Molina Healthcare of New Mexico Lawsuit - Complaint

Case 2:18-cv-00725 Document 1 Filed 07/27/18 Page 1 of 10

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

Civil Action No. 2:18-cv-00725 Molina Healthcare, Inc. Defendant.

ORIGINAL CLASS ACTION COMPLAINT Plaintiff Nora Candelaria brings this action individually and on behalf of the below-defined New Mexico Class Members against Defendant Molina Healthcare, Inc. (“Molina”).

I. 1.

SUMMARY

This is a Rule 23 class actions brought pursuant to the New Mexico Minimum

Wage Act, N.M. Stat. Ann. §50-4-19, et seq. (“NMMWA”).

2.

Defendant is a managed care company that provides health insurance to individuals

through government programs, including Medicaid and Medicare.

3.

Plaintiff and the New Mexico Class Members worked for Defendant as “Case

Managers” to assist Defendant with administering its health insurance programs by communicating with and gather information from members to document members’ medical circumstances in Defendant’s computer system, inputting member data into Defendant’s computer system, ensuring members completed all necessary authorizations for receipt of benefits, and ensuring all documentation adheres to Defendant’s documentation guidelines.

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4.

Defendant misclassified “Case Managers” as exempt from overtime, paid them on

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

5.

Because Defendant 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 is a resident of this District and worked for Defendant as

a Case Manager in New Mexico from approximately August 2015 to the present. The work Plaintiff performed in this state serves as the basis for her NMMWA claims.

7.

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

behalf of the “NM Class Members”. The NM Class Members consist of Defendant’s Case Managers who received pay on a salary basis that worked over 40 hours in a at least one workweek in New Mexico since the time Defendant began paying Case Managers pursuant to its OT Misclassification Policy. The NM Class Members include, without limitation, and other job titles performing the same or similar duties as Case Managers.

8.

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

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

III. 9.

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

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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 Defendant. Alternatively, the Court has supplemental jurisdiction pursuant to 28 U.S.C § 1367.

10.

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. 11.

COVERAGE

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

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

12.

At all relevant times, Defendant has been an employer or joint employer within the

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

13.

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.

FACTUAL ALLEGATIONS

14.

Plaintiff incorporates all allegations previously made in this complaint.

15.

Defendant has continuously conducted business in this judicial district over the last

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

16.

Plaintiff worked for Defendant as a Case Manager from approximately September

2013 to May 2017.

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17.

As a Case Manager, Plaintiffs’ Primary Job Duties consisted of assisting Defendant

with its administration of its health insurance programs by communicating with and gather information from members to document members’ medical circumstances in Defendant’s computer system, inputting member data into Defendant’s computer system, ensuring members completed all necessary authorizations for receipt of benefits, ensuring all documentation adheres to Defendant’s documentation guidelines, and other similar duties (“Case Management Work”).

18.

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

prolonged course of specialized intellectual instruction directly related to her position.

19.

As a Case Manager, Plaintiff’s job duties involved the application of knowledge

gained through Defendant-provided training.

20.

As a Case Manager, Plaintiff’s job duties did not involve work directly related to

Defendant’s management or general business operations.

21.

As a Case Manager, Plaintiff’s job duties involved helping Defendant produce the

product that served as the primary output Defendant sold the public—the service of administering government health plans for its customers.

22.

As a Case Manager, Plaintiff’s job duties were routine and rote and did not involve

the exercise of discretion or independent judgment with respect of matters of significance for Defendant. 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.

23.

Plaintiff worked overtime during one or more individual workweeks in New

Mexico over the last three years.

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24.

Defendant did not pay Plaintiff for all overtime hours worked in excess of 40 hours

per workweek during the relevant time period.

25.

Instead of providing Plaintiff with overtime pay, Defendant classified Plaintiff as

exempt and paid her a salary with no overtime pay for her many hours of overtime work during the relevant time period.

26.

Defendant knew that Plaintiff worked in excess of 40 hours per week during the

relevant time period.

27.

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

workweek in New Mexico during the relevant time period.

28.

Since beginning its OT Misclassification Policy, Defendant has employed other

NM Class Members whose Primary job duties consist of Care Management Work.

29.

As Case Managers, the NM Class Members’ primary job duties consisted of

performing Case Management Work.

30.

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

complete a prolonged course of specialized intellectual instruction directly related to her position.

31.

As Case Managers, the NM Class Members’ job duties involved the application of

knowledge gained through Defendant-provided training.

32.

As Case Managers, the NM Class Members’ job duties did not involve work

directly related to Defendant’s management or general business operations.

33.

As Case Managers, the NM Class Members’ job duties involved helping Defendant

produce the product that served as the primary output Defendant sold the public—the service of administering government health plans for its customers.

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34.

As 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 of matters of significance for Defendant. For example, as Case Managers, the NM Class Members were not allowed to deny a member’s claim for benefits or services under any circumstances without approval of senior management.

35.

The NM Class Members worked overtime during one or more individual

workweeks in New Mexico since the time Defendant initiated its Overtime Misclassification Policy.

36.

Defendant did not pay the NM Class Members for all overtime hours worked in

excess of 40 hours per workweek in New Mexico during the relevant time period.

37.

Instead of providing the NM Class Members with overtime pay, Defendant

classified the NM Class Members as exempt and paid them a salary with no overtime pay for their many hours of overtime work during the relevant time period.

38.

Defendant knew that NM Class Members worked in excess of 40 hours per week

during the relevant time period.

39.

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

of 40 per workweek in New Mexico during the relevant time period.

VI.

CLASS ALLEGATIONS

40.

Plaintiff incorporates all allegations previously made in this Complaint.

41.

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

Procedure 23.

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42.

The NM Class Members are Defendant’s current and former Case Managers who

worked over 40 hours in at least one workweek since Defendant initiated its OT Misclassification Policy who were paid on a salary basis and whose job duties included Care Management Work or other similar work.

43.

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).

44.

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.

45.

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.

46.

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 oneand-one half times their regular rates of pay for all overtime hours worked.

47.

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.

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48.

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.

49.

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

duplicative litigation resulting in inconsistent judgments pertaining to Defendant’s 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).

50.

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.

VII.

COUNT ONE: VIOLATION OF THE NEW MEXICO WAGE LAW

51.

Plaintiff incorporates all allegations previously made in this Complaint.

52.

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).

53.

During the relevant time period, Defendant violated and continues to violate NM

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

54.

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

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

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55.

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. 56.

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 Defendant’s continued course of conduct regardless of the date on which they occurred.

IX. 57.

RELIEF SOUGHT

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

judgment against Defendant as follows: a.

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

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 Defendant’s continued course of conduct pursuant to N.M. Stat. Ann. 50-432;

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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/ J. Derek Braziel 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

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

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