Justia Health Law Opinion Summaries

The case revolves around a dispute over the validity of a will. Robert Harrison Ashworth, the deceased, had four children: Christine, Gwendolyn, Brian, and Kimberly. In 2017, Ashworth, who was in the early stages of Alzheimer's disease, executed a will that divided his estate evenly among his four children and named his son, Brian, as the estate's personal representative. However, in 2022, Ashworth executed a new will that named Christine as the personal representative and included only Christine and Gwendolyn as beneficiaries, excluding Brian and Kimberly from any inheritance. After Ashworth's death, Christine submitted the 2022 will for probate. Brian contested its validity and sought access to medical records from the last eight years of Ashworth's life, arguing that the records would shed light on Ashworth's decision-making capacity at the time he executed his final will. Christine, however, refused to provide any medical records, citing the physician-patient privilege.The trial court ordered Christine to provide the medical records for an in camera review, stating that the court would not release any records unrelated to the mental capacity of the decedent. Christine petitioned the Supreme Court of the State of Colorado for relief from the trial court's order.The Supreme Court of the State of Colorado held that the physician-patient privilege survives the privilege holder's death, but the testamentary exception provides for disclosure of the decedent's privileged medical records if they are required to administer the estate. The court discharged the rule to show cause and lifted the stay on the trial court's in camera review of Ashworth's medical records. View "In the Matter of the Estate of Ashworth" on Justia Law

In a medical malpractice case, the plaintiff, Susan Ann Scholle, acting as the personal representative for the Estate of Daniel B. Scholle, sued the defendants, Edward Ehrichs, M.D.; Michael Rauzzino, M.D.; and HCA-HealthONE, LLC. The plaintiff alleged that the defendants' negligence during a back surgery led to severe complications, including cardiac arrest, infection, kidney injuries, stroke, and the need for multiple additional surgeries. The jury found the defendants negligent and awarded the plaintiff over $9 million in economic damages.The defendants argued that the damages should be capped at $1 million, as per the Health Care Availability Act (HCAA). The trial court, however, found good cause to exceed the cap, citing the severity of the plaintiff's injuries, the financial burden on his family, and the unfairness of limiting the damages due to the catastrophic outcome of the surgery.On appeal, the Colorado Court of Appeals reversed in part, holding that the trial court erred by not considering the plaintiff's insurance contract liabilities in its good cause analysis. The court reasoned that the plaintiff's insurers had waived their subrogation rights, meaning the plaintiff was not responsible for repaying the $4.1 million billed by the hospital.The Supreme Court of the State of Colorado reversed the appellate court's decision, holding that the contract exception to the collateral source statute prohibits a trial court from considering a plaintiff's insurance contract liabilities in determining whether good cause exists to exceed the HCAA's damages cap. The court remanded the case for the trial court to recalculate interest and enter judgment accordingly. View "Scholle v. Ehrichs" on Justia Law

At issue before the Colorado Supreme Court in this matter was a trial court’s order denying immunity to Defendant New Century Hospice, Inc. and its subsidiaries, Defendants Legacy Hospice, LLC, d/b/a New Century Hospice of Denver, LLC, and Legacy Hospice of Colorado Springs, LLC (collectively, “New Century”). New Century argued it was entitled to immunity under four different statutes. Tana Edwards filed suit against New Century (her former employer) and Kathleen Johnson, the Director of Operations for New Century Castle Rock (collectively, “Defendants”). As part of her employment with New Century, Edwards provided in-home care to an elderly patient. In December 2019, Johnson began to suspect that Edwards was diverting pain medications from the patient. Defendants reported the suspected drug diversion to the Castle Rock Police Department and the Colorado Department of Public Health and Environment (“CDPHE”). Defendants also lodged a complaint against Edwards’s nursing license with the Colorado Board of Nursing (“the Board”). After investigations, no criminal charges were filed and no formal disciplinary actions were taken against Edwards. Edwards subsequently brought this action against Defendants, alleging claims for negligent supervision and negligent hiring against New Century, as well as claims for defamation and intentional infliction of emotional distress against New Century and Johnson. Defendants moved for summary judgment. The trial court granted the motion as to Edwards’s claims for negligent hiring, defamation, and intentional infliction of emotional distress, finding that the claims were either time-barred or could not be proven. Three of the statutes New Century cited for its immunity claim, 12-20-402(1), C.R.S. (2022) (“the Professions Act”), 12-255-123(2), C.R.S. (2022) (“the Nurse Practice Act”), and 18-6.5-108(3), C.R.S. (2022) (“the Mandatory Reporter statute”), only authorized immunity for a “person.” Relying on the plain meaning of “person,” the Supreme Court held that New Century was not entitled to immunity under these three statutes because it was a corporation, not a person. The fourth statute, 18-8-115, C.R.S. (2022) (“the Duty to Report statute”), explicitly entitled corporations to immunity, but only if certain conditions were met. Applying the plain language of the statute, the Supreme Court held that New Century was not entitled to summary judgment on the issue of immunity under this statute because it did not carry its burden of demonstrating that all such conditions were met. View "In re Edwards v. New Century Hospice" on Justia Law

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

Peggy Harvey and Eileen Manzanares were injured in separate car accidents when their cars were struck by other drivers. Each was then taken to a Centura-affiliated hospital (along with Centura Health Corporation, “Centura”) for treatment. At the time they were treated by Centura, both women’s health insurance was solely through Medicare and Medicaid. And both women’s injuries resulted in hospital stays. In addition to Medicare and Medicaid, both women had automobile insurance whose policies included medical payment ("Med Pay") coverage for medical bills incurred as a result of a motor vehicle accident. In addition, the third-party tortfeasors who caused Harvey’s and Manzanares’s injuries also had automobile insurance. Both Harvey and Manzanares advised Centura of all of the available health and automobile insurance policies. Centura then assigned the women’s accounts to a collection agency, Avectus Healthcare Solutions, for processing; Avectus submitted Centura’s medical expenses to each of the automobile insurers involved, including the automobile insurers for Harvey, Manzanares, and the third-party tortfeasors. Within two weeks after submitting these charges to the various automobile insurers (and within two months of the women’s respective discharges from their hospital stays), Centura filed hospital liens against both of the women. Centura conceded it did not bill either Medicare or Medicaid before filing their respective liens. Both Harvey and Manzanares subsequently brought suit, alleging that Centura had violated the Lien Statute by not billing Medicare for the services provided to the women prior to filing the liens. The parties disputed whether when, as here, Medicare was a person’s principal source of health coverage, Medicare could be considered a “primary medical payer of benefits” under the Lien Statute (such that a hospital must bill Medicare before asserting a lien), or if such an interpretation was barred by the Medicare Secondary Payer statute, which designated Medicare as a “secondary payer.” The Colorado Supreme Court concluded that when Medicare was a patient’s primary health insurer, the Lien Statute required a hospital to bill Medicare for the medical services provided to the patient before asserting a lien against that patient. "Hospital liens are governed by state, not federal, law, and merely enforcing our Lien Statute does not make Medicare a primary payer of medical benefits in violation of the MSP Statute." View "Harvey v. Centura, No." on Justia Law

Alysha Walton pled guilty to driving under the influence (“DUI”), and the county court sentenced her to twelve months of unsupervised probation. Because Walton did not provide a medical professional to testify regarding her authorization to use medical marijuana, the court, as a condition of probation, prohibited Walton from using medical marijuana. Walton appealed, and the district court affirmed the county court’s decision. The Colorado Supreme Court held that the plain language of section 18-1.3-204(2)(a)(VIII), C.R.S. (2019) created a presumption that a defendant could use medical marijuana while serving a sentence to probation unless a statutory exception applied. The relevant exception here applied if the sentencing court found, based on material evidence, that prohibiting this defendant’s otherwise-authorized medical marijuana use was necessary and appropriate to promote statutory sentencing goals. Because the county court made no such findings here, the district court's judgment affirming the county court was reversed. Because defendant completed her sentence, reversing and remanding was deemed moot. View "Walton v. Colorado" on Justia Law

The issue this case presented for the Colorado Supreme Court’s review centered on whether an investigative subpoena issued by the Colorado Medical Board (the “Board”) can have a lawfully authorized purpose if the investigation was prompted by a complaint made by the Colorado Department of Public Health and Environment (the “CDPHE”) pursuant to a policy that violated the Open Meetings Law (the “OML”) or the State Administrative Procedure Act (the “APA”). Scott McLaughlin, M.D. was a physician licensed to practice medicine in Colorado. As part of his practice, he evaluated patients to see if they had a qualifying condition that would benefit from the use of medical marijuana. Information related to medical marijuana in Colorado is maintained by the CDPHE in a confidential registry that includes the names of all patients who have applied for and are entitled to receive a marijuana registry identification card, as well as the names and contact information for the patients’ physicians and, if applicable, their primary caregivers. In May 2014, the CDPHE referred McLaughlin to the Board for investigation based on a high caseload of patients for whom marijuana was recommended. McLaughlin refused to comply with the subpoena, and he and several other physicians whom the CDPHE had referred to the Board and who had received subpoenas from the Board filed suit in the Denver District Court, seeking, among other things, to enjoin the Board from enforcing its subpoenas. The Supreme Court concluded that because neither the CDPHE’s adoption of the Referral Policy nor its referral of Boland to the Board violated the OML or the APA, Boland’s contention that the subpoena to him was void because the Policy and referral were void was based on a flawed premise and was therefore unpersuasive. Even if the adoption of the Referral Policy and the referral itself violated the OML or the APA, however, we still conclude that the Board’s subpoena to Boland had a lawfully authorized purpose because it was issued pursuant to the Board’s statutory authority to investigate allegations of unprofessional conduct and was properly tailored to that purpose. View "Colorado Medical Board v. McLaughlin" on Justia Law

This case was companion to Colorado Medical Board v. McLaughlin, 2019 CO 93, __ P.3d __, wherein the Colorado Supreme Court was asked to determine whether an investigative subpoena issued by the Colorado Medical Board (the “Board”) could have a lawfully authorized purpose if the investigation was prompted by a complaint made by the Colorado Department of Public Health and Environment (the “CDPHE”) pursuant to a policy that violated the Open Meetings Law (the “OML”) or the State Administrative Procedure Act (the “APA”). Petitioner James Boland, M.D. was a physician licensed to practice medicine in Colorado. He primarily examined patients to determine if they would benefit from the use of medical marijuana. Information related to medical marijuana in Colorado is maintained by the CDPHE in a confidential registry that includes the names of all patients who have applied for and are entitled to receive a marijuana registry identification card, as well as the names and contact information for the patients’ physicians and, if applicable, their primary caregivers. In June 2014, the CDPHE referred Boland to the Board for investigation based on his “[h]igh plant count recommendations and high percent of patients under age of 30 [sic] for medical marijuana referrals.” Boland refused to comply with the subpoena, and he and several other physicians whom the CDPHE had referred to the Board and who had received subpoenas from the Board filed suit in the Denver District Court, seeking, among other things, to enjoin the Board from enforcing its subpoenas. The Supreme Court concluded that because neither the CDPHE’s adoption of the Referral Policy nor its referral of Boland to the Board violated the OML or the APA, Boland’s contention that the subpoena to him was void because the Policy and referral were void was based on a flawed premise and was therefore unpersuasive. Even if the adoption of the Referral Policy and the referral itself violated the OML or the APA, however, we still conclude that the Board’s subpoena to Boland had a lawfully authorized purpose because it was issued pursuant to the Board’s statutory authority to investigate allegations of unprofessional conduct and was properly tailored to that purpose. View "Boland v. Colorado Medical Board" on Justia Law

Consistent with Medical Marijuana Policy No. 2014-01 (the “Referral Policy”), which the Colorado Department of Public Health and Environment (the “CDPHE”) had developed after receiving input from staff of the Colorado Medical Board (the “Board”), the CDPHE referred John Does 1–9 (the “Doctors”) to the Board for investigation of unprofessional conduct regarding the certification of patients for the use of medical marijuana. The Doctors filed suit, contending, among other things, that: (1) the Referral Policy was void because it was developed in violation of the Colorado Open Meetings Law (the “OML”); and (2) both the Referral Policy and the referrals to the Board constituted final agency actions under the State Administrative Procedure Act (the “APA”), and the CDPHE did not follow the procedures outlined therein, thereby rendering both the Referral Policy and the referrals void. After review, the Colorado Supreme Court concluded: (1) an entire state agency could not be a “state public body” within the meaning of the OML, and therefore the Doctors did not establish the CDPHE violated the OML; (2) the Referral Policy was an interpretive rather than a legislative rule, therefore, it fell within an exception to the APA and was not subject to the APA’s rulemaking requirements; and (3) the act of referring the Doctors to the Board did not constitute final agency action and therefore was not reviewable under the APA. View "Doe v. Colorado Department of Public Health and Environment" on Justia Law

Plaintiff-petitioner Charissa Schultz was injured in a 2015 car accident in which the other driver failed to stop at a stop sign. The other driver’s insurance company settled for its $25,000 policy limit, and Schultz made a demand on her own uninsured/underinsured motorist benefits under her GEICO policy, which also had a $25,000 limit. In April 2017, after months of correspondence and apparent review of an MRI performed on Schultz in April 2015, GEICO offered Schultz its full policy limit, and it did so without requesting that she undergo an independent medical examination (“IME”). Indeed, GEICO’s claim logs reveal that at the time GEICO decided to offer Schultz its policy limits, it “concede[d] peer review wouldn’t be necessary,” indicating an affirmative decision not to request an IME. A few months later, Schultz filed the present lawsuit asserting claims for bad faith breach of an insurance contract and unreasonable delay in the payment of covered benefits. GEICO denied liability, disputing the extent and cause of Schultz’s claimed injuries and asserting that causation surrounding the knee replacement surgeries was “fairly debatable” because Schultz had preexisting arthritis, which GEICO claimed may independently have necessitated her surgeries. To establish its defense, GEICO ordered the IME and the district court granted that request. The Colorado Supreme Court concluded GEICO’s conduct had to be evaluated based on the evidence before it when it made its coverage decision and that, therefore, GEICO was not entitled to create new evidence in order to try to support its earlier coverage decision. The Court also concluded the district court abused its discretion when it ordered Schultz to undergo an IME over three years after the original accident that precipitated this case and a year and a half after GEICO had made the coverage decision at issue. View "Schultz v. GEICO Casualty Company" on Justia Law