Fox, et al v. Massey Ferguson Inc, et al

Filing 422

ORDER denying 421 Motion for Reconsideration. Signed by District Judge Arthur J. Tarnow. (MLan)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
SOUTHERN DIVISION
LARRY FOX, ET. AL.,
Case No. 93-74615
Plaintiffs,
SENIOR U.S. DISTRICT JUDGE
ARTHUR J. TARNOW

v.
MASSEY-FERGUSON,

U.S. MAGISTRATE JUDGE
ANTHONY P. PATTI

Defendant.
______________________________/
JOSEPH GOLDEN, ET. AL.,
Case No. 93-40530
Plaintiffs,
SENIOR U.S. DISTRICT JUDGE
ARTHUR J. TARNOW

v.
LUCAS VARITY KELSEY HAYES,

U.S. MAGISTRATE JUDGE
ANTHONY P. PATTI

Defendant.

______________________________/
ROBERT COLBY, ET. AL.,
Case No. 94-71698
Plaintiffs,
SENIOR U.S. DISTRICT JUDGE
ARTHUR J. TARNOW

v.
MASSEY-FERGUSON,

U.S. MAGISTRATE JUDGE
ANTHONY P. PATTI

Defendant.
/

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ORDER DENYING PLAINTIFF’S MOTION FOR RECONSIDERATION 94-71698 [337];
93-40530 [532]; 93-74615 [421]
On November 8, 2016 the Court entered an order granting Plaintiff’s Motion
to Enforce the Settlement Agreement, denying Plaintiff’s Motion for Contempt and
denying as moot Defendant’s Motion for Order Clarifying and Declaring TRW’s
Rights and Responsibilities Relative to the Delivery of Prescription Drug Benefits
Mandated by the Settlement Agreement [420]. Plaintiff’s filed a Motion for
Reconsideration on November 22, 2016 [421], requesting that the Court reconsider
its denial of the Motion for Sanctions. For the reasons stated below, Plaintiff’s
Motion for Reconsideration [421] is DENIED.
STANDARD OF REVIEW
Local Rule 7.1(h)(3) provides that:
Generally, and without restricting the court’s discretion, the
court will not grant motions for rehearing or reconsideration
that merely present the same issues ruled upon by the court,
either expressly or by reasonable implication. The movant must
not only demonstrate a palpable defect by which the court and
the parties and other persons entitled to be heard on the motion
have been misled but also show that correcting the defect will
result in a different disposition of the case.
See Hansmann v. Fid. Invs. Institutional Servs. Co., 326 F.3d 760, 767 (6th Cir.
2003) (A motion for reconsideration is granted only “if the movant demonstrates
that the district court and the parties have been misled by a palpable defect, and
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correcting the defect will result in a different disposition of the case”). “A palpable
defect is a defect which is obvious, clear, unmistakable, manifest or plain.” Fleck
v. Titan Tire Corp., 177 F. Supp. 2d 605, 624 (E.D. Mich. 2001) (internal citations
and quotations omitted). “The decision whether to grant reconsideration lies
largely within the discretion of the court.” Yuba Natural Res., Inc. v. United States,
904 F.2d 1577, 1583 (Fed. Cir. 1990).
ANALYSIS
In their Motion, Plaintiff contend that sanctions should be applied for the
violation of the 2011 Order because Defendants’ prior authorization process, first
implemented in 2014, required an appeals process to challenge adverse decisions,
it violates the 2011 Judge Cook Order. They also challenge the denial of sanctions,
contending that the later modifications also violate the 2011 order because they are
not as simple and automatic as the Defendants envision. Therefore, it is argued that
the Court’s previous order was based on a palpable defect that mischaracterized the
changes implemented by Defendants, and the Court should render sanctions as
appropriate.
“A litigant may be held in contempt if his adversary shows by clear and
convincing evidence that ‘he violate[d] a definite and specific order of the court
requiring him to perform or refrain from performing a particular act or acts with
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knowledge of the court's order.’” NLRB v. Cincinnati Bronze, Inc. 829 F.2d 585,
591 (6th Cir. 1987) (citation omitted). To be held in contempt, the prior Order
must be clear and unambiguous, with ambiguities being resolved in favor of the
party charged with contempt. Liberte Capital Grp., LLC v. Capwill, 462 F.3d 543,
551 (6th Cir. 2006).
While Plaintiffs contend that the 2014 changes had an appeal process similar
or identical to the one envisioned in the 2011 order, there are important differences
between the two processes contemplated by the Court in 2011 and those currently
before the Court. The 2011 order specifically addressed health care plan changes
that, inter alia: “(1) completely eliminated an entire drug class (i.e., the proton
pump inhibitors (PPIs)) for the treatment of certain stomach conditions,” and “(2)
excluded many standard medications from coverage, even for those conditions in
which PPIs are allowed as a form of treatment.” [369 at 10]. Thus, the order
addressed a situation in which entire categories of drugs were not covered without
prior authorization, resulting in a violation of the settlement agreement per the
order. The order also specifically refused to require Defendants “to cover all
legend drugs prescribed by a doctor for the treatment of any and all medical
conditions.” [Id at 19].

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In contrast, the process instituted in 2014 did not make an entire class of
previously covered drugs unavailable under the medical plan without prior
approval; rather the plan offered approved generic equivalents that did not require
a pre-approval process with the option to undergo an appeals process to obtain the
previously covered drug. Given the text of the order, it is neither clear nor
unambiguous whether a prior approval process would be allowed in situations in
which only certain drugs within a particular drug class deemed not medically
necessary, were not covered without prior approval, and in which generic
alternatives, deemed medically equivalent, were available and covered by
insurance, as was the case in 2014 through to the present.
Therefore, given the difference in the content of the changes to the plan at
issue in 2011 and in 2014 to present, regardless of any dispute concerning how
onerous the approval process actually was, or that the 2014 process included an
appeal that was very similar or identical to one previously found to violate the
settlement agreement, the Court disagrees that sanctions should be granted. It was
not unreasonable that Defendants’ interpreted the order to permit the various
changes to the health plan at issue since 2014, given the ambiguity in the order
concerning how the medical necessity and prior approval processes would be dealt
with in cases where entire classes of drugs were not affected and Plaintiffs retained
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the ability to have full coverage of a generic substitute without prior approval.
Accordingly,
IT IS ORDERED that Plaintiff’s Motion for Reconsideration 94-71698
[337]; 93-40530 [532]; 93-74615 [421] is DENIED.
SO ORDERED.

Dated: February 9, 2017

s/Arthur J. Tarnow
Arthur J. Tarnow
Senior United States District Judge

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