Justia Health Law Opinion Summaries

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The district court erred in affirming the magistrate’s decision that Medical Recovery Services, LLC (MRS) was estopped from requesting attorney fees under Idaho Code section 12-120(5). MRS attempted a garnishment of Penny Siler’s wages, which was returned unsatisfied because Siler, a school bus driver who cared for her disabled husband and made an average of $499.00 a month, did not earn enough to garnish. MRS agreed to accept $10.00 per month for payment on a default judgment entered after Siler failed to pay a medical bill. Siler went to MRS’s counsel’s office and was told the payoff amount was $1,224.88. She paid that amount in cash. Six days later, counsel for MRS filed an application for supplemental attorney fees under Idaho Code section 12-120(5). Following the hearing, the magistrate court issued an order denying MRS’s application for supplemental attorney fees. In its order, the magistrate court, sua sponte, found that MRS was barred by quasi and equitable estoppel from asking for attorney fees because MRS had told Siler the “payoff amount” was $1,224.88, and MRS did not inform Siler it planned to pursue additional postjudgment fees. MRS appealed the magistrate’s decision to the district court. The district court affirmed, finding “the Magistrate Court retains discretion as to whether, or what amount of, attorney fees will be awarded,” and therefore was free to consider any factor it deemed appropriate, including quasi or equitable estoppel, in determining the amount of attorney fees. View "Medical Recovery Svcs v. Siler" on Justia Law

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The court affirmed the issuance of a permanent injunction enjoining the merger of Anthem and Cigna under Section 7 of the Clayton Act, 15 U.S.C. 18. The court held that the district court did not abuse its discretion in enjoining the merger based on Anthem's failure to show the kind of extraordinary efficiencies necessary to offset the conceded anticompetitive effect of the merger in the fourteen Anthem states: the loss of Cigna, an innovative competitor in a highly concentrated market. The court also held that the district court did not abuse its discretion in enjoining the merger based on its separate and independent determination that the merger would have a substantial anticompetitive effect in the Richmond, Virginia large group employer market. View "United States v. Anthem" on Justia Law

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The Alabama Supreme Court granted Alfa Mutual Insurance Company's petition for a writ of certiorari with respect to the issue whether University of South Alabama Medical Center Hospital's (USA) hospital lien was impaired and the amount of damages recoverable by USA from Alfa for that impairment. The Court reversed the Court of Civil Appeals insofar as it affirmed the circuit court's ruling that the amount of damages recoverable from Alfa was an amount equal to the entirety of USA's reasonable charges, irrespective of the amount that was otherwise owed by Alfa under the terms of its policy, and remanded for further proceedings. View "Ex parte Alfa Mutual Insurance Company." on Justia Law

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This appeal stemmed from the parties' dispute over the precise language used in "corrective statements" cigarette manufacturers were ordered to disseminate. The district court's remedy requiring the manufacturers to issue corrective statements complied with the Racketeer Influenced and Corrupt Organizations Act (RICO), 18 U.S.C. 1964(a), because the manufacturers would be impaired in making false and misleading assurances about cigarettes if simultaneously required to tell the truth. In this case, the court held that the modified preambles satisfy RICO. Therefore, the court rejected the manufacturers' argument that the only reason to prefer the government's proposal is to taint manufacturers with implications of past wrongdoing. In regard to the manufacturers' First Amendment challenge, the court concluded that the preamble requirements are reasonably related to the government's interest in preventing deception of consumers. Here, the preambles are confined to purely factual and uncontroversial information, geared toward thwarting prospective efforts by manufacturers to either directly mislead consumers or capitalize on their prior deceptions by continuing to advertise in a manner that builds on consumers' existing misperceptions. In regard to the manufacturers' challenge to the topic descriptions in the preambles to Statements C and D, the court concluded that the manufacturers waived its argument as to Statement D, but the language in Statement C was not previously considered and is indeed backward-looking, because it implies that the manufacturers previously sold and advertised cigarettes in such a way. Accordingly, the court affirmed in part and reversed in part, remanding for further proceedings. View "United States v. Philip Morris USA Inc." on Justia Law

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Several Iowa chiropractors brought this class-action lawsuit against Wellmark, Inc., Iowa’s largest health insurer, alleging that it conspired with competitors to fix prices, allocate markets, and engage in other anticompetitive conduct in violation of the Iowa Competition Law. The district court stayed the case pending further proceedings in federal multidistrict litigation (MDL) in Alabama brought under federal antitrust laws. The Supreme Court vacated the order staying this action, holding that the district court abused its discretion in staying the Iowa litigation pending further proceedings in the Alabama MDL because (1) resolution of the Alabama MDL could take years, and (2) there are considerable differences in the issues the two cases present. Remanded. View "Chicoine v. Wellmark, Inc." on Justia Law

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In 1986, the Iowa legislature enacted House File 2219 to provide for payment by healthcare service corporations for services performed by chiropractors. Following the Supreme Court’s decision in Mueller v. Wellmark, several Iowa-licensed chiropractors (collectively, Appellants) brought this action alleging that Wellmark, Inc. wrongfully imposes restrictions and pays lower rates for chiropractic services than for equivalent services offered by medical and osteopathic doctors in violation of Iowa Code 514F.2. The Insurance Commissioner concluded that section 514F.2 does not require health insurers to compensate the chiropractors equally with medical and osteopathic doctors in network. The district court affirmed the Commissioner’s decision. The Supreme Court affirmed, holding (1) the interpretation of section 514F.2 has not been clearly vested by a provision of law in the discretion of the Commissioner; (2) the statute regulates payments to providers; (3) Wellmark’s fees for chiropractic care are not based solely on licensure; and (4) ERISA preempts the application of section 514F.2 to self-funded health plans. View "Abbas v. Iowa Insurance Division" on Justia Law

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After Henry B. was admitted to Pen Bay Medical Center (PBMC), PBMC staff applied to involuntarily commit Henry pursuant to the “white paper” procedures of Me. Rev. Stat. 34-B, 3863(5-A). After a commitment hearing, the district court ordered that Henry be submit to involuntary hospitalization for up to 120 days. The superior court affirmed the district court’s judgment of involuntary commitment. Henry appealed, arguing that he was not provided with effective assistance of counsel. The Supreme Judicial Court affirmed, holding (1) individuals subject to involuntary commitment proceedings in Maine have the right to effective representation of counsel, and the Strickland standard applies for courts reviewing claims of ineffective assistance of counsel in involuntary commitment proceedings; and (2) Henry was not deprived of the effective assistance of counsel in this case. View "In re Henry B." on Justia Law

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The Yellowstone County Attorney filed four petitions for commitment against C.B., a twenty-eight-year-old female with a lengthy history of mental illness. The first three petitions were dismissed. After an evidentiary hearing, the district court granted the fourth petition and commitment to the Montana State Hospital (MSH). The court also authorized the administration of involuntary medication in the event that C.B. refused to take her medications. The Supreme Court affirmed, holding (1) the district court did not err in concluding that the State had satisfied its burden of proof authorizing commitment; (2) the district court did not err by authorizing the administration of involuntary medication when it “may be necessary”; and (3) C.B. received effective assistance of counsel. View "In re C.B." on Justia Law

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A jury found Cecil Emerson was a sexually violent predator, and the district court ordered him committed. In 2001, Emerson filed a notice of appeal. The Court of Appeals ultimately dismissed the appeal in 2002 after Emerson’s counsel failed to file a brief. In 2014, Emerson moved the district court to permit an out-of-time appeal of the underlying ruling that he was a sexually violent predator. The district court ruled that it would give Emerson the right to appeal based upon his previous counsel’s lack of action after the notice of appeal was filed and the appeal was dismissed. In 2015, Emerson filed a notice of appeal. The Court of Appeals concluded that Emerson was entitled to an out-of-time appeal based on principles of fundamental fairness and then rejected Emerson’s arguments. Emerson petitioned for review. The Supreme Court dismissed the appeal, holding that the district court lost jurisdiction to authorize the filing of the out-of-time direct appeal when the initial appeal was docketed in the Court of Appeals, and therefore, the district court could not set aside the order of the Court of Appeals and reinstate the appeal. View "In re Care & Treatment of Emerson" on Justia Law

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Citing the 2014 State Health Plan, Methodist Healthcare - Olive Branch Hospital (Methodist) applied for a certificate of need (CON) - seeking approval to perform percutaneous coronary intervention(s), at its Olive Branch hospital. But Baptist Memorial Hospital - DeSoto (Baptist) - a competing hospital from the same service area - contested Methodist’s application. The Mississippi State Department of Health (MSDH) held a hearing and ultimately approved Methodist’s application. Baptist appealed to the Chancery Court. And after review, the chancellor affirmed MSDH’s decision. Baptist appealed to the Supreme Court. The Supreme Court found substantial evidence that Methodist’s application substantially complied with the State Health Plan and was consistent with its requirements. So it affirmed. View "Baptist Memorial Hospital-Desoto, Inc. v. Mississippi Dept. of Health" on Justia Law