges facts that establish an imminent 

threat of future injury. Whether Doe faces such a threat 

depends upon three contingencies: (1) whether Doe has 

alleged an ongoing need for prescription coverage; (2) 

whether he is likely to be denied coverage in the future; and 

(3) whether DHCF will fail to provide the required notice 

upon denial. 

 Doe has clearly alleged the first of these contingencies. 

According to the complaint, Doe is a disabled Medicaid 

recipient who “suffers from severe and chronic asthma,” as 

well as other conditions. Id. ¶¶ 60, 62, 71–72, 75. To prevent 

serious asthma attacks, he “must have 2 inhalers every 30 

days,” id. ¶ 63, along with other medications, and the out-ofpocket cost of his prescriptions ranges from “several hundred 

to over one thousand dollars each month,” id. ¶ 59. Given 

this, Doe is virtually certain to need Medicaid prescription 

coverage on a monthly basis for the foreseeable future. 

 Doe likewise faces an imminent threat of future coverage 

denials—the second contingency on our list—as demonstrated 

by two specific factual allegations. First, the complaint 

contains statistical evidence suggesting that DHCF denies 

prescription medication coverage at quite a high rate. Relying 

on data collected by ACS during an eleven-month period 

(April 30, 2008 to March 31, 2009), plaintiffs allege that “a 

significant number of point-of-sale electronic claims 

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submitted by pharmacy providers are denied on a daily basis.” 

Id. ¶ 40. On a single day during that eleven-month period 

(March 31, 2009), for example, District pharmacies denied 

nearly half (49.7 percent) of all Medicaid prescription claims. 

Id. And data from the DC Chartered Health Plan, which 

provides health care for some of the District’s Medicaid 

recipients, showed that in a single month (May 2009), DHCF 

denied coverage to 32.4 percent of Plan members who 

presented prescriptions. See id. ¶ 41. Of course, as the District 

points out, we have no way of knowing from these 

preliminary statistics alone whether these denial rates “relate[] 

to Medicaid beneficiaries who are in circumstances 

comparable to these plaintiffs’ circumstances.” Appellees’ Br. 

16. But at this stage of the proceedings, we grant plaintiffs the 

benefit of all reasonable inferences that can be drawn from the 

facts alleged. Viewed in this light, the complaint in this case 

fairly shows that Doe will face a relatively high likelihood of 

denial—possibly ranging from thirty to fifty percent—each 

time he submits a prescription for coverage. And given that 

Doe is virtually certain to submit at least one prescription 

every month, the cumulative chance that he will be denied 

coverage at some point over the course of a year—or “within 

some [other] fixed period of time in the future,” Newdow v. 

Roberts, 603 F.3d 1002, 1015 (D.C. Cir. 2010) (Kavanaugh, 

J., concurring in the judgment) (alternation and internal 

quotation marks omitted)—is likely even higher. See also Lee 

v. Weisman, 505 U.S. 577, 584 (1992) (finding “a live and 

justiciable controversy” because the alleged injury-causing 

event was likely to occur at plaintiff’s high school graduation, 

which was several years away when the complaint was filed); 

LaRoque, 650 F.3d at 788 (finding standing where the alleged 

injury-causing event was 19 months away). 

 Second, as plaintiffs point out, although “past exposure to 

illegal conduct does not in itself show a present case or 

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controversy regarding injunctive relief,” “[p]ast wrongs” may 

serve as “evidence bearing on whether there is a real and 

immediate threat of repeated injury.” City of Los Angeles v. 

Lyons, 461 U.S. 95, 102 (1983) (alteration and internal 

quotation marks omitted). And here, Doe’s past experience 

suggests that coverage denials and reductions are both 

frequent and recurring. According to the complaint, DHCF 

first reduced Doe’s inhaler coverage in March 2009, when a 

pharmacist told Doe’s mother that Medicaid would no longer 

cover two inhalers per month, forcing her to pay for her son’s 

second inhaler out-of-pocket. Compl. ¶ 63. Although DHCF 

resolved this problem for a few months, it recurred in June 

2009, and Doe continued to experience problems obtaining 

coverage for his second inhaler for another eight months until 

the problem was “fixed” for a second time in February 2010. 

Id. ¶¶ 63, 65. In the meantime, in December 2009, Doe began 

experiencing coverage denials for refills of his inhaler 

prescription. Id. ¶ 66. Although DHCF had previously 

covered the prescribed number of refills without requiring 

separate prior authorizations, one pharmacist informed Doe’s 

mother that Medicaid would no longer cover refills unless 

Doe’s physician obtained a prior authorization for each thirtyday supply. See id. ¶¶ 66–67. And in May 2010, Doe 

encountered yet another prior authorization problem when he 

was denied coverage of a nasal spray prescription, forcing his 

mother to pay more than $75 out-of-pocket. Id. ¶ 73. Because 

the pharmacy never informed Doe’s mother of the reason for 

the denial, either orally or in writing, she had no way of 

knowing that coverage had been denied because the 

medication, which Doe had received on at least five prior 

occasions without any problem, was subject to a prior 

authorization requirement and that the existing prior 

authorization had expired. Id. 

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 The District contends that Doe’s history of coverage 

denials actually undermines his claim to standing. Because his 

coverage problems have been “fixed,” the District argues, 

Doe is unlikely to experience denials in the future. Appellees’ 

Br. 14; Oral Arg. Rec. at 13:03–25. But Doe’s experience—

especially DHCF’s repeated denials of his inhaler prescription 

for recurring and varying reasons—suggests that, in practice, 

resolving a denial once does not necessarily make a problem 

less likely to recur and that DHCF’s evolving coverage 

restrictions can result in denials of prescriptions previously 

obtained without difficulty. Moreover, given that prior 

authorizations expire, and, as amici curiae explain, that 

doctors treating hundreds of patients cannot easily stay 

abreast of how any given patient is insured and which 

prescriptions require prior approval, it is far from clear that 

resolving a prior authorization issue once will make a 

Medicaid recipient less likely to experience prior 

authorization-based denials in the future. See Legal Aid Soc’y 

et al. Amicus Br. 15 (“Many physicians care for patients with 

a wide variety of insurance coverage options and do not know 

or simply guess at which medication is preferred, and thus 

available with or without prior authorization, under a given 

patient’s insurance plan.”). Indeed, as noted above, the 

complaint alleges that Doe “continues to be denied refills of 

inhalers,” Compl. ¶ 69, presumably due to continued prior 

authorization problems (though, of course, without adequate 

notice, Doe may be unable to determine whether any given 

denial stems from lack of prior authorization or some other 

DHCF-imposed restriction). All of this, we believe, is 

sufficient to show that Doe is likely to be denied coverage in 

the future. 

 Finally, the complaint clearly alleges the third 

contingency required for imminence: that DHCF has a policy 

of denying prescription coverage without providing the 

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various forms of notice that plaintiffs claim are required. 

Specifically, the complaint alleges not only that numerous 

specific denials of coverage were made without adequate 

notice, see id. ¶¶ 46, 48–49, 53–54, 70, 73, but also that 

DHCF’s guidance and manuals for ACS and pharmacies 

(obtained by plaintiffs through a freedom of information law 

request) contain no provisions for giving Medicaid recipients 

written notice of the reasons for coverage denials, their right 

to a hearing, or their right to continued coverage pending 

appeal, id. ¶¶ 34–39. In other words, assuming plaintiffs are 

correct that such notice is required (as we must in evaluating 

standing), and taking their detailed allegations as true (as we 

must at this stage), it seems extremely likely that Doe will 

suffer a procedural injury—and a concomitant threat to his 

interest in Medicaid prescription drug benefits—if DHCF 

denies him coverage in the future. 

 To be sure, these allegations do not add up to absolute 

certainty. But absolute certainty is not required. Unlike 

plaintiffs in Lujan, Doe, to the extent he has any control over 

future injury, has alleged not mere “ ‘some day’ intentions” to 

seek coverage, Lujan, 504 U.S. at 564, but an actual, ongoing 

need for monthly prescriptions paid for by Medicaid. And the 

probability that Doe will experience future coverage denials, 

accompanied by deprivations of procedural protections 

affecting his concrete interest in prescription benefits, is far 

from speculative. Compare O’Shea v. Littleton, 414 U.S. 488, 

496 (1974) (finding no standing where “the prospect of future 

injury rests on the likelihood that respondents will again be 

arrested for and charged with violations of the criminal law 

and will again be subjected to bond proceedings, trial, or 

sentencing before petitioners”). Given Doe’s persistent health 

problems, he will regularly seek prescription coverage from 

DHCF and will almost certainly suffer the alleged procedural 

violations if, as is quite likely, coverage is denied. Cf. Shays v. 

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FEC, 414 F.3d 76, 85 (D.C. Cir. 2005) (“[W]hen agencies 

adopt procedures inconsistent with statutory guarantees, 

parties who appear regularly before the agency suffer injury 

to a legally protected interest in fair decisionmaking.” 

(internal quotation marks omitted)). We thus conclude that the 

facts alleged in plaintiffs’ complaint and the reasonable 

inferences drawn from them establish a “ ‘likelihood’ of 

injury that rises above the level of ‘unadorned 

speculation’ ”—that is, a “ ‘realistic danger’ ” that Doe will 

suffer future harm. See Biggerstaff v. FCC, 511 F.3d 178, 183 

(D.C. Cir. 2007) (quoting Pennell v. City of San Jose, 485 

U.S. 1, 8 (1988)) (holding that plaintiff had standing to 

challenge the legality of a defense where plaintiff had 

encountered the defense in past litigation and alleged that he 

had refrained from suing other companies who would likely 

raise the defense). 

 Having determined that Doe faces an imminent threat of 

future injury, we find that the remaining two elements of 

constitutional standing are easily satisfied. With respect to 

causation, the alleged procedural injury—and the associated 

threat to Doe’s interest in prescription drug benefits—is 

directly traceable to DHCF’s failure to establish policies and 

procedures for providing the required notices when 

prescription coverage is denied at the point of sale. Claiming 

otherwise, the District contends that Doe’s injuries are 

traceable not to DHCF’s actions, but instead to the actions of 

private physicians who failed to obtain required prior 

authorizations or to Doe’s “need for more medication than 

was allowed by Medicaid rules.” Appellees’ Br. 27. But these 

arguments conflate the cause of Doe’s coverage denials—

such as lack of prior authorization and Medicaid coverage 

restrictions—with the cause of his alleged injury. For 

purposes of Doe’s standing, it makes no difference that a 

physician may cause a coverage denial by failing to seek prior 

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authorization, for the injury he alleges is not the initial denial 

of coverage, but rather DHCF’s failure to provide the 

information he needs to remedy that denial and obtain 

medically necessary prescriptions without undue cost or 

delay. The complaint nicely illustrates just how DHCF’s 

actions cause this type of injury. Had DHCF’s policies 

required pharmacies to provide written notice of the reasons 

for coverage denials, as Doe alleges the law requires, Doe’s 

mother could have remedied the denial of Doe’s nasal spray 

prescription by contacting Doe’s doctor and asking him to 

obtain the necessary prior authorization. But without such 

notice, Doe’s mother lacked sufficient information to resolve 

the coverage issue (information she obtained only two months 

later) and had to pay out-of-pocket for the medication. See

Compl. ¶ 73. 

 Finally, the remedy Doe seeks—declaratory and 

injunctive relief requiring the District to provide Medicaid 

recipients written notice of the reasons for prescription 

coverage denials, the right to request a hearing, and the 

circumstances under which coverage will be reinstated if a 

hearing is requested—will redress his alleged injuries by 

ensuring that he receives the information he needs to correct 

any underlying problems with his coverage in a timely 

manner. True, notice may not always enable Doe to obtain 

full and prompt prescription coverage. Some denials may 

ultimately prove justified and some delay may be inevitable. 

But a “plaintiff who alleges a deprivation of a procedural 

protection to which he is entitled never has to prove that if he 

had received the procedure the substantive result would have 

been altered.” Sugar Cane Growers Coop. of Fla. v. 

Veneman, 289 F.3d 89, 94 (D.C. Cir. 2002). Given this 

“relax[ed]” standard for redressability in procedural rights 

cases, Ctr. for Law & Educ., 396 F.3d at 1157, we have no 

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trouble finding that a favorable decision would redress Doe’s 

injuries. 

 Satisfied that Doe’s allegations sufficiently establish 

injury, causation, and redressability, we conclude that Doe 

has standing, at least at this stage of the proceedings, to 

pursue his claims for injunctive and declaratory relief. Thus 

having no need to decide whether the other plaintiffs have 

standing, see supra at 6, we reverse and remand for further 

proceedings consistent with this opinion. 

 

So ordered. 

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