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Plaintiff Jimmy Vasquez, an inmate in the Colorado Department of Corrections (“CDOC”), filed suit under 42 U.S.C. 1983, contending CDOC medical providers were deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. Vasquez specifically alleged Defendants delayed treating him for the hepatitis C virus (“HCV”), resulting in his suffering life-threatening permanent liver damage. In appeal No. 17-1026, the Tenth Circuit affirmed the district court’s decision to grant Defendants summary judgment, concluding Vasquez’s claims against Defendants Davis, Webster, Melloh, and Chamjock were time-barred, and Vasquez failed to present sufficient evidence that Defendant Fauvel acted with deliberate indifference. In appeal No. 17-1044, the Court vacated an injunction requiring the CDOC to test Vasquez’s liver function every three months. View "Vasquez v. Davis" on Justia Law

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In 2016, Kansas sent notices of decisions to terminate its Medicaid contracts with two Planned Parenthood affiliates, Planned Parenthood of Kansas and Mid-Missouri (“PPGP”), and Planned Parenthood of the St. Louis Region (“PPSLR”). The notices cited concerns about the level of PPGP’s cooperation in solid-waste inspections, both Providers’ billing practices, and an anti-abortion group’s allegations that Planned Parenthood of America (“PPFA”) executives had been video-recorded negotiating the sale of fetal tissue and body parts. Together, the Providers and three individual Jane Does (“the Patients”) immediately sued Susan Mosier, Secretary of the Kansas Department of Health and Environment (“KDHE”), under 42 U.S.C. 1983, alleging violations of 42 U.S.C. 1396a(a)(23) and the Equal Protection Clause of the Fourteenth Amendment. The Plaintiffs sought a preliminary injunction enjoining Kansas from terminating the Providers from the state’s Medicaid program. "States may not terminate providers from their Medicaid program for any reason they see fit, especially when that reason is unrelated to the provider’s competence and the quality of the healthcare it provides." The Tenth Circuit joined four of five circuits that addressed this same provision and affirmed the district court’s injunction prohibiting Kansas from terminating its Medicaid contract with PPGP. But the Court vacated the district court’s injunction as it pertained to PPSLR, remanding for further proceedings on that issue, because Plaintiffs failed to establish standing to challenge that termination. But on this record, the Court could not determine whether PPSLR itself could establish standing, an issue the district court declined to decide but now must decide on remand. View "Planned Parenthood v. Andersen" on Justia Law

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Michael, a licensed pharmacist at Chapmanville's Aracoma Pharmacy, separately co-owns another West Virginia pharmacy and one in Pennsylvania. The government suspected that Michael used the pharmacies to distribute on-demand prescription drugs, worth more than $4 million, over the Internet. A grand jury returned a multi-count indictment. Count 7 charged Michael with fraudulently submitting a claim for payment to Humana for dispensing medication that was never dispensed (18 U.S.C. 1347). Count 8 charged him with committing aggravated identity theft by using the “identifying information” of a doctor and a patient “in relation to the [health care fraud] offense” (18 U.S.C. 1028A(a)(1), (c)(11)). Michael had submitted a claim to Humana indicating that A.S. (doctor) had prescribed Lovaza for P.R., including the doctor’s National Provider Identifier and the patient’s name and birth date. A.S. was not P.R.’s doctor and did not issue the prescription. Section 1028A requires a person to “assume the identity” of someone else; the district court held that the statute covered only “impersonation,” and dismissed Count 8. The Sixth Circuit reversed. To “use” a means of identification is to “convert to one’s service” or “employ” the means of identification. Michael used A.S. and P.R.’s identifying information to fashion a fraudulent submission, making the misuse of these means of identification “during and in relation to” healthcare fraud. View "United States v. Michael" on Justia Law

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At issue was whether the Attorney General has authority to request injunctive relief against a nursing facility pursuant to two different provisions of the Patient’s Bill of Rights, a comprehensive statutory scheme enacted to identify and protect individuals’ rights in Maryland nursing facilities. The State sought an injunction against Defendant, a nursing facility. The trial court concluded that the allegations in the State’s complaint, if true, would be in violation of the Patient’s Bill of Rights but that the Injunction Clause did not authorize the kind of broad injunctive relief the State sought and that the State lacked authority to sue for an injunction under the Enforcement Clause. The Court of Appeals reversed, holding (1) under Md. Code Ann. Health-Gen. 19-345.3(c), the Attorney General may bring suit on behalf of individual residents who have been subjected to, or away, imminent, unlawful involuntary discharges if at least one individual’s statutory rights have been violated, and a court may issue injunctive relief for violations of Md. Code Ann. Health-Gen. 19-345, 19-345.1 and 19-345.2; and (2) the Attorney General’s authority to prosecute violations of Md. Code Ann. Health-Gen. 19-344(c)(4)-(5) permits the Attorney General to seek an injunctive to enforce certain provisions related to the Medicaid application process. View "State v. Neiswanger Management Services, LLC" on Justia Law

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In August 2014, Dianne and Reggie Harkins alleged the direct and proximate negligence of multiple healthcare providers located in Leake County and Hinds County resulted in, among other problems, the amputation of Dianne Harkins’s hands and feet. In January 2015, Madden Medical Clinic, PLLC (Madden Medical) and David Moody, M.D. (Dr. Moody) filed a motion to dismiss or, alternatively, for severance and transfer of venue to the Circuit Court of Leake County. Shortly thereafter, Baptist Medical Center-Leake, Inc. (BMC-Leake) and Mississippi Baptist Health Systems, Inc. (Baptist Health) filed a motion also to dismiss or transfer venue to the Circuit Court of Leake County. On February 26, 2016, the Circuit Court of the First Judicial District of Hinds County entered an order denying the motions of Dr. Moody, Madden Medical, BMC-Leake, and Baptist Health to dismiss or, in the alternative, to transfer venue. The parties appealed, collectively filing two interlocutory appeals, and both appeals were granted and consolidated. The Mississippi Supreme Court held that under the plain language of Mississippi Code Section 11-11-3(3), venue was proper for the properly joined defendants in Hinds County or Leake County, and the judgment of the trial court was affirmed. View "Mississippi Baptist Health Systems, Inc. v. Harkins" on Justia Law

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Plaintiffs Kerry and Scott Tomlinson (parents) and their son, T, brought separate negligence claims against defendants Mary K. Wagner, MD., Metropolitan Pediatrics, LLC, and Legacy Emanuel Hospital & Health Center. In their respective claims, plaintiffs alleged that defendants provided medical services to the parents’ older son, M, failed to timely diagnose M’s genetic disorder, and failed to inform the parents of that disorder. They further alleged that, “[h]ad defendants, and each of them, timely diagnosed [M’s] DMD, [the parents] would not have produced another child suffering from [DMD].” The trial court entered a judgment dismissing the complaint on the ground that neither the parents nor T were patients of defendants and, therefore, the court reasoned, defendants owed no obligation of professional care toward them. The Court of Appeals reversed that judgment as to the parents but affirmed as to T. The Oregon Supreme Court affirmed the decision of the Court of Appeals, and reversed in part and affirmed in part the trial court judgment dismissing this action. Under the parents’ theory of relief, the relevant injury was not the resulting life, but the negligent deprivation of information that was important to the parents’ protected interest in making informed reproductive choices. T’s claim necessarily depended on the premise that T had a legally protected interest in not being born, rather than risk being born with DMD. "[T]he doctrinal implications of recognizing T’s right to recover such damages would be significant." The Court concluded the factual allegations were sufficient as to the parents' claim. With respect to T's claims, however, the Court determined the "threshold difficulty with T’s argument is that it puts the damages cart before the liability horse; that is, T’s argument blurs the line between the identification of a cognizable injury and the determination of damages resulting from the injury. . . based on the facts that T alleges, defendants could not have caused T a physical harm." View "Tomlinson v. Metropolitan Pediatrics, LLC" on Justia Law

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The trial court abused its discretion in concluding that Plaintiff’s expert report did not represent a good-faith effort to meet the requirements of the Texas Medical Liability Act and in dismissing Plaintiff’s health care liability claims. Plaintiff sued Defendants, a certified registered nurse anesthetist and his employer, asserting medical malpractice claims relating to the nurse’s administration before cataract surgery. The trial court granted Defendants’ motion to dismiss, finding that Plaintiff’s expert report was deficient with respect to the elements of standards of care, breach of standards of care, and causation. The court of appeals affirmed. The Supreme Court reversed, holding that the report satisfied the good faith effort the Act requires. View "Baty v. Futrell" on Justia Law

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St. Alexius Medical Center, doing business as Great Plains Rehabilitation ("Great Plains"), appealed a district court judgment affirming a Department of Human Services ("the Department") determination that the Department was entitled to recoup overpayments made to Great Plains. Great Plains argued the Department's decision had to be reversed because the Department did not issue the decision within the statutory time limit, the Department did not provide a fair process for disputing the Department's position, and the Department's findings of fact are not supported by the evidence. Finding no reversible error in the district court or the Department's decisions, the North Dakota Supreme Court affirmed. View "St. Alexius Medical Center v. N.D. Dep't of Human Services" on Justia Law

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Legacy, a Federally Qualified Health Center (FQHC), filed suit against the Commission, alleging that Texas's reimbursement scheme violated the Medicaid Act. The Fifth Circuit reversed the district court's grant of summary judgment for Legacy, holding that the Commission's requirement that Managed Care Organizations (MCOs) fully reimburse FQHCs did not violate the Medicaid Act; Legacy lacked standing to challenge the Commission's lack of a policy that the state directly reimburse an FQHC if it is not fully reimbursed by the MCO; and Legacy was not entitled to reimbursement for the non-emergency, out-of-network services about which it complained. Accordingly, the court remanded with instructions. View "Legacy Community Health Services, Inc. v. Smith" on Justia Law

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Plaintiff-appellant Elizabeth Cates was a former patient of defendant-appellee Integris Health, Inc.’s medical facility and claimed defendant wrongfully billed her, and others like her, for services. She filed this action in state court, alleging state-law claims for breach of contract, violation of the Oklahoma Consumer Protection Act, and deceit. Defendant successfully moved to dismiss these claims on the ground that they were expressly preempted by the federal Employee Retirement Income Security Act. On appeal, the Oklahoma Supreme Court reversed and held that plaintiff’s claims were not preempted. The case was returned to the trial court for further proceedings. View "Cates v. Integris Health, Inc." on Justia Law