Justia Health Law Opinion Summaries

The Supreme Court held that in determining whether a petition for court-ordered treatment complies with statutory requirements, courts may consider contents of an extrinsic document attached to an affidavit if the affidavit specifically incorporates the attachment by reference.The trial court found that G.B. was persistently or actually disabled and ordered treatment for one year. The court of appeals vacated the trial court's order on the grounds that involuntary treatment proceedings require strict statutory compliance and that two affidavits submitted by G.B. failed to comply with Ariz. Rev. Stat. 36-533(B). The Supreme Court vacated the court of appeals' opinion and affirmed the order of the trial court, holding that that there was no fundamental, prejudicial error in this case because the trial court's error did not deprive G.B. of a fair opportunity to oppose the petition for involuntary treatment or to otherwise receive a fair hearing. View "In re Pima County Mental Health No. 20200860221" on Justia Law

In this special action challenging the trial court's ruling that Defendant's due process rights required disclosure of the victim's privileged records for in-camera review, the Supreme Court held that the trial court did not err in ordering in-camera review.Defendant was charged with second-degree murder for killing M.S., his girlfriend. Before trial, Defendant moved to compel Magellan Hospital to disclose for in-camera review M.S.'s privileged mental health records. The trial court ruled that Defendant's due process rights required dislosure of the privileged records for in-camera review. M.S.'s siblings filed a special action under Arizona's Victims' Bill of Rights challenging the ruling. The court of appeals granted relief, concluding that there was not a substantial probability that the records contained information critical to Defendant's justification defense. The Supreme Court vacated the court of appeals' opinion and affirmed the trial court's judgment, holding that a record of M.S.'s purported mental illness would be material to Defendant's justification defense. View "R.S. v. Honorable Peter A. Thompson" on Justia Law

The Supreme Court held that a plaintiff does not have to allege bad faith or rebut the good faith presumption in his complaint asserting a claim of negligent disclosure of medical information in order to withstand a motion to dismiss based on the immunity provided by Ariz. Rev. Stat. 12-2296.Plaintiff sued Costco, alleging several claims of action based on Costco's public disclosure of an embarrassing medication that Plaintiff twice rejected. Costco filed a motion to dismiss, asserting that Ariz. Rev. Stat. 12-2296 provided immunity and that Plaintiff's claims were preempted by Health Insurance Portability and Accountability Act (HIPAA). The trial court granted the motion. The Supreme Court reversed, holding (1) Plaintiff was not required to anticipate in his complaint Costco's affirmative defense of qualified immunity under section 12-2296 or to rebut the good faith presumption; and (2) Plaintiff permissibly referenced HIPAA to inform the standard of care for his negligence claim. View "Shepherd v. Costco Wholesale Corp." on Justia Law

The Supreme Court held that the Arizona Department of Health Services' (ADHS) interpretation of Arizona Administrative Code R9-17-303, which governs ADHS's allocation of marijuana dispensary registration certificates, violated Ariz. Rev. Stat. 36-2804(C).On June 16, 2016, ADHS announced that, because every county had at least one dispensary, it would allocate new registration certificates based on other factors set forth in R9-17-303. Saguaro Healing LLC timely applied for a certificate for its dispensary in La Paz County. During the application period, the only dispensary in La Paz County relocated out of the county. ADHS, however, did not consider the vacancy when prioritizing registration certificates and did not issue a certificate to Saguaro, leaving La Paz County without a dispensary. Saguaro filed a complaint for special action. The trial court dismissed the complaint because R9-17-303(B) "does not say when, during the process of issuing new certificates, [ADHS] must determine how certificates will be allocated." The Supreme Court reversed, holding (1) Ariz. Rev. Stat. 36-2804(C) requires ADHS to issue at least one medical marijuana dispensary registration certificate in each county with a qualified applicant; and (2) ADHS's interpretation of R9-17-303 contrary to this statutory mandate violates section 36-2804(C). View "Saguaro Healing LLC v. State" on Justia Law

The Supreme Court affirmed the judgment of the trial court enjoining the application of Arizona statutes authorizing the recording of liens against third-party tortfeasors to allow hospitals to recover health care costs for Medicaid patients beyond the amounts provided by Medicaid, holding that the statues are preempted to the extent hospitals utilize them against third-party tortfeasors for "balance billing" to recover costs beyond Medicaid reimbursement.Plaintiffs were patients who were treated at defendant hospitals under the state's contract provider for the federal Medicaid program, which negotiates reimbursement rates with hospitals. Defendants recorded liens against the third-party tortfeasors who caused the patients' injuries in order to recover the remainder of their fees exceeding Medicaid reimbursement. Plaintiff brought this class action challenging the liens, arguing that Ariz. Rev. Stat. 33-931(A) and 36-2903.01(G)(4) (the lien statutes) were preempted by federal Medicaid law. The trial court enjoined application of the lien statutes. The Supreme Court affirmed, holding (1) Plaintiffs had a private right of action to challenge the lien statutes; and (2) the lien statutes are unconstitutional as applied. View "Ansley v. Banner Health Network" on Justia Law

The Supreme Court affirmed Defendant’s convictions and sentences, holding that the Arizona Health Care Cost Containment System (AHCCCS) statutory scheme, Ariz. Rev. Stat. 36-2901 to -2999.57, abrogates and creates an exception to Arizona’s statutory physician-patient privilege, Ariz. Rev. Stat. 13-4062(4), in cases of suspected AHCCCS fraud.Defendant was convicted of defrauding AHCCCS for lying about having cancer so her abortion would fall within the exception to the rule that AHCCCS does not cover abortions except when necessary to save a woman’s life or to protect her health. On appeal, Defendant argued that the superior court erred by admitting her medical records and by allowing her physicians to testify against her. The court of appeals affirmed, holding that the AHCCCS statutes abrogated the physician-patient privilege in cases of suspected AHCCCS fraud. The Supreme Court affirmed, holding (1) the legislature’s grant of brand authority to AHCCCS to investigate suspected fraud necessarily implies an exception to the privilege for internal AHCCCS investigations and proceedings; and (2) the AHCCCS statutes implicitly abrogate the privilege in the criminal investigation and prosecution of suspected AHCCCS fraud because the provisions at issue exhibit an intent to provide law enforcement access to patient information when investigating and prosecuting AHCCCS fraud. View "State v. Zeitner" on Justia Law

The Supreme Court rejected a constitutional challenge to the provision in Ariz. Rev. Stat. 36-2901.08(A) that the director of Arizona’s indigent health care program, Arizona Health Care Cost Containment System (AHCCCS), “shall establish, administer and collect an assessment” from Arizona hospitals (the hospital assessment). The legislature added this provision to fund the costs remaining after federal monies to expand coverage under AHCCCS, as provided for in H.B. 2010, which the legislature enacted in 2013 by a simple majority vote. The Supreme Court held that the hospital assessment is not subject to Ariz. Const. art. IX, 22, which generally requires that acts providing for a net increase in state revenues be approved by a two-thirds vote in each house of the legislature, because the exception set forth in Ariz. Const. art. IX, 22(C)(2) that the above requirement does not apply to statutorily authorized assessments that “are not prescribed by formula, amount or limit, and are set by a state officer or agency” applied in this case. View "Biggs v. Betlach" on Justia Law

Premier Physicians Group, a non-hospital health care provider, treated Mandy Gipson for injuries sustained in a car accident allegedly caused by Kimberly Navarro. Premier was statutorily entitled to record a lien for its customary charges in treating Gipson, and the lien applied to claims Gipson may have had for damages related to her injury. Ariz. Rev. Stat. 33-932(A) requires that such liens must be recorded “before or within thirty days after the patient has received any services relating to the injuries….” The Navarros’ insurer paid Gipson to settle her claim but did not satisfy the lien, and Gipson failed to pay Premier for its services. Premier sued the Navarros to enforce the lien. The trial court dismissed the complaint because the lien was recorded more than thirty days after Premier first provided services to Gipson. Premier appealed, arguing that section 33-932() allowed it to perfect with lien within thirty days after services were last provided. The court of appeals agreed with Premier and reversed. The Supreme Court vacated the court of appeals’ opinion and affirmed the trial court’s dismissal of the complaint, holding that section 33-932(A) requires non-hospital providers to record liens before services are first provided or within thirty days thereafter. View "Premier Physicians Group, PLLC v. Navarro" on Justia Law

Medicare Part C, 42 U.S.C. 1395w-21 et seq., permits enrollees to obtain Medicare-covered healthcare services from private healthcare organizations and their third-party contractors. The Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq., regulates health plans offered by private employers to employees. At issue is whether continued inpatient treatment by Providers was medically necessary, and therefore compensable, for several MA Plan Members and ERISA Plan Members initially hospitalized for mental health evaluations or treatment. The court held that the administrative appeals process provided under the Medicare Act preempts arbitration of Medicare-related coverage disputes between private healthcare administrators and providers, even though arbitration would otherwise be required by the parties’ contracts and the Federal Arbitration Act (FAA), 9 U.S.C. 1 et seq. In this case, Providers’ coverage claims are inextricably intertwined with claims for Medicare benefits, and they therefore are subject to the Medicare Act. The Act provides mandatory administrative review procedures for these disputes, which preempt arbitration. The court concluded, however, that the court of appeals erred by deciding that whether Aurora’s ERISA-related claims are arbitrable depends on whether Aurora has standing to assert this claim. The court of appeals should decide on remand whether this claim is arbitrable without considering the standing issue or whether any valid defenses to the claim exist. Therefore, the court remanded to the court of appeals to decide whether ERISA similarly preempts arbitration of ERISA-related coverage disputes. View "United Behavioral Health v. Maricopa Integrated Health Sys." on Justia Law

Patients filed suit to set aside accord and satisfaction agreements and to recover the amounts paid to release liens. Hospitals, health care providers who treated patients injured by third parties, were paid by the Patients' insurer, AHCCCS, which had negotiated reduced rates with the Hospitals. The Hospitals then recorded liens against the Patients pursuant to A.R.S. 33-931 and A.R.S. 36-2903.01(G) for the difference between the amount typically charged for their treatment and the reduced amount paid by AHCCCS. In order to receive their personal injury settlements with the third parties, Patients settled with the Hospitals by paying negotiated amounts to release the liens. At issue is the validity of these accord and satisfaction agreements. The court assumed, without deciding, that Arizona’s lien statutes are preempted by federal law. But, because there was a bona fide dispute about the enforceability of these liens when the Patients and Hospitals entered into settlement agreements to achieve lien releases, the agreements were supported by adequate consideration and addressed a proper subject matter. Therefore, the accord and satisfaction agreements are valid. View "Abbott v. Banner Health Network" on Justia Law