Justia Health Law Opinion Summaries

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Defendant was convicted of conspiracy and substantive health care fraud for fraudulently billing Medicare and Medicaid for millions of dollars for visits to nursing home patients that he never made. He challenged the convictions, sentence, restitution amount, and forfeiture amount on appeal. In an April 12, 2022 opinion, the Eleventh Circuit affirmed Defendant's convictions and sentence.Following the court's initial opinion, Defendant filed a petition for rehearing en banc. The Eleventh Circuit considered Defendant's petition as a petition for a panel rehearing. The court granted Defendant's petition, vacated its previous opinion and issued a revised opinion that did not change the court's judgment or Defendant's sentence. Defendant was given 21 days to file a supplemental brief. View "USA v. Douglas Moss" on Justia Law

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During the COVID-19 pandemic, Illinois Governor J. B. Pritzker issued a series of executive orders that first required Illinois residents to shelter in place at their residences, compelled “non-essential” businesses temporarily to cease or reduce their operations and prohibited gatherings of more than 10 people (later increased to 50 people). Believing that these orders violated numerous provisions of the U.S. Constitution, several individuals joined with some Illinois businesses and sued the Governor in his official capacity. After granting the plaintiffs one opportunity to amend their complaint, the district court found that they lacked standing to sue. The court also concluded that it would be futile to allow a second amendment because, even if it had erred about the existence of a justiciable case or controversy, the plaintiffs could not state a claim upon which relief could be granted.The Seventh Circuit affirmed the dismissal of the complaint. With respect to five out of six counts, the plaintiffs have not satisfied the criteria for Article III standing to sue. The remaining count attempts to state a claim under the Takings Clause. The business plaintiffs “may have squeaked by the standing bar” for that theory but have not stated a claim upon which relief can be granted. View "Nowlin v. Pritzker" on Justia Law

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The Supreme Court reversed the decision of the court of appeals and remanded this case, holding that, for property to be commandeered, the government must exercise exclusive control over or obtain exclusive possession of the property such that the government could physically use it for an emergency management purpose.Appellant brought this suit arguing that his hospitality businesses were commandeered when the Governor issued emergency executive orders in response to the COVID-19 pandemic that imposed capacity limits for dining beginning in March 2020. As the owner of the commandeered property, Appellant argued, he was entitled to just compensation for the government's use under Minn. Stat. 12.34. The district court dismissed the commandeering claim, and the court of appeals affirmed. The Supreme Court reversed, holding (1) the government exercises exclusive physical control or exclusive possession of private property when only the government may exercise control or possession of the property and the owner is denied all control over or possession of the property; and (2) remand to the district court for further proceedings was required in this case. View "Buzzell v. Walz" on Justia Law

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Head Start is a federal program that funds early childhood education for low-income children and provides other resources and education to the children’s families. Michigan Head Start grantees challenged the COVID-19 vaccine mandate for Head Start program staff, contractors, and volunteers imposed by an interim final rule of the Department of Health and Human Services. The district court denied a preliminary injunction.The Sixth Circuit denied an injunction pending appeal. The plaintiffs have not shown that they will likely prevail on the merits. HHS likely did not violate the Administrative Procedure Act when it promulgated the vaccine requirement through an interim final rule instead of notice-and-comment rulemaking, 5 U.S.C. 553(b)(B). That rule contains ample discussion of the evidence in support of a vaccine requirement and the justifications for the requirement, 86 Fed. Reg. 68,055-059. HHS likely has the statutory authority to issue a vaccine requirement for Head Start program staff, contractors, and volunteers under 42 U.S.C. 9836a(a)(1)(A), (E). The risk that unvaccinated staff members could transmit a deadly disease to Head Start children—who are ineligible for the COVID-19 vaccine due to their young age—is “a threat to the health” of the children. The court noted HHS’s history of regulating the health of Head Start children and staff. View "Livingston Educational Service Agency v. Becerra" on Justia Law

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In 2019 a woman sued her former husband’s medical provider, alleging that from 2003 to 2010 the provider negligently prescribed the husband opioid medications, leading to his addiction, damage to the couple’s business and marital estate, the couple’s divorce in 2011, and ultimately the husband's death in 2017. The superior court ruled the claims were barred by the statute of limitations and rejected the woman’s argument that the provider should have been estopped from relying on a limitations defense. Because the undisputed evidence shows that by 2010 the woman had knowledge of her alleged injuries, the provider’s alleged role in causing those injuries, and the provider’s alleged negligence, the Alaska Supreme Court concluded that the claims accrued at that time and were no longer timely when filed in 2019. And because the record did not show that the woman’s failure to timely file her claims stemmed from reasonable reliance on fraudulent conduct by the provider, the Supreme Court concluded that equitable estoppel did not apply. View "Park v. Spayd" on Justia Law

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The Supreme Court reversed the judgment of the court of appeals affirming the decision of the circuit court upholding the State Health Commissioner's denial of Chesapeake Regional Medical Center's (CMRC) application for a Certificate of Public Need, holding that the harmless error doctrine does not apply to an error of law in an administrative agency case under the Virginia Administrative Process Act.CMRC applied for a new open-heart surgery service and additional cardiac catheterization equipment. The Commissioner denied the application. CRMC appealed, contending that the Commissioner erred in his interpretation of the relevant administrative regulation. The circuit court affirmed, determining that the Commissioner's incorrect interpretation and application of the regulation was harmless error. The court of appeals affirmed. The Supreme Court reversed, holding (1) the court of appeals erred in applying the harmless error doctrine to the agency's legal error in interpreting and applying its own regulations; and (2) the lower courts erred by failing to remand the case to the Commissioner for further proceedings. View "Chesapeake Hospital Authority v. State Health Commissioner" on Justia Law

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Petitioner Lisa French went to respondents Centura Health Corporation and Catholic Health Initiatives Colorado d/b/a St. Anthony North Health Campus (collectively, “Centura”) for surgery. Upon reviewing French’s insurance information prior to surgery, Centura advised her that she would personally be responsible for $1,336.90 of the amounts to be billed. After the surgery, however, Centura determined that it had misread French’s insurance card and that she was, in fact, an out-of-network patient. Centura then billed French $229,112.13 and ultimately sued her to collect. The Colorado Supreme Court granted certiorari to review: (1) whether here, Centura’s database used by listing rates for specific medical services and supplies, was incorporated by reference into hospital services agreements (“HSAs”) that French had signed; and (2) if so, whether the price term in the HSAs was sufficiently unambiguous to render the HSAs enforceable. The Court concluded that because French neither had knowledge of nor assented to the chargemaster, which was not referenced in the HSA or disclosed to her, the chargemaster was not incorporated by reference into the HSA. Accordingly, the HSA left its price term open, and therefore, the jury appropriately determined that term. The Court reverse the judgment of the division below, and did not decide whether the price that French was to pay was unambiguous, even if the HSA incorporated the chargemaster. View "French v. Centura Health" on Justia Law

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Defendants Kim Reynolds, Governor of Iowa, and Ann Lebo, Director of the Iowa Department of Education, appealed the district court’s entry of a preliminary injunction completely barring enforcement of Iowa’s facial covering statute, Code Section 280.31. The Eighth Circuit vacated the district court’s entry of preliminary injunction completely barring enforcement of Iowa Code Section 280.31 as moot.   The court reasoned that the issue surrounding the preliminary injunction is moot because the current conditions differ vastly from those prevailing when the district court addressed it. The court reasoned that COVID-19 vaccines are now available to children and adolescents over the age of four, greatly decreasing Plaintiffs’ children’s risk of serious bodily injury or death from contracting COVID-19 at school. Further, when Plaintiffs sought a preliminary injunction, delta was the dominant variant, producing high transmission rates and caseloads throughout the country. Now, omicron has become dominant and subsided, leaving markedly lower transmission rates and caseloads throughout Iowa and the country. The court noted that to the extent that the case continues, the Court emphasized that the parties and district court should pay particular attention to Section 280.31’s exception for “any other provision of law.” Iowa Code Section 280.31. This exception unambiguously states that Section 280.31 does not apply where “any other provision of law” requires masks. The word "any” makes the term “provision of law” a broad category that does not distinguish between state or federal law. View "The Arc of Iowa v. Kimberly Reynolds" on Justia Law

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This putative class action against California and San Diego County officials challenged California Governor Gavin Newsom’s emergency orders and related public health directives restricting business operations during the COVID-19 pandemic. Plaintiffs, owners of affected restaurants and gyms (Owners), primarily contended the orders were procedurally invalid because they were adopted without complying with the Administrative Procedure Act (APA). Furthermore, Owners contended that the business restrictions were substantively invalid because they effected a taking without compensation, violating the Fifth Amendment to the United States Constitution. Rejecting these claims, the superior court sustained demurrers to the third amended complaint without leave to amend and dismissed the action. While the Court of Appeal sympathized with the position some Owners find themselves in and the significant financial losses they alleged, the unambiguous terms of the Emergency Services Act and controlling United States Supreme Court regulatory takings caselaw required that the judgment be affirmed. View "640 Tenth, LP v. Newsom" on Justia Law

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On November 21, 2017, Richard Bush presented to Saint Bernard Parish Hospital for depression and suicidal ideations. At the hospital, Dr. Miguel Aguilera treated and discharged him. Bush attempted re-admittance with the same complaints, but was refused re-admittance. Thereafter, Bush attempted suicide in the hospital bathroom. He was found alive and transported to University Hospital in New Orleans for treatment; however, he succumbed to his injuries from the suicide attempt and died on November 30, 2017. In November 2018, his wife, Patricia Bush, on behalf of herself, her daughters, Madalyn and Ashley Bush, and on behalf of the decedent, Richard Bush, filed a formal pro se complaint with the Patient Compensation Fund (“PCF”) to convene a medical review panel (“MRP”), naming Saint Bernard Parish Hospital and Dr. Aguilera for malpractice relating to Richard Bush's death. The Louisiana Supreme Court granted this writ application in order to determine: (1) whether contra non valentem interrupted prescription; and (2) whether the court of appeal erred in relying on documents that were not entered as evidence and were not part of the record. The Court found that, while contra non valentem may interrupt prescription in a wrongful death claim in certain instances, it did not interrupt prescription in this case due to the fact that the court of appeal incorrectly considered documents that were not in evidence. The Court reversed the court of appeal’s ruling in part, affirmed in part, and remanded for further proceedings. View "Medical Review Panel for the Claim of Richard Bush" on Justia Law