ROBERT B. CIARPAGLINI, Plaintiff-Appellant,
FELICIA NORWOOD, in her official capacity as Director of Illinois Department of Healthcare and Family Services, et al., Defendants-Appellees
from the United States District Court for the Northern
District of Illinois, Western Division. No. 13 C 50213 --
Philip G. Reinhard, Judge.
ROBERT B. CIARPAGLINI, Plaintiff - Appellant: Barry
Levenstam, Attorney, Erica L. Ross, Attorney, JENNER & BLOCK
LLP, Chicago, IL.
BRUCE V. RAUNER, in his official capacity as Govenor of the
State of Illinois, FELICIA F. NORWOOD, in her official
capacity as Director of Illinois Department of Healhcare and
Family Services, LISA ARNDT, in her official capacity of
Bureau Chief of Healthcare and Family Services Pharmacy
Services, JAMES PARKER, in his official capacity as Deputy
Director of Medical Services of Healthcare and Family
Services, HEATHER STEANS, in her official capacity as Senator
of the State of Illinois, Defendants - Appellees: Timothy M.
Maggio, Attorney, OFFICE OF THE ATTORNEY GENERAL, Chicago,
WOOD, Chief Judge, and MANION and HAMILTON, Circuit Judges.
HAMILTON, Circuit Judge.
Plaintiff Robert B. Ciarpaglini, an Illinois Medicaid
participant, challenges Illinois legislation that caps at
four the number of prescriptions a Medicaid recipient can
receive without prior approval within a thirty-day period.
See 305 Ill. Comp. Stat. 5/5-5.12(j). At the time he filed
suit, he was subject to that legislation and alleged he was
struggling to obtain his medications because of it. While his
suit was pending, though, he was moved to a managed care
program. As a result he is no longer subject to that cap.
main dispute before us, though not the only one, is whether
the transfer to managed care rendered moot Ciarpaglini's
claims for declaratory and injunctive relief. The district
court held that it did. Ciarpaglini v. Quinn, No. 13
C 50213, 2014 WL 1018146 (N.D.Ill. Mar. 17, 2014). Although
Ciarpaglini offered evidence that the switch might not be
permanent, the court held his arguments were " simply
speculation," " no more than a guess," and
insufficient to create a " reasonable expectation"
that the four-prescription limit would apply to him in the
future. Id. at *3.
that there is insufficient evidence in the record to
determine whether Ciarpaglini's claims for injunctive
relief are moot, a conclusion we explain further below. We
remand this matter to the district court for limited
fact-finding proceedings aimed at permitting both sides to
develop a record on the question of mootness. We retain
jurisdiction of this matter pending completion of those
Factual and Procedural Background
central claim in this appeal is plaintiff's challenge
under federal law to what he calls the "
four-prescription limitation" in Illinois's Medicaid
program. The Medicaid program covers prescription medicines.
As a cost-control measure, Illinois enacted legislation in
2012 requiring prior approval for reimbursement for more than
four prescriptions for one patient within a thirty-day
period. 305 Ill. Comp. Stat. 5/5-5.12(j). We refer to this
provision as the prior-approval requirement.
accept plaintiff Robert Ciarpaglini's well-pled
allegations as true for purposes of this appeal. See St.
John's United Church of Christ v. City of Chicago,
502 F.3d 616, 625 (7th Cir. 2007), quoting Long v.
Shorebank Development Corp., 182 F.3d 548, 554 (7th Cir.
1999). Because courts may properly look beyond the
jurisdictional allegations of a complaint and view evidence
to determine whether subject matter jurisdiction exists in
fact, id., we also consider Ciarpaglini's
declaration, the truth of which defendants have not
challenged at this stage of the case.
Ciarpaglini is an Illinois Medicaid recipient. He suffers
from several chronic conditions, including bipolar disorder,
attention deficit hyperactivity disorder, panic disorder, and
generalized anxiety disorder. Doctors have prescribed at
least seven medications to manage these conditions.
Ciarpaglini alleges that after the prior-approval requirement
took effect, he could not, at least at times, obtain the
medications he needed. (He acknowledges the prior-approval
mechanism but calls the system " fraught with
flaws" and says it does not guarantee he will be able to
get his medications.) He alleges that as a result he has
contemplated committing suicide, committing petty crimes so
that he would be jailed, or checking himself into
hospitals just to get the medications he needed.
informal complaints to state officials failed to produce
action, Ciarpaglini filed this pro se lawsuit in June 2013.
He challenges the prior-approval requirement as a violation
of federal Medicaid law, the Americans ...