Justia Health Law Opinion Summaries

Plaintiff Yesenia Pacheco sought contraception from Neighborcare Health, a federally funded community health center, “to prevent the birth of an unwanted child.” The method Pacheco and her care providers selected was Depo-Provera, “a highly effective” injectable contraceptive medication that “must be administered on a timely basis every eleven to thirteen weeks.” Pacheco received regular Depo-Provera injections from December 2009 until July 2011. On September 30, 2011 for her next scheduled appointment, a medical assistant “mistakenly injected [Pacheco] with a flu vaccine instead.” The medical assistant “failed to confirm why Ms. Pacheco was there, to document consent to the flu vaccine or a change in the orders, or to advise Ms. Pacheco of the side effects of a flu shot and/or the consequences of skipping a Depo-Provera injection.” Neighborcare did not inform Pacheco of its mistake until December 2011, when she sought an appointment for her next Depo-Provera injection. At that time, Neighborcare asked Pacheco to come to the clinic for a pregnancy test, which was positive. Plaintiff S.L.P. was born to Pacheco and plaintiff Luis Lemus, diagnosed with perisylvian polymicrogyria (PMG), a congenital defect resulting in permanent disabilities. In March 2017, Pacheco, Lemus, and S.L.P. filed an amended complaint against the United States pursuant to the Federal Tort Claims Act (FTCA) at the federal district court for the Western District of Washington, seeking damages relating to Pacheco’s pregnancy and S.L.P.’s PMG. The federal district court certified a question of law to the Washington Supreme Court, asking whether a patient who received negligent reproductive health care could recover all damages proximately caused by the provider’s negligence, regardless of the patient’s reason for seeking care. To this, the Supreme Court answered yes: if any Washington health care provider breaches their duty “to follow the accepted standard of care,” then damages proximately caused by the provider’s negligence may be recovered upon the necessary factual findings. Where negligent contraceptive care results in the birth of a child, and that child has a congenital defect, the provider may be liable for damages relating to the child’s condition. Such liability does not require proof that the child was at a known, heightened risk for developing congenital defects or that the patient sought contraception for the specific purpose of preventing the birth of a child with congenital defects. View "Pacheco v. United States" on Justia Law

The First Circuit affirmed the conclusion of the district court that the Maine Medical Marijuana Act's requirement that officers and directors of medical marijuana dispensaries operating in Maine be Maine residents violates the dormant Commerce Clause of the United States Constitution, holding that that Maine residency requirement violates the dormant Commerce Clause.Plaintiffs brought this suit under 42 U.S.C. 1983 and 28 U.S.C. 2201 alleging that the Act's residence requirement violates the dormant Commerce Clause by permitting only in-staters to serve as officers or directors of dispensaries. The district court granted judgment for Plaintiffs. On appeal, Defendants argued that because the Controlled Substances Act (CSA), 21 U.S.C. 801 et seq., makes marijuana contraband, the residency requirement does not run afoul of the dormant Commerce Clause. The First Circuit disagreed, noting that "a congressional exercise of commerce power can never, merely by being in place, displace the dormant Commerce Clause." The Court then affirmed, holding that "nothing on the face of the CSA purports to bless interstate discrimination in the market for medical marijuana that continues to operate even in the face of the CSA." View "Northeast Patients Group v. United Cannabis Patients & Caregivers of Maine" on Justia Law

The Supreme Court held that a trial court lacks discretion to deny a request for a recommended change in the commitment conditions of a mentally ill person subject to court-ordered commitment to a mental health facility when the state has failed to present clear and convincing evidence that the change represents a threat to public safety or any person.Appellant was found not guilty by reason of insanity of murder, tampering with evidence, and abuse of a corpse. The trial court ordered Appellant committed to a mental health facility. The chief clinical officer at the facility later filed a request with the trial court asking that Appellant be allowed to leave the facility to go on trips (Level IV community movement). The trial court denied the request, and the appellate court affirmed. The Supreme Court reversed, holding that the appellate court erred in concluding that the trial court had discretion to deny the requested change in Appellant's commitment level even if the state failed to meet its burden of proof. View "State v. Stutler" on Justia Law

In 2020, California and Santa Clara County issued public health orders intended to combat the Covid-19 pandemic, including orders restricting indoor gatherings and requiring face coverings, social distancing, and submission of a social distancing protocol by businesses, including churches. Calvary Chapel failed to comply with those orders. On November 2, 2020, the trial court issued a temporary restraining order, followed by a November 24 modified TRO, and a preliminary injunction that enjoined Calvary from holding indoor gatherings that did not comply with the restrictions on indoor gatherings and requirements that participants wear face coverings and social distance. Calvary was also enjoined from operating without submitting a social distancing protocol. Calvary violated the orders, failing to comply with any of the public health orders.The government sought an order of contempt, which the trial court issued on December 17, 2020, ordering Calvary and its pastors to pay monetary sanctions (Code of Civil Procedure sections 177.51 and 1218(a)). The court of appeal annulled the contempt orders and reversed the sanctions. The temporary restraining orders and preliminary injunctions are facially unconstitutional under the recent guidance of the U.S. Supreme Court regarding the First Amendment’s protection of the free exercise of religion in the context of public health orders that impact religious practice. View "People v. Calvary Chapel San Jose" on Justia Law

When Plaintiff-appellant Linda Smith purchased a prescribed continuous blood glucose monitor (CGM) and its necessary supplies between 2016 and 2018, she sought reimbursement through Medicare Part B. Medicare administrators denied her claims. Relying on a 2017 ruling issued by the Centers for Medicare and Medicaid Services (CMS), Medicare concluded Smith’s CGM was not “primarily and customarily used to serve a medical purpose” and therefore was not covered by Part B. Smith appealed the denial of her reimbursement claims through the multistage Medicare claims review process. At each stage, her claims were denied. Smith then sued the Secretary of the Department of Health and Human Services in federal court, seeking monetary, injunctive, and declaratory relief. Contending that her CGM and supplies satisfied the requirements for Medicare coverage. Instead of asking the court to uphold the denial of Smith’s claims, the Secretary admitted that Smith’s claims should have been covered and that the agency erred by denying her claims. Rather than accept the Secretary’s admission, Smith argued that the Secretary only admitted error to avoid judicial review of the legality of the 2017 ruling. During Smith’s litigation, CMS changed its Medicare coverage policy for CGMs. Prompted by several adverse district court rulings, CMS promulgated a formal rule in December 2021 classifying CGMs as durable medical equipment covered by Part B. But the rule applied only to claims for equipment received after February 28, 2022, so pending claims for equipment received prior to that date were not covered by the new rule. Considering the new rule and the Secretary’s confession of error, the district court in January 2022 remanded the case to the Secretary with instructions to pay Smith’s claims. The district court did not rule on Smith’s pending motions regarding her equitable relief claims; instead, the court denied them as moot. Smith appealed, arguing her equitable claims were justiciable because the 2017 ruling had not been fully rescinded. The Tenth Circuit agreed with the Secretary that Smith’s claims were moot: taken together, the December 2021 final rule and the 2022 CMS ruling that pending and future claims for CGMs would be covered by Medicare deprived the Tenth Circuit jurisdiction for further review. View "Smith v. Becerra" on Justia Law

The Supreme Court dismissed this appeal from the judgment of the court of appeals affirming the ruling of the district court that Catherine Roll did not have a statutory right to remain at Parsons State Hospital and Training Center, where she had been a long-term resident, holding that the appeal was moot.Defendants sought to relocate Roll, a person with significant mental and physical disabilities, from the Hospital to a community-based treatment center. Through her guardians, Roll opposed the transfer, arguing that, under the Social Security Act (SSA) and the Americans with Disabilities Act, the proposed transfer from the Hospital violated her right to choose which facility would provide her treatment. The district court entered judgment in favor of Defendants. Roll appealed. Before the Court reached a decision on the merits, Defendants voluntarily provided Roll with the relief she had been seeking by stating their intention to maintain her residence at the Hospital. The Supreme Court dismissed the appeal, holding that the case was moot. View "Roll v. Howard" on Justia Law

The Supreme Court dismissed this appeal from a district court's order denying injunctive relief, holding that this Court lacked jurisdiction to hear the appeal.Plaintiffs were ten students at Creighton University who brought this petition seeking to enjoin Creighton from administratively withdrawing students who did not comply with its COVID-19 vaccine policy. After a hearing, the district court denied the petitions, concluding that Plaintiffs failed to show irreparable harm or a likelihood of success on the merits. Plaintiffs appealed. The Supreme Court dismissed the appeal, holding that the court's denial of a temporary injunction was not a final order, and therefore, this Court lacked jurisdiction over the appeal. View "Ramaekers v. Creighton University" on Justia Law

Plaintiffs worked for MBO and Trustmark, which provide medical billing and debt‐collection services to healthcare providers. After they raised concerns about their employers’ business practices, the plaintiffs were fired. They sued MBO, Trustmark, and MBO's client, the University of Chicago Medical Center (UCMC), under the False Claims Act, 31 U.S.C. 3729. Regulations specify that Medicare providers seeking reimbursement for “bad debts” owed by beneficiaries must first make reasonable efforts to collect those debts. The plaintiffs claim that UCMC knowingly avoided an obligation to repay the government after it effectively learned that it had been reimbursed for non-compliant debts; MBO and Trustmark caused the submission of false claims to the government. Each plaintiff also claimed retaliation.The Seventh Circuit affirmed the dismissal of the complaint, in part. The district court properly dismissed the claim against UCMC, which neither had an established duty to repay the government nor acted knowingly in avoiding any such duty. The direct false claim against MBO was also correctly dismissed. The complaint failed to include specific representative examples of non-compliant patient debts, linked to MBO, for which reimbursement was sought. The court reversed in part; the complaint includes specific examples of patient debts involving Trustmark. Two plaintiffs alleged facts that support the inference that they reasonably believed their employers were causing the submission of false claims. View "Sibley v. University of Chicago Medical Center" on Justia Law

The Supreme Court affirmed the judgment of the district court dismissing the complaint in this case for failure to state a claim, holding that an employee discharged after testing positive at work based on recreational marijuana use does not have a common-law tortious discharge claim.Plaintiff was terminated from his employment based on a positive test result for marijuana. Plaintiff brought this complaint arguing that he did not use marijuana in the twenty-four hours before that shift and that his use complied with Nevada's recreational marijuana laws. The district court dismissed the complaint. At issue before the Supreme Court was whether adult recreational marijuana use qualifies for protection under Nev. Rev. Stat. 613.333. The Supreme Court answered the question in the negative, holding that because federal law criminalizes the possession of marijuana in Nevada, marijuana use is not lawful in the state and does not support a private right of action under Nev. Rev. Stat. 613.333. View "Ceballos v. NP Palace, LLC" on Justia Law

The United States District Court for the District of South Carolina certified a question of law to the South Carolina Supreme Court. Sullivan Management, LLC operated restaurants in South Carolina and filed suit to recover for business interruption losses during COVID-19 under a commercial property insurance policy issued by Fireman's Fund and Allianz Global Risks US Insurance Company (Fireman's). Specifically, the questions was whether the presence of COVID-19 in or near Sullivan's properties, and/or related governmental orders, which allegedly hinder or destroy the fitness, habitability or functionality of property, constituted "direct physical loss or damage" or did "direct physical loss or damage" require some permanent dispossession of the property or physical alteration to the property. The Supreme Court held that the presence of COVID-19 and the corresponding government orders prohibiting indoor dining did not fall within the policy’s trigger language of “direct physical loss or damage.” View "Sullivan Mgmt v. Fireman's Fund" on Justia Law