Justia Health Law Opinion Summaries

Appellants Heritage Healthcare of Ridgeway, LLC, Uni-Health Post-Acute Care - Tanglewood, LLC (Tanglewood), and UHS-Pruitt Corporation (collectively, Appellants) ask this Court to reverse the circuit court's denial of their motion to compel arbitration in this wrongful death and survival action involving Appellants' allegedly negligent nursing home care. Tanglewood is a skilled nursing facility located in Ridgeway, owned and controlled by Appellants. In January 2007, Tanglewood and Respondent Darlene Dean entered into a nursing home residency agreement in which Tanglewood assumed responsibility for the care of Respondent's mother, Louise Porter (the patient). The same day, Respondent signed a separate, voluntary arbitration agreement. The patient did not sign either the residency agreement or the Agreement on her own behalf, although she was competent at the time of her admission to Tanglewood. Moreover, Respondent did not have a health care power of attorney empowering her to sign on the patient's behalf. In 2009, the patient fell three separate times within a ten day period, fracturing her hip in the third fall. Over the next two months, the patient underwent two hip surgeries; however, due to complications following the surgeries, the patient died on September 30, 2009. In late 2011, Respondent (acting in her capacity as personal representative of her mother's estate) filed a Notice of Intent (NOI) to file a medical malpractice suit against Appellants, as well as an expert affidavit in support of her NOI. Respondent also alleged claims for survival and wrongful death. In lieu of filing an answer to the complaint, Appellants filed a motion to dismiss pursuant to Rules 12(b)(1) and (6), SCRCP, or, in the alternative, a motion to compel arbitration and stay the litigation. Relying on "Grant v. Magnolia Manor-Greenwood, Inc.," (678 S.E.2d 435 (2009)), the circuit court invalidated the Agreement in its entirety and refused to compel arbitration between the parties. Appellants filed a motion to reconsider, which the circuit court denied. Upon review, the Supreme Court found that Respondent's argument that Appellants' waived their right to enforce the Agreement was without merit. On remand, the Supreme Court mandated that the circuit court consider her remaining arguments (concerning Respondent's authority to sign the Agreement and whether there was a meeting of the minds between the parties) prior to deciding whether to compel arbitration between the parties. View "Dean v. Heritage Healthcare" on Justia Law

This case involved a petition for injunctive and declaratory relief brought by plaintiffs Harbor Homes, Inc. and Gary Dube, Thomas Taylor, Cynthia Washington, and Arthur Furber against defendants the New Hampshire Department of Health and Human Services (DHHS), the Commissioner of DHHS, the Associate Commissioner of DHHS, and the Administrator of the Bureau of Behavioral Health seeking, in part, to enjoin DHHS from denying the individual plaintiffs the right to obtain Medicaid-funded services from their chosen provider, Harbor Homes. The individual plaintiffs received Medicaid-funded rehabilitative services from Harbor Homes. Since 1991, Harbor Homes participated in New Hampshire's Medicaid program pursuant to a Medicaid Provider Enrollment Agreement. On June 23, 2008, Harbor Homes entered into an interagency agreement (IAA) with a community mental health program, Community Council of Nashua, NH, now known as Greater Nashua Mental Health Center (GNMHC), which authorized Harbor Homes to provide certain Medicaid-funded rehabilitative services to GNMHC patients. In February 2011, Harbor Homes learned that GNMHC did not intend to renew its IAA and that the Medicaid reimbursable services provided by Harbor Homes would be transitioned to GNMHC. This was done pursuant to Administrative Rule He-M 426.04(a)(2), which meant that Harbor Homes would no longer have an IAA with a community mental health provider, and it would no longer be permitted to provide Medicaid funded mental health services to approximately one hundred and forty of its clients, including the individual plaintiffs in this case. Plaintiffs filed a petition for injunctive and declaratory relief, seeking a court order enjoining DHHS from "terminating or limiting Harbor Homes' status as a qualified Medicaid provider" and to direct the State to allow the individual plaintiffs to obtain community mental health services from Harbor Homes, the provider of their choice. Following two hearings, the court denied the plaintiffs' request for a preliminary injunction. Thereafter, all parties moved for partial summary judgment on the plaintiffs' claim that DHHS's reliance upon the IAA requirement as a reason to terminate Harbor Homes' status as a qualified Medicaid provider was improper because the requirement was invalid both on its face and as applied in this case. Plaintiffs appealed rulings of the Superior Court that denied their summary judgment motions and granting the defendants' cross-motions for summary judgment on two counts in the plaintiffs' petition. Upon review of the matter, the Supreme Court reversed the Superior Court's ruling that New Hampshire Administrative Rules, He-M 426.04(a)(2) did not violate the federal Medicaid Act. The case was remanded for further proceedings. View "Dube v. New Hampshire Dept. of Health & Human Svcs." on Justia Law

The issue this case presented to the Pennsylvania Supreme Court centered on the interpretation of Sections 6152(a)(1) and (a)(2)(i) of the Medical Records Act ("MRA,"42 Pa.C.S. secs. 6151-6160), which requires businesses such as appellee MRO Corporation, which reproduces medical records for patients and their representatives, to limit their copying charges to their estimated actual and reasonable expenses of reproducing requested charts or records (subject to a statutory ceiling rate), or whether such businesses may simply charge the statutory ceiling rate. Appellant asked the Court to review the Superior Court's finding that, where a medical records reproducer fails to disclose and charge its estimated actual and reasonable expenses and instead charges the MRA's ceiling rates which the records requestor then pays, the defenses of "voluntary payment" and "prior approval" bars the records requestor from maintaining a breach of contract claim to recoup alleged overpayments. MRO did not dispute that the MRA requires the records reproducer to disclose to the requestor “the estimated actual and reasonable expenses” of reproduction. But, MRO argues that the "expenses" so disclosed do not represent actual costs of reproduction; rather, MRO argues that "expenses" refers to the cost to the party making the request, and that expense is determined by the pricing schedule. In MRO's view, the pricing schedule establishes the "expense" to be estimated and then passed on to the requestor. "MRO's construction of the Act is intricate and ingenious in some respects, and it articulates what may be a rational and legitimate approach to the general question of how best and fairly to regulate the expenses of securing medical records." However, the Supreme Court did not believe that the structure and plain language of the provisions of the Act at issue here supported MRO's construction. The Supreme Court reversed the Superior Court and remanded the matter to the trial court for further proceedings. View "Wayne M. Chiurazzi Law, Inc., et al. v. MRO Corporation" on Justia Law

This case was among a number of civil actions brought by state attorneys general against pharmaceutical companies challenging the propriety of prescription drug pricing, as it impacted third-party reimbursement for brand-name drug purchases subsidized by government social welfare programs. The Commonwealth focused its claims upon alleged overpayments tied to the use of an industry benchmark figure (average wholesale price, or "AWP") in government reimbursement formulas. While many issues of concern were raised about the Commonwealth’s approach to this litigation and the judgment it has obtained, the Pennsylvania Supreme Court overturned the monetary component of that judgment grounded on the Commonwealth’s failure to offer a rational accounting for the billion dollars in rebate monies which Commonwealth agencies received from the drug manufacturers it sued. View "Pennsylvania v. TAP Pharmaceutical Products, Inc." on Justia Law

Mountain Regional Services, Inc. (MRSI), which provides services to individuals who receive medical benefits administered by the Wyoming Department of Health, filed a petition seeking judicial review of a “Provider Bulletin” issued by the Department concerning these benefits. The district court dismissed the petition for lack of ripeness and because MRSI failed to exhaust its administrative remedies before seeking judicial review. The Supreme Court affirmed, holding (1) the district court correctly concluded that the matter was not ripe for judicial review, and (2) therefore, it was unnecessary to consider the issue of exhaustion of administrative remedies.View "Mountain Reg’l Servs., Inc. v. State ex rel., Dep’t of Health" on Justia Law

Plaintiffs filed an action individually and on behalf of a class of persons similarly situated against Respondents, Charleston Area Medical Center (CAMC) and CAMC Health Education and Research Institute, asserting causes of action for breach of duty of confidentiality, invasion of privacy, and negligence for placing Plaintiffs’ personal and medical information on a specific CAMC electronic database and website that was accessible to the public. The circuit court denied class certification, finding that Plaintiffs did not meet the prerequisites for class certification and that Plaintiffs lacked standing to sue Respondents. The Supreme Court reversed, holding that the circuit court erred in finding that Petitioners lacked standing and abused its discretion in ruling that Petitioners failed to meet the requirements for class certification. Remanded.View "Tabata v. Charleston Area Med. Ctr." on Justia Law

Plaintiffs filed wrongful death and lost chance of recovery claims against Defendants-health care providers. Plaintiffs voluntarily dismissed their first case but refiled the same claims in a second case. The trial court dismissed the second case for failure to file health care affidavits as required by Mo. Rev. Stat. 538.225. In their third case, Plaintiffs refiled their petition, along with the required affidavits. The trial court dismissed the third case as barred by the statute of limitations. The Supreme Court affirmed the trial court’s judgment dismissing the second and third cases, holding (1) Plaintiffs failed to preserve their constitutional challenges to section 538.225 and failed to show they had substantially complied with the statute; and (2) the trial court correctly applied the statute of limitations in finding that the claims in the third case were time barred. View "Mayes v. Saint Luke’s Hosp. of Kansas City" on Justia Law

A psychiatrist at Chicago-Read Mental Health Center sought a court order authorizing involuntary treatment of Rita. Stating that Rita met the criteria for a diagnosis of “schizophrenia paranoid type,” the doctor requested authorization to administer specific medications, including Risperidone, for up to 90 days. At a hearing, there was testimony about Rita’s behavior before her hospitalization, about police response to a call about Rita’s behavior, and about Rita’s own descriptions of her delusions and trying to choke herself to kill the people inside her. Rita had not threatened anyone at Chicago-Read, and no cause existed to place her in restraints or administer emergency medication. Although generally cooperative, Rita refused to attend group therapy, and would not take medication. The circuit court authorized involuntary treatment. The appellate court reversed, finding that the trial court failed to comply with the Mental Health and Developmental Disabilities Code, 405 ILCS 5/3-816(a), requirement that final orders “shall be accompanied by a statement on the record of the court’s findings of fact and conclusions of law.” The Illinois Supreme Court reinstated the trial court order, reasoning that reading the code as “directory,” so that noncompliance can be excused, does not impair the safeguards the law is intended to protect.View "In re Rita P." on Justia Law

Two Patients were injured in a car accident with Third-Party. Patients were treated at Hospital, and to secure payment, Hospital filed hospital liens under the Hospital Lien Statute. Patients settled with Third-Party and released their claims against him. Third-party’s Insurer made the settlement checks jointly payable to Patients and Hospital. Patients deposited the checks without Hospital’s endorsement, and Hospital was never reimbursed for the treatment costs. Hospital sued Insurer to enforce its hospital liens, but Insurer refused payment, contending that it met its obligation to pay Hospital under the Hospital Lien Statute by making the checks payable to Hospital as a copayee. The trial court granted summary judgment for Insurer, and the court of appeals affirmed. The Supreme Court reversed, holding (1) Hospital’s charges were not “paid” under the Hospital Lien Statute and Uniform Commercial Code; and (2) Hospital’s liens on Patients’ causes of action remained intact. View "McAllen Hosps., LP v. State Farm County Mut. Ins. Co." on Justia Law

Sara Townsend and A.S. were co-workers. Townsend completed an application to initiate a process to seek immediate emergency treatment for A.S., alleging that A.S. was a threat to herself or others. A trial court judge issued a warrant for A.S.’s detention and treatment. Doctors at the hospital where A.S. was subsequently detained, however, determined that there was no cause to continue detaining A.S. and discharged her. Thereafter, the trial judge found Townsend in contempt of court and imposed sanctions. The court of appeals (1) concluded that the trial court lacked statutory authority to find Townsend in indirect civil contempt, but (2) upheld the trial court’s order directing Townsend to pay A.S.’s hospital bill and attorney fees as a legitimate exercise of the trial court’s inherent powers to issue sanctions. The Supreme Court vacated the court of appeals’ opinion and reversed, holding (1) the trial court lacked the statutory authority to find Townsend in contempt and impose sanctions; and (2) Townsend’s actions did not place her under the trial court’s authority to impose sanctions as an inherent power of the judiciary. View "In re Mental Health Actions for A.S." on Justia Law