Justia Health Law Opinion Summaries

In May 2009 Jesse Collens, then 21 years old, was permanently injured in a bicycle accident that left him a C-1 quadriplegic, paralyzed from the neck down, and dependent on a ventilator to breathe. In December 2009 he contracted with Maxim Healthcare Services, a national healthcare corporation with a home healthcare division, to provide his nursing care. In late 2011 issues arose between Collens and Maxim over the company’s management of his care. These issues escalated, and in early March 2012, Alaina Adkins, Maxim’s Alaska office manager, met with Collens to discuss his main concerns with Maxim’s services. The following business day, Adkins emailed various members of Maxim’s legal and administrative staff about one of the issues Collens had raised. Internal concerns surfaced about the legal compliance of the staff working with Collens. In an email responding to the report, Maxim’s area vice president wrote, “We are in dangerous territory right now with the liability of this case and we are going to have to seriously consider discharge.” Collens’s care plan was subject to routine recertification every 60 days; Maxim’s Alaska Director of Clinical Services visited Collens’s house to complete the review necessary for this recertification, noting “discharge is not warranted.” Concurrent to the recertification, Adkins requested Maxim’s legal department provide her a draft discharge letter for Collens. The draft letter stated the discharge had been discussed with Collens’s physician and care coordinator and that they agreed with the discharge decision. But in fact neither approved the discharge. The draft letter also included a space for names of other entities that could provide the care needed by the patient. Adkins noted in an email to the legal department, “We already know that there are no providers in our area that provide this type of service.” The discharge letter she eventually delivered to Collens filled in the blank with four agency names. Adkins delivered and read aloud the discharge letter at Collens’s home on March 30. Collens sued Maxim and Adkins for breach of contract, fraudulent misrepresentation, unfair and deceptive acts and practices under Alaska’s Unfair Trade Practices and Consumer Protection Act (UTPA), and intentional infliction of emotional distress (IIED). The superior court ruled for Collens on all his claims and entered a $20,379,727.96 judgment against Adkins and Maxim, which included attorney’s fees. Maxim and Adkins appealed, arguing that: (1) they were not liable under the UTPA; (2) the superior court erred in precluding their expert witnesses from testifying at trial; (3) the court’s damages award was excessive; and (4) the court’s attorney’s fee award was unreasonable. The Alaska Supreme Court agreed the superior court’s attorney’s fee award was unreasonable, but on all other issues it affirmed the superior court’s decision. View "Maxim Healthcare Services, Inc. v. Collens" on Justia Law

The Alaska Department of Health and Social Services required most healthcare facilities to document the need for proposed services before the state approves construction of a new facility. The agency determined that an ambulatory surgical facility seeking to relocate from Anchorage to Wasilla did not need to submit such documentation because it was moving within the same community as defined by the relevant statute. Competing medical facilities in the Matanuska-Susitna Borough objected to the determination, arguing that Anchorage and Wasilla were not the “same community” and that the proposed relocation required the usual certification of need. Because Anchorage and Wasilla were not the same community as contemplated by the statute, the Alaska Supreme Court reversed the determination that the facility was exempt from the required certification process. View "Alaska Spine Center, LLC v. Mat-Su Valley Medical Center, LLC" on Justia Law

The district court found that a woman, "Linda M.," charged with several misdemeanors was incompetent to stand trial and committed her to a state hospital. The hospital later brought petitions in the superior court for civil commitment and involuntary medication. Linda moved to dismiss or stay the proceedings, contending that the superior court was an improper forum because of the criminal case pending in the district court. The superior court denied the motion, asserted its jurisdiction to hear the case, and granted the hospital’s petition for authority to administer medication. Linda appealed. The Alaska Supreme Court held the superior court properly asserted its jurisdiction over the civil commitment and involuntary medication petitions and that the superior court did not err in finding that involuntary medication was in Linda's best interests. View "In Re Hospitalization of Linda M." on Justia Law

Connor J. was living at a shelter for homeless youth, when his psychiatric condition allegedly began to deteriorate. A social worker filed a petition in superior court seeking authority to hospitalize Connor for evaluation. The petition noted Connor had a history of suicidal thoughts; that he had been diagnosed at various times with depression, anxiety, post-traumatic stress disorder, and oppositional defiant disorder; and that he had been treated for mental illness in the past at a hospital and several counseling centers. Connor was transported to Alaska Psychiatric Institute (API) for an evaluation. A few days later API filed a petition for 30-day commitment and a proceedings were initiated that lead to his commitment. The superior court issued a 30-day involuntary commitment order after finding that Connor was "gravely disabled" and there were no less restrictive alternatives to hospitalization. The respondent appealed, arguing that it was plain error to find he waived his statutory right to be present at the commitment hearing, that it was clear error to find there were no less restrictive alternatives, and that the commitment order should be amended to omit a finding that he posed a danger to others, a finding the superior court meant to reject. The Alaska Supreme Court concluded it was not plain error to find that the respondent waived his presence at the hearing. We further conclude that it was not clear error to find that there were no less restrictive alternatives to a 30-day hospital commitment. However, because there was no dispute that the “danger to others” finding should not have been included in the commitment order, the case was remanded for issuance of a corrected order. View "In Re Hospitalization of Connor J." on Justia Law

A 2014 statute and 2013 regulation re-defined which abortions qualified as “medically necessary” for the purposes of Medicaid funding. The statute defined medically necessary abortions as those that “must be performed to avoid a threat of serious risk to the life or physical health of a woman from continuation of the woman’s pregnancy” as a result of a number of listed medical conditions; the regulation was similarly restrictive. Planned Parenthood of the Great Northwest challenged both the statute and regulation as unconstitutional, and the superior court held that both measures violated the equal protection clause of the Alaska Constitution. The court reasoned that these measures imposed a “high-risk, high- hazard” standard on abortion funding unique among Medicaid services, and held that our 2001 decision striking down an earlier abortion funding restriction on equal protection grounds compelled the same result. The State appealed, arguing that the statute and regulation should be interpreted more leniently and therefore do not violate the Alaska Constitution’s equal protection clause. The Alaska Supreme Court affirmed the superior court’s decision: the statute’s and the regulation’s facially different treatment of pregnant women based upon their exercise of reproductive choice required the Court to apply strict scrutiny, and the proposed justifications for the funding restrictions "did not withstand such exacting examination." View "Alaska v. Planned Parenthood of the Great Northwest" on Justia Law

Two separate appeals from involuntary commitment orders, brought by two appellants, one of whom also appealed a related involuntary medication order were consolidated for the Alaska Supreme Court's review. The challenged orders expired while the respective appeals were pending; the issue each case presented centered on whether the Supreme Court should revisit its mootness jurisprudence in involuntary commitment and involuntary medication appeals. The Court held that all appeals of involuntary admissions for treatment and involuntary medication were categorically exempt from the mootness doctrine. After reviewing each case on its merits and finding no error in the orders appealed, the Court affirmed in each case. View "In Re Hospitalization of Naomi B." on Justia Law

The Alaska Supreme Court granted this petition for review to consider how the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) affected Alaska personal injury case law allowing a defendant ex parte contact with a plaintiff’s doctors as a method of informal discovery. The issue the Court requested the parties specifically brief was whether the federal law preempted Alaska case law, or, if not, whether federal law otherwise required us to overrule or modify our case law. After review, the Court concluded the federal law did not preempt existing Alaska case law. But the Court also concluded it should overrule the case law because its foundations "have been eroded by a cultural shift in views on medical privacy and new federal procedural requirements undermining the use of ex parte contact as an informal discovery measure." The Court therefore held that - absent voluntary agreement - a defendant may not make ex parte contact with a plaintiff’s treating physicians without a court order, which generally should not be issued absent extraordinary circumstances. "We believe that formal discovery methods are more likely to comply with the federal law and promote justice and that such court orders rarely, if ever, will be necessary." View "Jones v. Drury" on Justia Law

An association representing naturopathic physicians challenged a new Alaska regulation that effectively forbade naturopaths from using and prescribing injectable vitamins and minerals. The association argued the statutory definition of naturopathy included the use of dietetics, that dietetics included injectable vitamins and minerals obtained by pharmaceutical prescription, and that the statutory restrictions on the practice of naturopathy prohibited the use of only prescription drugs, not all prescription medicines. After review, the Alaska Supreme Court concluded the statutory text, the larger statutory context, and the legislative history together suggest that the legislature did not intend to grant prescriptive authority to naturopaths. Therefore, the Court affirmed the superior court’s decision to grant summary judgment against the association on this issue. View "Alaska Association of Naturopathic Physicians v. Alaska Division of Corporations, Business & Professional Licensing" on Justia Law

Providence Alaska Medical Center terminated Dr. Michael Brandner’s hospital privileges without an opportunity to be heard after determining he had violated hospital policy by failing to report an Alaska State Medical Board order requiring him to undergo an evaluation of his fitness to practice medicine. Brandner unsuccessfully challenged this action through the hospital's hearing and appeal procedures. Brandner thereafter took his cause to court, seeking reinstatement and damages for the alleged due process violations both in the procedures used and in the substantive standard applied in his termination. The superior court found no such violations and that he was not entitled to reinstatement. Brandner appealed. The Alaska Supreme Court affirmed in part and reversed in part, finding that Brandner was not entitled to reinstatement or post-termination-hearing damages. However, the doctor's due process rights were violated when he was not given a hearing following termination of his hospital privileges. The matter was remanded for further proceedings. View "Brandner v. Providence Health & Services" on Justia Law

A woman was admitted to a hospital emergency room with pregnancy-related complications. The attending physician recommended that she be transported by medivac to a different facility. The woman and her husband informed the physician that they needed their insurer’s preauthorization for that course of action or they could be personally liable for the costs. The physician allegedly promised to call the insurer and, if it would not approve the medivac, have the hospital bear the costs itself. But the physician failed to contact the insurer until much later, and the insurer declined coverage. The couple sued the physician and the hospital, alleging that the physician breached her fiduciary duty by failing to obtain preauthorization as promised; that her promise created an enforceable contract, which was breached; and that if there was no contract the physician’s promise should be enforced through the doctrine of promissory estoppel. The superior court granted summary judgment to the physician and hospital. The couple appealed. After review, the Alaska Supreme Court held that the superior court did not err when it ruled in favor of the physician and hospital on the claims for breach of fiduciary duty and breach of contract, but that genuine issues of material fact precluded summary judgment on the claim for promissory estoppel. The Court reversed and remanded for further proceedings. View "Thomas v. Archer" on Justia Law