Smith v. Walgreens Boots Alliance, Inc

Background

Susan Smith filed a proposed class action on behalf of people who had opioid prescriptions for chronic pain, cancer-related pain, palliative or nursing-home care, or sickle-cell anemia. She alleged that Walgreens Boots Alliance, Inc., WAGDCO, LLC, Costco Wholesale Corporation, and other defendants interfered with access to opioid prescriptions in ways that discriminated against people with disabilities.

Smith asserted claims under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, the Affordable Care Act’s antidiscrimination provisions, California’s Unruh Civil Rights Act, and California’s Unfair Competition Law. She alleged that Walgreens used practices including limits on opioid dosage and duration, requirements for medical records or non-opioid prescriptions, and restrictions involving particular patients or prescribers. She alleged that Costco pharmacists had refused to fill her opioid prescriptions and that Costco had a policy or practice restricting opioid sales.

WBA moved to dismiss for lack of personal jurisdiction. Walgreens moved to dismiss for failure to state a claim. Costco moved to dismiss for failure to state a claim and lack of constitutional standing. The court held a hearing on January 28, 2021.

Legal standard

The court applied Rule 12(b)(6), which tests whether a complaint contains enough factual matter to state a plausible claim for relief. Labels, conclusions, and a bare repetition of legal elements are not enough. The court also stated that plaintiffs ordinarily should be allowed to amend unless amendment would be futile.

Disability allegations

The court held that Smith adequately alleged that she herself was disabled, but not that all members of the proposed class were disabled under the federal statutes. Under those statutes, disability generally requires an impairment that substantially limits one or more major life activities.

The court ruled that chronic pain alone does not establish a disability. It also rejected Smith’s theory that every acute-pain patient was temporarily disabled because of pain. The court further found that Smith had not adequately supported her theory that Walgreens regarded all opioid patients as having a disability. As a result, the proposed class could include both disabled and nondisabled people, while the alleged pharmacy policies generally applied to both groups.

Claims against Costco

The court found that Smith had not identified a Costco policy or practice suggesting that Costco discriminated because of disability. Smith’s allegations described two unexplained refusals and treated them as evidence of a total ban on opioid sales, but the court found that theory insufficient to state a disability-discrimination claim.

The court also concluded that amendment would be futile because alleging a discriminatory Costco opioid policy would contradict Smith’s original allegation that Costco did not sell opioids to anyone. It therefore granted Costco’s motion to dismiss with prejudice. The court dismissed Smith’s ADA, Rehabilitation Act, Affordable Care Act, Unruh Act, and Unfair Competition Law claims against Costco. The California claims were dismissed because they depended on liability for the federal claims.

Claims against Walgreens

The court found no factual allegations supporting intentional discrimination by Walgreens. It said the complaint mainly alleged that Walgreens had applied opioid-safety policies in a misguided but good-faith way, rather than alleging facts showing discriminatory motive.

The court considered two remaining theories. First, under a meaningful-access or disparate-impact theory, a facially neutral policy may violate disability law if it disproportionately denies disabled people access to a public accommodation or federally funded service. The court found that the only Walgreens policy that could possibly have such an effect was the alleged dosage-and-duration restriction. But Smith’s allegations about medical-record reviews, an identification code, and a request to purchase Narcan did not plausibly show that the prescription denials resulted from a dosage-and-duration limit. Smith also alleged that she had regularly filled prescriptions at Walgreens for years, which made that theory implausible as pleaded.

Second, under a reasonable-accommodation theory, a plaintiff must show that she is disabled, that the defendant operates a public accommodation, that the defendant used a discriminatory policy or practice, and that the defendant failed to make a reasonable and necessary modification. The court found that Smith had not alleged that she requested an accommodation. It also found that the proposed accommodations—such as dispensing opioids as prescribed, ending bundled-purchase requirements, eliminating medical-record requirements, limiting pharmacist discretion, and training employees to distinguish acute-pain from chronic-pain patients—were not plausibly shown to be reasonable or necessary.

The court therefore held that Smith had failed to state claims against Walgreens under the ADA, Rehabilitation Act, Affordable Care Act, Unruh Act, and Unfair Competition Law. It granted Walgreens’ motions to dismiss without prejudice and dismissed the claims against Walgreens without prejudice.

Disposition

The court granted Costco’s motion to dismiss with prejudice. It granted Walgreens’ motions to dismiss without prejudice and granted Smith leave to amend within thirty days to address deficiencies involving only a meaningful-access or disparate-impact theory and a reasonable-accommodation theory against Walgreens. The court did not address the outstanding jurisdictional arguments in WBA’s motion to dismiss, stating that it would address them if Smith amended the complaint to state a plausible claim against Walgreens.