Justia Health Law Opinion Summaries

Cameo Williams, Sr. was a veteran of the United States Army, who spent his entire service stateside - never overseas or in combat. But for years, based on false statements about combat service, he obtained VA benefits for combat-related PTSD. The issue presented for the Tenth Circuit Court of Appeals in this case was whether it mattered about Williams’ lies about overseas service to obtain his PTSD benefits. The Court rejected Williams’s argument that his lie was not material under 18 U.S.C. 1001(a)(2), as well as his two challenges to evidentiary rulings. View "United States v. Williams" on Justia Law

Appellees Augustus Feleccia and Justin Resch were student athletes who played football at Lackawanna Junior College (Lackawanna), a nonprofit junior college. Lackawanna had customarily employed two athletic trainers to support the football program. The Athletic Director, Kim Mecca, had to fill two trainer vacancies in the summer of 2009. She received applications from Kaitlin Coyne, and Alexis Bonisese. At the time she applied and interviewed for the Lackawanna position, Coyne had not yet passed the athletic trainer certification exam, and was therefore not licensed by the Board. Bonisese was also not licensed, having failed the exam on her first attempt, and still awaiting the results of her second attempt when she applied and interviewed for the Lackawanna position. Nevertheless, Lackawanna hired both Coyne and Bonisese in August 2009 with the expectation they would serve as athletic trainers, pending receipt of their exam results, and both women signed “athletic trainer” job descriptions. After starting their employment at Lackawanna, Coyne and Bonisese both learned they did not pass the athletic trainer certification exam. Mecca retitled the positions held by Coyne and Bonisese from “athletic trainers” to “first responders.” However, neither Coyne nor Bonisese executed new job descriptions, despite never achieving the credentials included in the athletic trainer job descriptions they did sign. Appellants were also aware the qualifications of their new hires was called into question by their college professors and clinic supervisors. In 2010, appellees participated in the first day of spring contact football practice, engaging in a variation of the tackling drill known as the “Oklahoma Drill.” While participating in the drill, both Resch and Feleccia suffered injuries. Resch attempted to make a tackle and suffered a T-7 vertebral fracture. Resch was unable to get up off the ground and Coyne attended to him before he was transported to the hospital in an ambulance. Later that same day, Feleccia was injured while attempting to make his first tackle, experiencing a “stinger” in his right shoulder, i.e., experiencing numbness, tingling and a loss of mobility in his right shoulder. Bonisese attended Feleccia and cleared him to continue practice “if he was feeling better.” In this discretionary appeal arising from the dismissal of appellees’ personal injury claims on summary judgment, the Pennsylvania Supreme Court considered whether the superior court erred in: (1) finding a duty of care; and (2) holding a pre-injury waiver signed by student athletes injured while playing football was not enforceable against claims of negligence, gross negligence, and recklessness. After careful review, the Court affirmed the superior court’s order only to the extent it reversed the trial court’s entry of summary judgment on the claims of gross negligence and recklessness. The Case was remanded back to the trial court for further proceedings. View "Feleccia v. Lackawanna College, et al." on Justia Law

Sarah DeMichele, M.D., was a board-certified psychiatrist licensed to practice medicine in Pennsylvania. From August 2011 through February 2013, Dr. DeMichele provided psychiatric care to M.R. M.R. struggled with suicidal ideations and engaged in a pattern of self-harming behavior, which she discussed regularly with Dr. DeMichele. In December 2012, M.R.’s self-inflicted injuries necessitated emergency medical treatment. M.R. ultimately was transferred to a Trauma Disorders Program in Maryland. In the program, M.R. was treated by psychiatrist Richard Loewenstein, M.D., and psychologist Catherine Fine, Ph.D. During the course of his treatment of M.R., Dr. Loewenstein obtained M.R.’s medical records from Dr. DeMichele. In 2014, Dr. Loewenstein submitted a complaint to the Professional Compliance Office of Pennsylvania’s State Board of Medicine (“Board”), in which he alleged that Dr. DeMichele’s care of M.R. was professionally deficient. Dr. Loewenstein’s complaint prompted an investigation and, ultimately, the initiation of disciplinary proceedings against Dr. DeMichele. In 2015, the Pennsylvania Department of State’s Bureau of Professional and Occupational Affairs (“Bureau”) filed an order directing Dr. DeMichele to show cause as to why the Board should not suspend, revoke, or restrict her medical license, or impose a civil penalty or the costs of investigation. In advance of the hearing, Dr. DeMichele requested that the hearing examiner issue subpoenas for the testimony of M.R. and the medical records of Dr. Loewenstein, Dr. Fine, the program, and M.R.’s former treating psychologist, April Westfall, Ph.D. Relying upon the authority provided under 63 P.S. 2203(c), the hearing examiner issued the requested subpoenas. However, when served with the subpoenas, all of M.R.’s treatment providers refused to release their records absent a court order or M.R.’s authorization. M.R. subsequently refused to authorize the release of her records. In this direct appeal, the Pennsylvania Supreme Court was asked to consider the enforceability of the subpoenas, as well as related questions regarding the scope and applicability of numerous statutes that protect a patient’s medical information. The Commonwealth Court granted the physician’s petition to enforce the subpoenas. Because the Supreme Court concluded the Commonwealth Court lacked subject matter jurisdiction to decide the issue, it vacated that court’s order. View "In Re: Enforcement of Subpoenas b/f the Bd of Med." on Justia Law

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

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

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

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

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

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

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