Justia Health Law Opinion Summaries

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The Supreme Court reversed the decision of the court of appeal affirming the finding of the City of San Diego that adoption of an ordinance authorizing the establishment of medical marijuana dispensaries and regulating their location and operation did not constitute a project, holding that the court of appeal misapplied the test for determining whether a proposed activity has the potential to cause environmental change under Cal. Pub. Res. Code 21065. The City did not conduct any environmental review when adopting the ordinance, finding that adoption of the ordinance did not constitute a project for purposes of the California Environmental Quality Act, Cal. Pub. Res. Code 21000 et seq. (CEQA). Petitioner filed a petition for writ of mandate challenging the City's failure to conduct CEQA review. The trial court denied the petition. The court of appeal affirmed, concluding that the City correctly concluded that the ordinance was not a project because it did not have the potential to cause a physical change in the environment. The Supreme Court reversed and remanded the case for further findings, holding that the City erred in determining that the adoption of the Ordinance was not a project. View "Union of Medical Marijuana Patients, Inc. v. City of San Diego" on Justia Law

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Kearney sought judicial review of the Board's decision denying its application to participate in the Medicare program. Although the facility later received approval, the initial denial prevented Kearney from participating in Medicare and receiving reimbursements for 87 days during 2014. The Eighth Circuit held that the Board failed adequately to explain the legal standard that it applied in resolving Kearney's administrative appeal. In this case, the court was unable to discern what meaning the Board attributed to 42 U.S.C. 1395x(e)(1) and the definition of "hospital." Furthermore, without an adequate explanation for what time period the agency considered in determining whether Kearney was primarily engaged in providing care to inpatients, the court was unable to resolve whether the Board's decision correctly applied the relevant legal standards. Therefore, the court reversed the district court's grant of summary judgment to the Department and remanded with directions. View "Kearney Regional Medical Center, LLC v. US Department of Health and Human Services" on Justia Law

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The Court of Appeals reversed the judgments of the Court of Special Appeals and circuit court dismissing D.L.'s petition for judicial review challenging her involuntary admission to a facility operated by Sheppard Pratt Health Systems, Inc. as moot based on her release from Sheppard Pratt, holding that D.L. faced collateral consequences as a result of her involuntary admission, and therefore, her appeal was not moot. An ALJ involuntarily admitted D.L. to Sheppard Pratt. After she was released, D.L. petitioned for judicial review. The circuit court granted Sheppard Pratt's motion to dismiss on grounds of mootness because D.L. had already been released from the facility. The Court of Special Appeals affirmed. The Court of Appeals reversed, holding that D.L. was subject to collateral consequences stemming from her involuntary admission, and therefore, the circuit court erred in dismissing the case as moot. View "D.L. v. Sheppard Pratt Health System Inc." on Justia Law

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A group of children's hospitals that receive Disproportionate Share Hospital (DSH) payments under the Medicaid Act filed suit challenging the Secretary's promulgation of a regulation defining "costs incurred" in furnishing hospital services to low income patients (the 2017 Rule). The DC Circuit reversed the district court's decision vacating the 2017 Rule and reinstated it, holding that the rule did not exceed the Secretary's statutory authority under the Medicaid Act and rejecting plaintiffs' reasons for why the statute did not grant the Secretary authority to require that payments by Medicare and private insurers be considered in calculating a hospital's "costs incurred;" the 2017 Rule is consistent with the statute's context and purpose, both of which suggest DSH payments are meant to assist those hospitals that need them most by covering only those costs for which DSH hospitals are in fact uncompensated; and the 2017 Rule was not a product of arbitrary and capricious reasoning. View "Children's Hospital Association of Texas v. Azar" on Justia Law

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The Supreme Court dismissed this petition for extraordinary relief asserting that the actions of Governor Gary R. Herbert, Lieutenant Governor Spencer J. Cox, and the Utah Legislature in replacing a citizens' initiative approved by Utah voters that legalized medical cannabis and replacing the initiative with H.B. 3001 were unconstitutional, holding that some of Petitioners' arguments failed on the merits and that the remainder of the petition did not comply with Rule 19 of the Utah Rules of Appellate Procedure. The day H.B. 3001 passed, some of the Petitioners filed a referendum application with the Lieutenant Governor that would have allowed H.B. 3001 to be put to a vote of the people. The Lieutenant Governor denied the petition because he determined one of the referendum sponsors did not meet the applicable statutory requirements and because the Utah House of Representatives and the Utah Senate passed the bill by a supermajority, which made the bill referendum-proof. Petitioners subsequently brought this petition. The Supreme Court dismissed the petition, holding (1) the Governor did not effectively veto Provision 2, and the Two-Thirds Provisions of the Utah Constitution and Utah Code applied to the legislation here; and (2) the rest of the petition is dismissed without prejudice for failure to comply with Rule 19. View "Grant v. Governor Gary R. Herbert" on Justia Law

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This case presented a narrow issue of whether respondent Michelle Rouillard in her capacity as director of California’s Department of Managed Health Care (Department) violated the California Administrative Procedure Act (APA) when she sent letters to seven health care service plans directing them to comply with California law in their coverage of abortion services. The issue reduced to whether a “voluntary” abortion was a “medically necessary” procedure that health care service plans were required to cover. The letters told the recipients that health care plans could not limit or exclude coverage for termination of pregnancies. Petitioner Missionary Guadalupanas of the Holy Spirit, Inc., claimed that by sending out the letters interpreting “basic health care services” to include abortions, respondent ignored the APA rulemaking process. The Court of Appeal concluded petitioner’s argument set forth a false dichotomy between a “voluntary” service and a “medically necessary” health care service, which health care plans were required to cover under California Code of Regulations, title 28, section 1300.67."This false assumption led petitioner to the flawed conclusion that the Department’s letters were for the purpose of clarifying an ambiguity in the statute, and that compliance with the rulemaking procedures of the APA was necessary." The Court determined the application of the regulation to the facts of this case was unambiguous, and the Department was not required to comply with the APA. View "Missionary Guadalupanas of the Holy Spirit v. Rouillard" on Justia Law

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ACLA filed suit alleging that the Secretary's final ruling implementing the Protecting Access to Medicare Act's (PAMA) definition of "applicable laboratory" unlawfully excluded most hospital laboratories from PAMA's reporting requirements. The district court dismissed the complaint for lack of subject matter jurisdiction. As a preliminary matter, the DC Circuit held that ACLA had standing. In view of PAMA's text, its structure, and the distinct nature of the processes of data collection and establishment of payment rates, the court could not conclude that the bar against reviewing the "establishment of payment amounts" also prevents its review of the rule setting up a new and detailed process for collecting data on market rates that private insurers pay to laboratories. Because the statute is "reasonably susceptible" to this interpretation, the court held that it does not bar judicial review of the Secretary's rule establishing the parameters of data collection under 42 U.S.C. 1395m-1(a). Finally, the court rejected ACLA's claim that the Secretary's rule was ultra vires. Accordingly, the court reversed the district court's holding on subject matter jurisdiction and remanded for further proceedings. View "American Clinical Laboratory Assoc. v. Azar" on Justia Law

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The owners and operators of a skilled nursing facility contended the trial court erred when it denied their petition to compel arbitration. They attempted to enforce arbitration in this action for elder abuse and wrongful death brought by a decedent through her husband as successor in interest, her husband individually, and their children. Appellants claimed the successor had signed the arbitration agreements as the decedent’s authorized agent. The trial court determined that although the successor did not sign the agreements as the decedent’s agent, he expressly bound himself to arbitrate all claims he held individually and as the successor in interest. As a result, the decedent’s claim for elder abuse and the husband’s individual claim for wrongful death were subject to arbitration. However, the court denied the petition because the children’s claims were not subject to arbitration, and allowing the arbitration and the litigation to proceed concurrently could result in inconsistent findings of fact and law. Finding no reversible error in the trial court’s judgment, the Court of Appeal affirmed. View "Valentine v. Plum Healthcare Group, LLC" on Justia Law

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Health and Safety Code section 1418.8 concerns nursing home residents who lack the capacity to make their own health care decisions and are without family members or other legal surrogates. The superior court held that the statute, on its face, violates due process under the California Constitution by failing to require notice to residents of a physician’s predicate determinations that the patient lacks capacity, has no surrogate decision-maker, needs a recommended medical intervention, and has a right to judicial review; was never intended to authorize interdisciplinary team (IDT) decision-making for administration of antipsychotic medication, and violates due process, as applied, when used to authorize such drugs; and violates the patient’s privacy rights and is unconstitutional as applied to decisions regarding end of life withdrawal of care. The court of appeal reversed, construing the statute to uphold its constitutionality rather than enjoining its use, and directing the superior court to enter a modified judgment, requiring nursing homes to adopt additional procedures. Written and oral notice must be provided to every resident for whom section 1418.8 is invoked, of any determination of the resident’s incapacity; any determination that no surrogate decision-maker is available; any proposed medical intervention; the fact that a decision will be made by the IDT; the resident’s right to have a patient representative participate in IDT decision-making; and the resident’s right to judicial review of IDT decisions. Except in emergency circumstances, no medical treatment decision by an IDT on behalf of a resident may be implemented until the resident has been given a reasonable opportunity to seek judicial review. Except in emergency circumstances, every IDT must include a patient representative, and where the resident has no family or friend willing to serve, someone unaffiliated with the nursing home must serve as the patient representative. The IDT process may be used to authorize the administration of antipsychotic medications and for decisions to create or change physician orders for life-sustaining treatment, DNRs or comfort care orders, and to transfer patients to hospice care. View "California Advocates for Nursing Home Reform v. Smith" on Justia Law

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The Fifth Circuit denied Southern Hens' petition for review of the ALJ's determination that the poultry processing plant committed two violations of occupational safety standards after an employee suffered a serious injury when her hand got caught in a machine's moving parts. The court upheld the ALJ's decision with regard to the lockout violation because Southern Hens lacked the sort of established work rule required for the "unpreventable employee misconduct" defense; upheld that machine-guarding standard and adopted the reasonably predictable standard, holding that there was substantial evidence that employee injury from the hazard was reasonably predictable; and upheld the penalties for the lockout violation and the machine-guarding violation. View "Southern Hens, Inc. v. Occupational Safety and Health Review Commission" on Justia Law