Opinion ID: 2784541
Heading Depth: 2
Heading Rank: 1

Heading: Past Proceedings

Text: This action began in 1993 when Plaintiffs, representatives of a class of over 1.5 million Texas children eligible for EPSDT, sued Defendants under 42 U.S.C. § 1983 for violations of federal Medicaid law in the state’s implementation of the Program. 1 As noted, the parties concluded a consent decree in 1996 in which Defendants promised to implement a number of changes, among which was a training program for participating health care providers. 2 A few years later, after little progress had been made, the district court found Defendants in violation of the Decree (“Frew I”). 3 We reversed, solely on Defendants’ challenge to the Decree’s validity under the Eleventh Amendment (“Frew II”). 4 The Supreme Court then reversed Frew II (“Frew III”). In Frew III, the Court noted that Defendants’ legitimate concerns over the Decree’s potential to “undermine the sovereign interests and accountability of state governments” were not properly addressed to the Eleventh Amendment but to the district court’s power, under Rule 60(b)(5), to grant Frew ex rel. Frew v. Hawkins, 540 U.S. 431, 434 (2004); Frew v. Gilbert, 109 F. Supp. 1 2d 579, 587 (E.D. Tex. 2000). 2 See Frew, 109 F. Supp. 2d at 588. 3 See id. at 678. 4 See Frazar v. Gilbert, 300 F.3d 530, 543 (5th Cir. 2002). 2 Case: 14-40048 Document: 00512959210 Page: 3 Date Filed: 03/05/2015 No. 14-40048 relief “if ‘it is no longer equitable that the judgment should have prospective application.’” 5 The Court reiterated the “flexible standard” for modification of institutional-reform consent decrees 6 found in Rufo v. Inmates of Suffolk County Jail 7 and urged district courts to return the “responsibility for discharging the State’s obligations” promptly to state officials once “the objects of the decree have been attained.” 8 On remand, we returned the case to the district court (“Frew IV”). 9 Defendants moved to dissolve the Decree under Rule 60(b)(5)’s third clause, claiming that its continued enforcement would be inequitable. 10 The district court, applying Rufo and Frew III, denied their motion, and we affirmed (“Frew V”). 11 Back in the district court, the parties agreed on eleven corrective action orders, each aimed at bringing Defendants into compliance with a specific portion of the Decree. CAO 637-8, the order at issue in this appeal, implemented ¶¶ 124–30 of the Decree, which concerned deficiencies in Medicaid-participating pharmacies’ understanding of EPSDT. All eleven orders were entered into the record in 2007. 12