Molina Healthcare of New Mexico Lawsuit - Amended Complaint

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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO Nora Candelaria,

Plaintiff, v.

No. 2:18-cv-00725-SMV-GBW

Molina Healthcare, Inc., and Molina Healthcare of New Mexico, Inc.,

Defendants.

FIRST AMENDED CLASS ACTION COMPLAINT Plaintiff Nora Candelaria brings this action individually and on behalf of the proposed New Mexico Class Members (defined below) against Defendants Molina Healthcare, Inc. and Molina Healthcare of New Mexico, Inc. (collectively, “Defendants”), and in support shows the Court the following: I. 1.

SUMMARY

This is an opt-out Rule 23 class action brought pursuant to the New Mexico Minimum

Wage Act, N.M. Stat. Ann. §50-4-19, et seq. (“NMMWA”) and Federal Rule of Civil Procedure 23.

2.

Defendants employed Plaintiff and the NM Class Members as “Case Managers”

whose main job duties consist of communicating with and gathering data from members to

document members’ medical circumstances in Defendants’ computer system (“Data Collection”), inputting member data into Defendants’ computer system (“Data Entry”), using established guidelines to maximize utilization of plan resources through application of predetermined criteria (“Care Utilization”), providing information to members and providers regarding plan benefits and resources to address members healthcare needs (“Plan

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Education”), and working with members and providers to set up medical care (“Care Coordination”), and other similar work (collectively, “Care Management Work”).

3.

Defendants misclassified “Case Managers” as exempt from overtime, paid them a

salary, and failed to pay them overtime despite regularly working over 40 hours per week (“OT Misclassification Policy”).

4.

Because Defendants have violated the NM Wage Law as part of a “continuing course

of conduct,” this lawsuit should encompass all violations that occurred as a result of that “continuing course of conduct regardless of the date on which the occurred.” N.M. Stat. Ann. § 50–5–32.

II. 6.

PARTIES

Plaintiff Nora Candelaria worked for Defendants as a Case Manager, and specifically

as a Case Manager II, over the last two years and worked over 40 hours in this District for one or more weeks during that time period.

7.

Plaintiff brings her NMMWA claim individually and as a Rule 23 Class Action on

behalf of the “NM Class Members”. The NM Class Members consist of Defendants’ employees referred to as Case Managers who received pay on a salary basis that worked over 40 hours in at least one workweek in New Mexico since the time Defendants began paying Case Managers pursuant to the OT Misclassification Policy. The NM Class Members include, without limitation, all of Defendants’ employees referred to as Case Managers who perform Case Management Work or similar job duties to assist Defendants with administering health plans.

8.

Defendant Molina Healthcare, Inc. is a Delaware corporation that has appointed

Corporation Service Company located at 123 E. Marcy Street, Suite 101, Santa Fe, NM 87501 as its agent for service of process in this state.

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9.

Defendant Molina Healthcare of New Mexico, Inc. is a New Mexico corporation that

has appointed Corporation Service Company located at 123 E. Marcy Street, Suite 101, Santa Fe New Mexico 87501 as its agent for service of process in this state.

III. 10.

JURISDICTION AND VENUE

This Court has subject matter jurisdiction over the claims made in this complaint

pursuant to 28 U.S.C. § 1332(d) because the case involves over 100 NM Class Members; the NM Class Members claims excess $5,000,000 in the aggregate, exclusive of costs or interest; and at least one NM Class Members is from a different state than Defendants. Alternatively, the Court has supplemental jurisdiction pursuant to 28 U.S.C § 1367.

11.

Venue is proper in this District pursuant to 28 U.S.C. § 1391 because the events

forming the basis of the suit occurred in this District and because one or more of the Parties resides in this District.

IV. 12.

COVERAGE

At all relevant times, Defendants acted, directly or indirectly, in the interest of an

employer or joint employer with respect to Plaintiff and the NM Class Members.

13.

At all relevant times, Defendants have been employers or joint employers within the

meaning of the NMMWA and specifically N.M. Stat. Ann. § 50–4-21(B).

14.

At all relevant times, Plaintiff and the NM Class Members constituted individual

employees employed by an employer as the term “employee” is understood under N.M. Stat. Ann. § 50–4-21(C).

V. 15.

FACTUAL ALLEGATIONS

Plaintiff incorporates all allegations previously made in this complaint.

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16.

Defendants have continuously conducted business in this judicial district over the last

three years and since the time they began paying the NM Class Members pursuant to the OT Misclassification Policy.

17.

Plaintiff worked for Defendants as a Case Manager in New Mexico from

approximately August 2015 to May 2017.

18.

As a Case Manager, Plaintiff’s primary job duties consisted primarily of Case

Management Work, including Data Collection, Data Entry, Care Utilization, and Plan Education.

19.

As a Case Manager, Plaintiff’s job duties did not require Plaintiff to complete a

prolonged course of specialized instruction directly related to her position. Instead, her job duties involved the application of knowledge gained through training provided by Defendants.

20.

As a Case Manager, Plaintiffs’ job duties were routine and rote and did not involve the

exercise of discretion or independent judgment with respect to matters of significance for Defendants.

For example, as a Case Manager, Plaintiff was not allowed to deny a member’s claim for benefits or services under any circumstances without approval of senior management.

21.

Plaintiff worked overtime during one or more individual workweeks in New Mexico

during the relevant time period.

22.

Defendants did not pay Plaintiff overtime for all hours she worked in excess of 40 per

workweek.

23.

Instead of paying Plaintiff overtime pay, Defendants classified Plaintiff as exempt and

paid her a salary with no overtime pay for her many hours of overtime work.

24.

Defendants knew that Plaintiff worked in excess of 40 hours per week.

25.

Plaintiff is entitled to overtime pay for all hours worked in excess of 40 per workweek.

26.

Since beginning its OT Misclassification Policy, Defendants have employed NM Class

Members whose primary job duties include Care Management Work.

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27.

As Case Managers, the NM Class Members job duties did not require them to

complete a prolonged course of specialized instruction directly related to their positions. Instead, their job duties involved the application of knowledge gained through training provided by Defendants.

28.

As a Case Managers, the NM Class Members’ job duties were routine and rote and did

not involve the exercise of discretion or independent judgment with respect to matters of significance for Defendants. For example, as Case Managers, the NM Class Members were prohibited from denying a member’s claim for benefits or services under any circumstances without approval of senior management.

29.

The NM Class Members worked overtime during one or more individual workweeks

in New Mexico during the relevant time period.

30.

Defendants did not pay the NM Class Members overtime pay for all hours they

worked in excess of 40 per workweek during the relevant time period.

31.

Instead of paying the NM Class Members overtime pay, Defendants classified them

as exempt and them a salary with no overtime pay for their many hours of overtime work.

32.

Defendants knew that the NM Class Members worked in excess of 40 hours per week.

33.

The NM Class Members are entitled to overtime pay for all hours worked in excess of

40 per workweek.

VI.

CLASS ALLEGATIONS

34.

Plaintiff incorporates all allegations previously made in this Complaint.

35.

Plaintiff brings her NMMWA claims as a class action under Federal Rule of Civil

Procedure 23.

36.

Plaintiff brings her class action on behalf of the NM Class Members, which is

maintainable under subsections (1), (2), (3), and (4) of Rule 23(a).

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37.

The NM Class Members are so numerous that their joinder is impracticable. While the

precise number of the NM Class Members is unknown, at least 100 NM Class Members have worked at least one workweek of more than 40 hours in New Mexico during the relevant time period.

38.

Common questions of law and fact for the NM Class Members predominate over any

questions affecting any individual member, including: (1) whether Defendant violated the NMMWA by filing to pay the NM Class Members overtime pay for all hours worked in excess of 40 per workweek; (2) the proper measure of damages sustained by the NM Class Members; and (3) whether Defendant should be enjoined for such violations in the future.

39.

Plaintiff’s claims are typical of those of the NM Class Members. Plaintiff and the NM

Class Members: (1) had the same primary job duties; (2) were classified as exempt from overtime; (3) worked in New Mexico in at least one workweek for over 40 hours since the Defendant initiated its OT Misclassification Policy; and (4) were denied overtime at a rate of one-and-one half times their regular rates of pay for all overtime hours worked.

40.

Plaintiff will fairly and adequately protect the NM Class Members’ interests and has

retained counsel experienced in complex wage and hour collective and class litigation.

41.

The class action is maintainable under subsection (3) of Rule 23(b) because common

questions of law and fact predominate among the class members and because the class action is superior to other available methods for the fair and efficient adjudication of the controversy.

42.

Class litigation is also superior because it will preclude the need for unduly duplicative

litigation resulting in inconsistent judgments pertaining to Defendants’ policies and practices. No apparent difficulties exist in managing this class action. Plaintiff intends to send notice to the proposed NM Class Members to the extent required by Fed. R. Civ. 23(c).

43.

The class action is also maintainable under subsection (4) of Rule 23(c) with respect

to the legal and factual issues raised in this litigation.

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VII.

COUNT ONE: VIOLATION OF THE NEW MEXICO MINIMUM WAGE ACT 44.

Plaintiff incorporates all allegations previously made in this Complaint.

45.

Plaintiff and the NM Class Members are entitled to unpaid overtime in an amount

equal to one-and-one-half times the regular rate of pay for work performed in excess of 40 hours in a workweek pursuant to the formula outlined in N.M. Stat. Ann. § 50-4-22(D).

46.

During the relevant time period, Defendants violated and continue to violate

NMMWA by employing employees and regularly and repeatedly failing to pay them for all hours worked and pay overtime wages at a rate of at least one-and-a-half times their regular rates of pay.

47.

As a direct and proximate result of Defendants’ unlawful conduct, Plaintiff and the

NM Class Members have suffered and will continue to suffer from a loss of income and other damages.

48.

Plaintiff and the NM Class Members are entitled to their unpaid wages, plus an amount

equal to twice their unpaid wages, prejudgment interest, all costs in bringing this action, and all attorneys’ fees accrued that are recoverable under New Mexico Law. 49.

Pursuant to N.M. Stat. Ann. 50-4-32, Plaintiff and the NM Class Members are entitled

to recover for all violations that occurred as part of Defendants’ continued course of conduct regardless of the date on which they occurred.

IX. 50.

RELIEF SOUGHT

Plaintiff, individually and on behalf of the NM Class Members, prays for judgment

against Defendant as follows: a.

For an order, preliminarily and permanently restraining Defendants from engaging in the aforementioned pay violations;

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b.

For an Order certifying the NM Wage Law claims as a Class Action pursuant to Fed. R. Civ. P. 23, for designation of Plaintiff as Class Representative under applicable NM law, and for designation of Plaintiff’s counsel as class counsel;

c.

For an Order Awarding Plaintiff and the NM Class Members damages pursuant to N.M. Stat. Ann. 50-4-26;

d.

For an Order Awarding Plaintiff and the NM Class Members damages for all violations, regardless of the date on which they occurred, as a result of Defendants’ continued course of conduct pursuant to N.M. Stat. Ann. 50-432;

e.

For an award of attorneys’ fees, expenses, expert fees and costs incurred by plaintiffs in vindicating their rights under federal and New Mexico law;

f.

For a service payment to the Plaintiff for services provided on behalf of the class; and

g.

For such other and further legal or equitable relief as this Court deems to be just and appropriate.

Respectfully submitted, /s/ Jack Siegel J. DEREK BRAZIEL Co-Attorney in Charge Texas Bar No. 00793380 jdbraziel@l-b-law.com TRAVIS GASPER Texas Bar No. 24096881 gasper@l-b-law.com Lee & Braziel, L.L.P. 1801 N. Lamar Street, Suite 325 Dallas, Texas 75202 (214) 749-1400 phone (214) 749-1010 fax www.overtimelawyer.com 8

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JACK SIEGEL Co-Attorney in Charge Texas Bar No. 24070621 jack@siegellawgroup.biz Siegel Law Group, PLLC 2820 McKinnon, Suite 5009 Dallas, Texas 75201 (214) 706-0834 phone (469) 339-0204 fax www.siegellawgroup.biz ATTORNEYS FOR PLAINTIFF CERTIFICATE OF SERVICE I certify that a copy of this First Amended Complaint will be served on Defendants along with a copy of the Original Complaint and summons in accordance with the Federal Rules of Civil Procedure. /s/ Jack Siegel JACK SIEGEL

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