Carl Kirk was committed to the custody of the Department of Mental Health under the Sexually Violent Predator Act (SVPA), Mo. Rev. Stat. 632.480 through 632.525. On appeal, the court of appeals transferred the case to the Supreme Court on the ground that the appeal involved issues within the Supreme Court’s exclusive appellate jurisdiction as set forth in Mo. Const. art. V, section 3. The Supreme Court affirmed, holding (1) the issues raised in this case did not fall within the Supreme Court’s exclusive appellate jurisdiction, and even thought he court of appeals erred in transferring the case, the Supreme Court granted transfer prior to opinion pursuant to Rule 83.01 and therefore had jurisdiction; (2) the SVPA, among other things, evidences no punitive intent and violates no constitutional prohibits against ex post facto laws, and the standard of proof required under the SVPA and employed in Kirk’s case is not unconstitutional; and (3) Kirk’s remaining claims of error were unavailing. View "In re Care & Treatment of Kirk" on Justia Law

Defendant was committed to the custody of the Department of Mental Health under the Sexually Violent Predator Act (SVPA), Mo. Rev. Stat. 632.480 through 632.525. On appeal, the court of appeals transferred the case to the Supreme Court on the ground that the appeal involved issues within the Supreme Court’s exclusive appellate jurisdiction. For the reasons set forth in In re Care & Treatment of Kirk, __ S.W.3d __ (Mo. 2017), decided also on this day, Defendant’s constitutional claims were “merely colorable” and did not invoke the Supreme Court’s jurisdiction. However, the court, on its own motion, granted transfer from the court of appeals prior to opinion pursuant to Rule 83.01 and therefore had jurisdiction. The Supreme Court affirmed, holding (1) Defendant’s constitutional claims that the purpose and effect of the SVPA is punitive are rejected; and (2) Defendant’s remaining claims on appeal were unavailing. View "In re Care & Treatment of Nelson" on Justia Law

The Supreme Judicial Court affirmed the judgment of the superior court denying Mark Gessner’s petition for release from the Riverview Psychiatric Center. On appeal, Gessner argued that the statute governing his opportunity for release from institutional inpatient residency, Me. Rev. Stat. 15, 104-A, was unconstitutionally vague as applied to him. Because Gessner did not raise the vagueness issue to the trial court, the Supreme Judicial Court reviewed for obvious error. The court held (1) considering Gessner’s history of mental illness and violence and his refusal to acknowledge his mental illness or to participate in treatment, the statute’s terms were not unconstitutionally vague for purposes of addressing the individual circumstances at issue in this case; and (2) therefore, Gessner failed to meet his burden of demonstrating that the court committed obvious error. View "Gessner v. State" on Justia Law

In this declaratory judgment proceeding, petitioner Exeter Hospital, Inc. (Exeter) appealed a superior court order denying its motion for partial summary judgment as to the amount at which coverage was triggered under an umbrella policy (the policy) issued to Exeter by respondent Steadfast Insurance Company (Steadfast). In the spring of 2012, an outbreak of Hepatitis C infections among patients serviced by Exeter’s cardiac catheterization lab led investigators to discover that a technician had spread the virus to patients “through a clandestine drug diversion scheme.” The technician allegedly injected certain drugs into his body by way of intravenous needles, then reused the needles on patients, thereby infecting them with the virus. Numerous lawsuits were lodged against Exeter by affected patients. Exeter was primarily insured through a Self-Insurance Trust Agreement (SIT), which provided professional liability coverage in the amount of $1 million per medical incident, with a $4 million annual aggregate cap. Exeter also maintained the policy with Steadfast, which provided excess health care professional liability coverage. Steadfast maintained that it would pay damages only in excess of the $100,000 retained limit for each medical incident. Exeter filed this proceeding, seeking a declaration that it was not required to pay $100,000 retained limit per claim. The trial court interpreted the term “applicable underlying limit” as being a variable amount “dependent on the actual coverage remaining under [the] other [limits of] insurance,” here, the limits of the SIT. Because Exeter had paid out the limits of the SIT, the court found that the “applicable underlying limit” was zero, thereby rendering the $100,000 retained limit greater than the “applicable underlying limit.” Thus, the court determined that, pursuant to “Coverage A,” Steadfast was required “to pay damages in excess of $100,000 for each medical incident.” Exeter sought reconsideration of the court’s order, which the court denied. Although the New Hampshire Supreme Court did not agree with every underlying argument pressed by Exeter, it concluded that its overall argument regarding the interpretation of Coverage A was reasonable, and the trial court therefore erred in granting partial summary judgment as to the terms of Coverage A. View "Exeter Hospital, Inc. v. Steadfast Insurance Company" on Justia Law

Plaintiff-appellee Elizabeth Cates filed on her behalf and a putative class asserting claims against the defendant-appellee INTEGRIS Health, Inc. for breach of contract, violation of the Oklahoma Consumer Protection Act, deceit, specific performance, and punitive damages. INTEGRIS successfully moved to dismiss the claims based on the ground that they are all preempted by the Employee Retirement Income Security Act. Cates appealed. Because the trial court in this matter did not take into consideration the federal Tenth Circuit Court of Appeals’ decision in Salzer v. SSM Health Care of Oklahoma Inc., 762 F.3d 1130 (10th Cir. 2014), which was factually similar to the facts of this case and found that the plaintiff’s claims were not preempted, the Oklahoma Supreme Court reversed and remanded the trial court in this matter for reconsideration in light of Salzer. View "Cates v. Integris Health, Inc." on Justia Law

Dr. Benjamin Reid, a licensed general surgeon, filed a complaint against KentuckyOne Health, Inc. (“Hospital”) alleging various claims arising from the Hospital’s review of Reid’s surgical privileges at the Hospital. The circuit court granted the Hospital’s motion for judgment on the pleadings, concluding that Reid failed to rebut the presumption that the Hospital was immune under the Health Care Quality Improvement Act of 1986 because the Hospital’s conduct with respect to Reid was related to its professional review activities. The court of appeals reversed, concluding that the Hospital had taken a “professional review action” against Reid rather than a “professional review activity.” The Supreme Court reversed, holding (1) a factual dispute existed as to whether the Hospital’s actions were merely “professional review activities” that would be entitled to immunity under the Act or whether they were “professional review actions,” and (2) therefore, the record was insufficient on the immunity question under the Act. View "KentuckyOne Health, Inc. v. Reid" on Justia Law

This case turned on whether an attorney-in-fact who admitted her principal to a residential care facility for the elderly made a “health care” decision. If she did, as the trial court found, she acted outside the scope of her authority under the power of attorney, and the admission agreement she signed, and its arbitration clause this appeal sought to enforce, were void. On these facts the Court of Appeal concluded the decision was health care decision, and the attorney-in-fact who admitted her, acting under the PAL, was not authorized to make those kinds of decisions on behalf of the principal. As a result of this conclusion, the Court affirmed the trial court’s denial of a motion by the residential care facility to compel arbitration. Because the attorney-in-fact acting under the PAL did not have authority to admit the principal to the residential care facility for the elderly, her execution of the admission agreement and its arbitration clause were void. View "Hutcheson v. Eskaton Fountainwood Lodge" on Justia Law

Critical Access Hospitals are reimbursed by Medicare for the reasonable and necessary costs of providing services to Medicare patients. The Medicaid program requires states to provide additional (DSH) payments to hospitals that serve a disproportionate share of low-income patients, 42 U.S.C. 1396a(a)(13)(A)(iv). In Kentucky, DSH payments are matched at 70% by the federal government. Kentucky’s contribution to DSH programs comes from payments from state university hospitals and Kentucky Provider Tax, a 2.5% tax on the revenue of various hospitals, including Appellants, The amount of DSH payments a hospital receives is unrelated to the amount of KP-Tax it paid. During the years at issue, DSH payments covered only 45% of Appellants' costs in providing indigent care. Appellants filed cost reports in 2009 and 2010 claiming their entire KP-Tax payment as a reasonable cost for Medicare reimbursement. Previously, they had received full reimbursement; for 2009 and 2010, however, the Medicare Administrative Contractor denied full reimbursement, offsetting the KP-Tax by the amount of DSH payments Appellants received. The Provider Reimbursement Review Board and Centers for Medicare and Medicaid Services upheld the decision. The Sixth Circuit affirmed, reasoning that the net economic impact of Appellants’ receipt of the DSH payment in relation to the cost of the KP-Tax assessment indicated that the DSH payments reduced Appellants’ expenses such that they constituted a refund. View "Breckinridge Health, Inc. v. Price" on Justia Law

Since 2009, AIDS Support Group of Cape Cod, Inc. (ASGCC) has been operating a free hypodermic needle access program in a village in Barnstable. The Town of Barnstable ordered the cessation of the program, asserting that ASGCC was in violation of Mass. Gen. Laws ch. 94C, 27 and Mass. Gen. Laws ch. 111, 215. In response to the Town’s cease and desist order, ASGCC filed this action seeking injunctive relief and a declaration that its nonsale needle access program was not statutorily prohibited. The superior court judge reported the question to the Appeals Court, and the Supreme Judicial Court allowed ASGCC’s application for direct appellate review. The court remanded the matter to the superior court for entry of a declaration that neither statute prohibits ASGCC from engaging in free distribution of hypodermic needles and an injunction permanently enjoining enforcement of the Town’s order to cease and desist, holding that the plain language of the statutes does not proscribe free distribution of hypodermic needs by a private individual or organization such as ASGCC that does not operate a program implemented by the Department of Public Health. View "AIDS Support Group of Cape Cod, Inc. v. Town of Barnstable" on Justia Law

Raymond, injured in a slip-and-fall accident, received medical treatment at Mercy Health Anderson Hospital. Strunk, injured in a car accident, received medical treatment at Mercy Health Clermont Hospital. Both have health insurance. Each of their insurers has an agreement with Mercy for the provision of services. Raymond and Strunk provided all information necessary for the hospital to submit claims. Mercy did not submit claims to the insurers. Instead, Avectus, on behalf of Mercy, sent letters to Raymond’s and Strunk’s attorneys stating the balance due for medical services and requesting that, to prevent collection efforts against their respective clients, the attorneys sign a “letter of protection” against any settlement or judgment, agreeing “to withhold and pay directly to Mercy Health the balance of any unpaid charges ... should my firm obtain any settlement or judgment for this patient." Raymond and Strunk claimed that Mercy and Avectus sought compensation from them for their medical expenses, in violation of Ohio Revised Code 1751.60. The district court dismissed. The Sixth Circuit reversed. The defendants sought payment “from a health-insuring corporation’s insured” while in a healthcare services contract with their health-insurance providers. The court rejected a claim that the defendants effectively sought compensation from a third party. View "Raymond v. Avectus Healthcare Solutions, LLC" on Justia Law