govinfo:USCOURTS-kywd-3_25-cv-00543-0

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UNITED STATES DISTRICT COURT 
WESTERN DISTRICT OF KENTUCKY 
LOUISVILLE DIVISION 
 
RHEMA OF FOX VALLEY, LLC, et al., 
 
Plaintiffs, 
 
v. 
 
COMMONWEALTH OF KENTUCKY, 
CABINET FOR HEALTH AND FAMILY 
SERVICES, DEPARTMENT OF 
MEDICAID SERVICES, et al., 
 
Defendants. 
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Civil Action No. 3:25-CV-543-CHB 
 
 
MEMORANDUM OPINION AND 
ORDER 
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This matter is before the Court on the Motion to Dismiss or in the Alternative for Summary 
Judgment, [R. 5], filed by Defendants Commonwealth of Kentucky Cabinet for Health and Family 
Services, Department of Medicaid Services, Dr. Steven J. Stack, Lisa Lee, and John Does 1-10, as 
well as Defendants Attorney General Rusell Coleman and the Kentucky Office of the Attorney 
General’s Motion to Dismiss, [R. 6]. Plaintiffs responded, [R. 7], and Defendants replied. [R. 10]; 
[R. 11]. The matter has thus been fully briefed and is ripe for review. For the reasons that follow, 
the Court will grant Defendants’ motions to dismiss. 
I. BACKGROUND 
This suit arises from allegations of fraudulent billing purportedly conducted by Plaintiff 
Rhema of Fox Valley, LLC (hereinafter, “Rhema”). [R. 1, ⁋ 20]. Rhema operates an outpatient 
program that provides addiction, recovery, and mental health services to Medicaid patients. Id. ⁋ 6. 
Plaintiff Kanisha Leonard (hereinafter, “Leonard”) is an Advanced Practice Registered Nurse 
licensed in Kentucky and allegedly associated with Rhema’s operations. Id. ⁋ 7. On September 11, 
2024, Defendant Commonwealth of Kentucky, Cabinet for Health and Family Services, PageID #:
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Department of Medicaid Services (hereinafter, “CHFS-DMS”) issued notices of suspension to 
Rhema and Leonard due to “a credible allegation of fraud relating to billing for services not 
rendered or performed and falsifying records.” Id. ⁋⁋ 20, 24; [R. 1-1, p. 1]. As a result of these 
notices, Rhema was no longer paid under Medicaid for the services it provided. [R. 1, ⁋ 42]; see 
[R. 1-1, p. 1]. Shortly after receiving these notices, Rhema and Leonard requested a dispute 
resolution meeting, [R. 1, ⁋⁋ 28–29], but CHFS-DMS waived the meeting pursuant to 907 KAR 
1:671, Section 8(12), and issued a decision on September 26, 2024, upholding the suspension due 
to an open investigation by the Kentucky Office of the Attorney General’s Office of Medicaid 
Fraud and Abuse Control. [R. 1-2, pp. 1–2]. After Rhema requested an administrative hearing, 
which was not held until April of 2025, the administrative hearing officer found that the notices of 
suspension were deficient under 907 KAR 1:671, Section 4(3) and reversed Rhema’s suspension. 
Id. at 1–2, 4; [R. 1, ⁋ 34]. Despite Leonard “being a provider under the umbrella of the relieved 
entity, Rhema,” Leonard’s suspension remains intact. [R. 1, ⁋ 35]. 
According to the Complaint, CHFS-DMS’s administrative action occurred as part of a 
coordinated effort with the Kentucky Office of the Attorney General, which had been weighing 
criminal charges against Plaintiff Cameron Brown (hereinafter, “Brown”), the sole member of 
Rhema. Id. ⁋⁋ 36, 38. The Complaint alleges CHFS-DMS’s administrative proceedings were 
pretextual and served merely “to gather evidence for criminal prosecution while denying Brown 
the procedural protections that would be available in criminal proceedings,” as well as to suspend 
Rhema’s business activities. Id. ⁋ 40. Plaintiffs Rhema, Brown, and Leonard (hereinafter, 
collectively, “Plaintiffs”) allege they each suffered harm as a result; Rhema’s Medicaid payments 
were suspended and escrowed for approximately eleven months, requiring Rhema to shutter its 
business, which had earned $6,000,000 in annual revenue, id. ⁋⁋ 42, 43; Leonard could not practice PageID #:
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as an Advanced Practice Registered Nurse and suffered reputational and economic harm as a result 
thereof, id. ⁋ 44; and Brown underwent “invasive investigation procedures” and suffered personal 
and professional damage to his reputation, id. ⁋ 45. 
On August 28, 2025, Plaintiffs filed their Complaint alleging claims against numerous 
defendants, including: CHFS-DMS; the Kentucky Office of the Attorney General; Dr. Steven J. 
Sack, the Secretary of the Cabinet for Health and Family Services; Lisa Lee, the Commissioner of 
the Department for Medicaid Services; Russell Coleman, the Attorney General of Kentucky; and 
John Does 1–10, unknown state actors who purportedly participated in, directed, or authorized the 
actions by CHFS-DMS and the Kentucky Office of the Attorney General (hereinafter, collectively, 
“Defendants”). Id. ⁋⁋ 9–14. Based on the factual allegations outlined in the Complaint, Plaintiffs 
asserted the following causes of action: a § 1983 claim for violations of procedural due process 
under the Fourteenth Amendment (Count I, against all defendants in their individual and official 
capacities); a § 1983 claim for violations of substantive due process under the Fourteenth 
Amendment (Count II, against all defendants in their individual and official capacities); a § 1985 
claim for “conspiracy to deprive civil rights” (Count III, against all defendants in their individual 
and official capacities); a claim under the Fifth Amendment regarding compelled self-
incrimination (Count IV, against the Kentucky Office of the Attorney General and Rusell Coleman 
in his individual and official capacities); a claim under § 2 of the Kentucky Constitution for 
violations of due process (Count V, against all defendants in their individual and official 
capacities); and a claim under the Kentucky Administrative Procedures Act for failing to follow 
required procedures in administrative actions (Count VI, against CHFS-DMS and Dr. Steven J. 
Sack in his individual and official capacities). Id. ⁋⁋ 48–83. In their prayer for relief, Plaintiffs 
sought: a declaratory judgment that Defendants’ actions violated Plaintiffs’ rights under the United PageID #:
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States Constitution and Kentucky Constitution; a permanent injunction prohibiting Defendants 
from enforcing the invalid suspension notices against any Plaintiffs, requiring Defendants to 
restore Plaintiffs’ provider status, requiring Defendants to expunge any negative records related to 
the deficient proceedings, and establishing procedural safeguards to prevent future similar 
violations; monetary damages, including compensatory damages for lost income, business losses, 
and other economic harm, damages for reputational harm and emotional distress, punitive damages 
against individual defendants in their individual capacities; and attorneys’ fees and costs. Id. at 10. 
On October 22, 2025, pursuant to the parties’ Proposed Agreed Order of Partial Dismissal, 
[R. 8], the Court entered an Order of Partial Dismissal, [R. 9], dismissing Plaintiffs’ claims against 
Defendants Dr. Steven J. Stack, Lisa Lee, Russell Coleman, and John Does 1–10 (collectively, 
hereinafter, the “Individual Defendants”) in their respective individual capacities. Accordingly, 
any remaining claims against the Individual Defendants are solely in their respective official 
capacities. 
Two motions are pending before this Court: (1) a Motion to Dismiss or in the Alternative 
for Summary Judgment, [R. 5], filed by Defendants CHFS-DMS, Dr. Steven J. Stack, Lisa Lee, 
and John Does 1-10 (collectively, hereinafter, the “Cabinet Defendants”), and (2) Defendants 
Attorney General Rusell Coleman and the Kentucky Office of the Attorney General’s Motion to 
Dismiss, [R. 6], filed by the Kentucky Office of the Attorney General and Russell Coleman 
(collectively, hereinafter, the “OAG Defendants”). Plaintiffs filed a single response addressing 
both motions, [R. 7], and Defendants filed replies, [R. 10 (Cabinet Defendants)]; [R. 11 (OAG 
Defendants)]. Because both motions are fully briefed, this matter is ripe for review. PageID #:
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II. LEGAL STANDARD 
Under Federal Rule of Civil Procedure 12(b)(6), a party may move for dismissal for 
“failure to state a claim upon which relief may be granted.” To survive a Rule 12(b)(6) motion to 
dismiss, “a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to 
relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell 
Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007)). A claim is “plausible on its face” if the 
factual allegations in the complaint “allow the court to draw the reasonable inference that the 
defendant is liable for the misconduct alleged.” Id. (citing Twombly, 550 U.S. at 556). This 
standard “is not akin to a ‘probability requirement,’ but it asks for more than a sheer possibility 
that a defendant has acted unlawfully.” Id. (citing Twombly, 550 U.S. at 556). “Where a complaint 
pleads facts that are ‘merely consistent with’ a defendant’s liability, it ‘stops short of the line 
between possibility and plausibility of entitlement to relief.’” Id. (quoting Twombly, 550 U.S. at 
557) (internal quotation marks omitted). “Threadbare recitals of the elements of a cause of action, 
supported by mere conclusory statements, do not suffice.” Id. (citing Twombly, 550 U.S. at 555). 
Determining if a complaint sufficiently alleges a plausible claim for relief is “a context-
specific task that requires the reviewing court to draw on its judicial experience and common 
sense.” Id. at 679 (citation omitted). Further, “[t]he complaint is viewed in the light most favorable 
to [Plaintiff], the allegations in the complaint are accepted as true, and all reasonable inferences 
are drawn in [Plaintiff’s] favor.” Gavitt v. Born, 835 F.3d 623, 639–40 (6th Cir. 2016) (citing 
Jelovsek v. Bredesen, 545 F.3d 431, 434 (6th Cir. 2008)). 
Rule 12(b)(1) permits a litigant to contest a court's subject matter jurisdiction over a case. 
Fed. R. Civ. P. 12(b)(1). A challenge to subject matter jurisdiction may be brought at any time 
during a proceeding. Zurich Ins. Co. v. Logitrans, Inc., 297 F.3d 528, 531 (6th Cir. 2002). Motions PageID #:
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to dismiss based on a lack of subject matter jurisdiction take two forms. Gentek Bldg. Prods., Inc. 
v. Sherwin-Williams Co., 491 F.3d 320, 330 (6th Cir. 2007). A facial attack merely questions the 
sufficiency of the pleadings set forth in the complaint to support jurisdiction. Id. On the other hand, 
a factual attack raises a factual controversy that challenges the predicate basis for jurisdiction. 
United States v. Ritchie, 15 F.3d 592, 598 (6th Cir. 1994). A district court reviewing a facial attack 
“takes the allegations in the complaint as true,” but where a party makes a factual attack, “no 
presumptive truthfulness applies to the allegations [in the complaint].” Id. (citing Ohio Nat’l Life 
Ins., 922 F.3d at 325). 
III. ANALYSIS 
Courts typically treat a defendant’s assertion of Eleventh Amendment immunity as a 
threshold question of jurisdiction. Does v. Whitmer, 69 F.4th 300, 305 (6th Cir. 2023) (“[The Sixth 
Circuit] treat[s] sovereign immunity as a ‘jurisdictional bar,’ that, ‘once raised as a jurisdictional 
defect, must be decided before the merits.’” (quoting Russell v. Lundergan-Grimes, 784 F.3d 1037, 
1046 (6th Cir. 2015))). Here, because Defendants each attack this Court’s subject-matter 
jurisdiction by raising Eleventh Amendment immunity as a defense, [R. 5, pp. 9–12, 16–18]; [R. 6, 
pp. 5–8], the Court will address these arguments as an initial matter.1 And, because Defendants 
appear to raise facial attacks on the Court’s subject-matter jurisdiction, the Court will take the 
allegations in the Complaint as true as it considers its subject-matter jurisdiction to hear Plaintiffs’ 
claims. See Gentek, 491 F.3d at 330 (citing Ohio Nat’l Life Ins., 922 F.3d at 325). 
 
1 Defendants raise additional arguments beyond their sovereign immunity for why Plaintiffs’ claims fail. See generally 
[R. 5]; [R. 6]. Because the Court finds that sovereign immunity bars all remaining claims against Defendants and the 
Ex parte Young exception to sovereign immunity does not apply, see infra, the Court need not reach Defendants’ other 
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A. Sovereign Immunity 
1. Entity Defendants 
Plaintiffs sue two state entities, CFHS-DMS and the Kentucky Office of the Attorney 
General (hereinafter, the “Entity Defendants”). [R. 1, ⁋⁋ 9–10]. The Eleventh Amendment 
immunizes states from suit, providing that “[t]he Judicial power of the United States shall not be 
construed to extend to any suit in law or equity, commenced or prosecuted against one of the 
United States by Citizens of another State, or by Citizens or Subjects of any Foreign State.” U.S. 
Const. amend. XI. Although the Eleventh Amendment does not mention lawsuits that citizens 
bring against their own states, the Supreme Court closed this gap in Edelman v. Jordan, where it 
held that a state has Eleventh Amendment immunity from a lawsuit that its own citizen brings 
against it in federal court. 415 U.S. 651, 662–63 (1974). The Eleventh Amendment protects against 
claims for relief under both federal and state law, see Pennhurst State Sch. & Hosp. v. Halderman, 
465 U.S. 89, 106 (1984), as well as claims seeking both damages and injunctive or declaratory 
relief, see id. at 101. The exceptions to Eleventh Amendment sovereign immunity are narrow, and 
include waiver, consent, abrogation, and Ex parte Young. Id. at 98–103; see also Faller v. Attorney 
General of Kentucky, No. 1:08-CV-86-R, 2009 WL 530646, at *4 (W.D. Ky. Mar. 3, 2009) (“There 
are essentially three exceptions [sovereign immunity]: (1) when the state consents to suit; (2) when 
Congress has abrogated a state’s sovereign immunity; and (3) when under the fiction created by 
Ex Parte Young, 209 U.S. 123 (1908), a litigant seeks injunctive or prospective relief from a state 
officer in order to prevent future constitutional violations.”). Plaintiffs only argue that abrogation 
under § 1983 and Ex parte Young applies, and the Court addresses these arguments below. See 
infra Sections III.A.2, III.B. PageID #:
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In their motions to dismiss, the Entity Defendants argue the Eleventh Amendment’s 
sovereign immunity bars all claims made against them, and no exception to that immunity applies. 
See [R 5, pp. 9–12, 16–18 (CHFS-DMS’s motion)]; [R. 6, pp. 5–7 (Kentucky Office of the 
Attorney General’s motion)]. Plaintiffs’ brief response, contained in a single filing addressing all 
Defendants’ motions to dismiss, fails to address the Entity Defendants’ sovereign immunity and 
instead solely argues no immunity applies for suits brought against officials such as the Individual 
Defendants. See [R. 7, pp. 8–9 (citing Hafer v. Melo, 502 U.S. 21, 30–31 (1991))]. In reply, the 
Cabinet Defendants and OAG Defendants each contend that Hafer is irrelevant and unpersuasive 
because the Court already dismissed all claims against the Individual Defendants in their individual 
capacities. [R. 10, pp. 2–3]; [R. 11, p. 3]. The OAG Defendants further argue Plaintiffs’ “lack of 
discussion about sovereign immunity as it relates to the official-capacity claims effectively means 
the Plaintiffs have conceded the issue,” thereby requiring dismissal of Plaintiffs’ claims against 
them. [R. 11, p. 4 (collecting cases)]. 
The Court finds the Entity Defendants are immune from suit under the Eleventh 
Amendment. As the Entity Defendants each note, both are arms of the state to whom the Eleventh 
Amendment’s protection applies—a contention Plaintiffs do not dispute. [R. 5, p. 11 (“[CFHS-
DMS] is a state created governmental agency of the executive branch.” (citing K.R.S. 
§ 12.020(II)(8))]; [R. 6, p. 5 (“[T]he Office [of the Attorney General] is an arm of the 
Commonwealth . . . .” (citing K.R.S. § 15.010(1))]; see generally [R. 7]. Accordingly, Plaintiffs’ 
state and federal claims for monetary and injunctive relief are barred unless Plaintiffs establish that 
an exception to the sovereign immunity applies here. See Cox v. Dep’t of Transp., 53 F.3d 146, 
152 n.2 (6th Cir. 1995) (“Eleventh Amendment immunity bars all suits, whether for injunctive or 
monetary relief, against the state and its departments.” (citing Pennhurst, 465 U.S. at 100–01)). PageID #:
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But nowhere do Plaintiffs suggest that the Entity Defendants have waived or abrogated any 
Eleventh Amendment immunity or consented to suit in this context, see generally [R. 1]; [R. 7], 
and the Entity Defendants’ motions to dismiss note the same, see [R. 5, p. 11 (“Plaintiffs can point 
no express waiver permitting [Counts V and VI] to be brought against [CFHS-DMS].”)]; [R. 6, 
p. 6 (“Kentucky has not waived immunity, and § 1983 claim does not abrogate State immunity.” 
(citing Quern v. Jordan, 440 U.S. 332, 341 (1979); Will v. Michigan Dept. of State Police, 491 
U.S. 58, 71 (1989)))]. Moreover, Plaintiffs’ citations to Ex parte Young do not suggest the Entity 
Defendants are proper parties to this suit, as Plaintiffs’ briefing correctly and repeatedly states that 
Ex parte Young permits suit against individual officers of the state under certain circumstances, 
not against the state itself. [R. 7, pp. 8–9 (asserting Ex parte Young “permits suit against officials” 
and does not stop suits “against individual state officers” (emphases added) (citation omitted))]. 
Taken together, the Court concludes all Plaintiffs’ claims for monetary damages and injunctive 
relief against the Entity Defendants are barred by the Eleventh Amendment’s sovereign immunity. 
2. Individual Defendants 
Plaintiffs also sue the Individual Defendants in their official capacities, various state 
officials who allegedly committed or assisted in the purported violations of federal and state law. 
[R. 1, ⁋⁋ 11–14]. The Court has already outlined that the Eleventh Amendment’s umbrella covers 
the state itself, as well as state agencies, departments, and other arms of the state, see supra Section 
III.A.1, but the Eleventh Amendment’s sovereign immunity also extends to state officials acting 
in their official capacity. See Matthews v. Jones, 35 F.3d 1046, 1049 (6th Cir.1994) (“A suit against 
an individual in his official capacity is the equivalent of a suit against the governmental entity.”); 
see also Puckett v. Lexington-Fayette Urb. Cnty. Gov’t, 833 F.3d 590, 598 (6th Cir. 2016) (“[A] 
suit against a state official in his or her official capacity is not a suit against the official but rather PageID #:
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is a suit against the official’s office, i.e., against the state itself.” (citation and quotations omitted)). 
Although Congress may abrogate the Eleventh Amendment through an “unequivocal expression 
of congressional intent” to do so, Pennhurst, 465 U.S. at 99, neither 42 U.S.C. § 1983 nor 42 
U.S.C. § 1985 did so. Faller 2009 WL 530646, at *4 (“Congress did not abrogate states’ sovereign 
immunity when it enacted 42 U.S.C. §§ 1983, 1985, or 1986.” (citations omitted)). 
In their motions to dismiss, the Individual Defendants argue the Eleventh Amendment bars 
Plaintiffs’ claims against them in their official capacities. [R. 5, p. 12]; [R. 6, pp. 5–6]. Plaintiffs’ 
response argues Ex parte Young applies and “permits suits against officials in official capacity 
roles” to the extent the relief sought is “prospective.” Id. at 8. Plaintiffs further argue that “neither 
Ex parte Young nor the Eleventh Amendment can be used as a shield to stop a Section 1983 action 
for damages against individual state officials in their official capacities.” Id. at 8–9 (citing Hafer, 
502 U.S. at 30–31 (1991)). In response, the Individual Defendants point out that the Court has 
dismissed all claims against them in their individual capacities. See [R. 8]; [R. 9]. This means 
Hafer is irrelevant as to Plaintiffs’ remaining claims against the Individual Defendants in their 
official capacities, since Hafer only discussed Ex parte Young and Eleventh Amendment immunity 
in the context of suits brought against officials in their individual capacities. [R. 10, pp. 2–3]; 
[R. 11, p. 3]. Further, the OAG Defendants argue that due to Plaintiffs’ failure to address 
“sovereign immunity as it relates to the official-capacity claims,” Plaintiffs have conceded the 
issue. [R. 11, p. 4 (collecting cases)]. 
The Court agrees with Defendants. As already discussed, the Eleventh Amendment’s 
sovereign immunity extends to state officials acting in their official capacity. See supra; Pennhurst, 
465 U.S. at 114 n.25; Matthews v. Jones, 35 F.3d at 1049. The Individual Defendants are state 
officials covered by this immunity, a fact Plaintiffs do not dispute. See generally [R. 7]. PageID #:
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Accordingly, Plaintiffs’ claims against the Individual Defendants are barred unless Plaintiffs 
establish an exception—waiver, consent, abrogation, or Ex parte Young—applies. See Pennhurst, 
465 U.S. at 98–103. Reading Plaintiffs’ Response generously, Plaintiffs appear to invoke § 1983 
and Ex parte Young as each permitting suit against the Individual Defendants. See [R. 7, pp. 8–9]. 
But, as the Court has already noted, neither § 1983 nor § 1985 abrogated Eleventh Amendment 
immunity for state officials acting in their official capacities. See supra; Kentucky v. Graham, 473 
U.S. 159, 169 n.17 (1985) (“[Section] 1983 was not intended to abrogate a State’s Eleventh 
Amendment immunity.” (citations omitted)); Sykes v. U.S., 507 Fed. App’x 455, 462 (6th Cir. 
2012) (finding that University of Cincinnati enjoyed Eleventh Amendment immunity as to a claim 
brought under 42 U.S.C. § 1985); Faller, 2009 WL 530646, at *4. And, while the Ex parte Young 
exception permits suits against state officials acting in their official capacities, the exception only 
authorizes injunctive relief, not damages. See Boler v. Earley, 865 F.3d 391, 412 (6th Cir. 2017) 
(“[T]he [Ex parte Young] doctrine does not extend to retroactive relief or claims for money 
damages.”). The Court addresses Plaintiffs’ Ex parte Young argument below, but the law is clear 
that Plaintiffs fail to establish that an exception to Eleventh Amendment immunity applies to 
permit suit against the Individual Defendants in their official capacities for monetary damages. 
The Court will therefore dismiss Plaintiffs’ claims against the Individual Defendants in their 
official capacities for monetary damages. 
On sovereign immunity grounds, the Court has dismissed all claims against the Entity 
Defendants as well as all the claims against the Individual Defendants in their official capacities 
for monetary damages. See supra Sections III.A.1–2. Because the Court has already dismissed 
Plaintiffs’ claims against the Individual Defendants in their individual capacities pursuant to the 
parties’ agreement, see [R. 8]; [R. 9], Plaintiffs’ only remaining claims are those against the PageID #:
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Individual Defendants in their official capacities for injunctive relief. The Court will now consider 
whether the Ex parte Young exception applies and permits those remaining claims for relief. 
B. Ex Parte Young 
Generally, a lawsuit against a state official in his or her official capacity is not against the 
official, but rather against the official’s office, and is accordingly treated as a lawsuit against the 
state itself to which Eleventh Amendment immunity applies. Printz v. United States, 521 U.S. 898, 
930–31 (1997). The Ex parte Young exception is grounded in the theory that unconstitutional 
actions by state officials are void from the start, meaning they cannot be authorized by the state; 
accordingly, the state official’s actions are not viewed as the action of the state itself and, therefore, 
the state’s Eleventh Amendment immunity does not apply to protect the official’s actions. See 
Pennhurst, 465 U.S. at 102 (citing Ex parte Young, 209 U.S. 123, 160 (1908)). Specifically, the 
Ex parte Young exception to the Eleventh Amendment’s sovereign immunity provides that state 
officials who are “clothed with some duty in regard to the enforcement of the laws of the state, and 
who threaten and are about to commence proceedings . . . to enforce against parties affected an 
unconstitutional act, violating the Federal Constitution, may be enjoined by a Federal court of 
equity from such action.” Ex parte Young, 209 at 156. In other words, the exception allows citizens 
to sue in federal court to challenge a state official’s action where that action allegedly violates the 
United States constitution and where the citizen seeks prospective injunctive relief. See Pennhurst, 
465 U.S. at 102–03. The Sixth Circuit has noted that “this exception to sovereign immunity created 
in Ex parte Young has been read narrowly,” EMW Women’s Surgical Ctr., P.S.C. v. Beshear, 920 
F.3d 421, 445 (6th Cir. 2019), and it “‘does not apply when a defendant state official has neither 
enforced nor threatened to enforce the allegedly unconstitutional state statute,’” id. (quoting 
Children’s Healthcare is a Legal Duty, Inc. v. Deters, 92 F.3d 1412, 1415 (6th Cir. 1996)). “There PageID #:
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must be a ‘realistic possibility the official will take legal or administrative actions against the 
plaintiff’s interests.’ . . . General enforcement authority is insufficient.” Id. (quoting Russell v. 
Lundergan-Grimes, 784 F.3d 1037, 1048 (6th Cir. 2015)). 
In their motions to dismiss, Defendants argue Plaintiffs are not entitled to injunctive relief 
under Ex parte Young because “no Cabinet officials are continuing or threatening to continue to 
engage in the conduct of which the Plaintiffs complain,” [R. 5, p. 18], and because “there is no 
ongoing violation of federal law by the Attorney General to enjoin” and “the relief the Plaintiffs 
seek is effectively retrospective or would intrude into the Commonwealth’s proceedings,” [R. 6, 
p. 7 (emphasis in original)]. Plaintiffs’ response agrees that Ex parte Young only “permits suits 
against officials in official capacity roles” to the extent the relief sought is “prospective,” [R. 7, 
p. 8], and further cites to Hafer for the proposition that Ex parte Young cannot “be used as a shield 
to stop a Section 1983 action for damages against individual state officials in their official 
capacities,” id. at 8–9. Defendants’ replies each aptly point out that Hafer addressed suits against 
state officials in their individual capacity, not their official capacity, see [R. 10, p. 2 (describing 
Hafer as deciding “whether the Eleventh Amendment . . . barred a suit against a state official sued 
in his or her individual, i.e., personal capacity”)]; [R. 11, p. 3 (“The quoted language from Hafer 
v. Melo . . . only indicates that the Eleventh Amendment is not a barrier to suits seeking to impose 
individual or personal liability—that is, claims against an official in their individual capacity.”)]. 
Defendants make the further point that because all claims against the Individual Defendants in 
their individual capacities have been dismissed, [R. 10, p. 3]; [R. 11, p. 4]; see [R. 8]; [R. 9], Hafer 
does not support Plaintiffs’ position. Additionally, the OAG Defendants suggest that in light of 
Plaintiffs’ failure to address other components of the defendants’ Ex parte Young arguments (i.e., 
the lack of ongoing violations and the retrospective nature of the relief sought), “Plaintiffs have PageID #:
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conceded the issue” of sovereign immunity as it relates to the official-capacity claims against the 
Individual Defendants. [R. 11, p. 4 (collecting cases)]. 
The Court agrees with Defendants that Plaintiffs’ response amounted to no response at all. 
Plaintiffs failed to point to any allegations that might support application of the Ex parte Young 
exception. Nowhere do Plaintiffs argue or allege a “realistic possibility” the Individual Defendants 
“will take legal or administrative actions against [their] interests,” Russell, 784 F.3d at 1048, or 
that such actions have been “threaten[ed]” or are “about to commence,” Ex parte Young, 209 U.S. 
at 156. As a result, and as the OAG Defendants point out, Plaintiffs have conceded the Ex parte 
Young issue because they have utterly failed to address it. See [R. 11, p. 4 (collecting cases)]. 
Because “a plaintiff generally concedes a defense when they fail to respond to the defendant’s 
argument,” 4th Leaf, LLC v. City of Grayson, 425 F. Supp. 3d 810, 823 (E.D. Ky. 2019), and 
because Plaintiffs do not address Defendants’ assertions regarding the lack of ongoing or imminent 
violations and the retrospective nature of much of Plaintiffs’ relief sought, the Court finds all 
claims for injunctive relief against the Individual Defendants in their official capacities fail to meet 
the narrow exception to sovereign immunity under Ex parte Young, and must therefore be 
dismissed. 
IV. CONCLUSION 
For the above-stated reasons, the Court will grant Defendants’ motions to dismiss and will 
dismiss all claims against all defendants in this matter. Accordingly, and the Court being otherwise 
sufficiently advised, IT IS HEREBY ORDERED as follows: 
1. The Motion to Dismiss or in the Alternative for Summary Judgment, [R. 5], filed 
by Defendants Commonwealth of Kentucky Cabinet for Health and Family PageID #:
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Services, Department of Medicaid Services, Steven J. Stack, Lisa Lee, and John 
Does 1-10, is GRANTED. 
2. Defendants Attorney General Rusell Coleman and the Kentucky Office of the 
Attorney General’s Motion to Dismiss, [R. 6], is GRANTED. 
3. All remaining claims against Defendants are DISMISSED WITH PREJUDICE. 
4. A separate Judgment shall enter. 
This the 22nd day of May, 2026. PageID #:
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