Justia Health Law Opinion Summaries

Articles Posted in Iowa Supreme Court
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In response to a 2009 executive order announcing a ten percent reduction in state departments and agencies for the fiscal year ending June 30, 2010, the Iowa Department of Human Services (IDHS) promulgated temporary rules adjusting the reimbursement rates paid to Medicaid service providers. Thereafter, the legislature passed a law directing IDHS to continue for the next fiscal year the rate reductions as specified under the 2009 executive order. Accordingly, IDHS promulgated permanent rules implementing certain rate reductions. IDHS, however, inadvertently omitted a reduction for one component of the rate calculation for certain Medicaid service providers. Nevertheless, IDHS continued to reimburse those service providers at the reduced rates established under the temporary rules. In an administrative proceeding, Plaintiffs, several providers, challenged the rate calculation, arguing that, even if the “missing” rule was an oversight, IDHS could not reimburse them at the reduced rate without a rule authorizing it to do so. An administrative law judge granted summary judgment for IDHS, and the decision was affirmed on review. The district court reversed. The Supreme Court reversed, holding that the statute provides sufficient authority for IDHS to reimburse service providers at the reduced rates without a rule authorizing it to do so. View "Exceptional Persons, Inc. v. Iowa Dep’t of Human Servs." on Justia Law

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Plaintiffs filed a class action alleging that the fees Defendant charged for providing copies of their medical records and billing statements were excessive in violation of Iowa Code 622.10(6). Defendant filed a motion to dismiss for failure to state a claim, alleging that section 622.10(6) did not apply to it because it was not a provider under the statute. The district court denied the motion to dismiss. The Supreme Court affirmed, holding (1) an entity that acts as a provider’s agent in fulfilling records requests covered by section 622.10(6) cannot charge more for producing the requested records than the provider itself could legally charge; and (2) the well-pleaded facts in the petition indicated that Defendant acted as an agent of the providers by fulfilling the records requests on their behalf, and therefore, the district court was correct in denying Defendant’s motion to dismiss Plaintiffs’ petition. View "Young v. Healthport Technologies, Inc." on Justia Law

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After Plaintiff, an at-will employee, reported a forgery on the part of supervisors at an assisted living facility, the facility terminated Plaintiff's employment. The Department of Inspections and Appeals later concluded that certain state-mandated documents relating to the facility's dementia training program had been forged. Plaintiff subsequently filed an action against the facility for wrongful discharge. The jury returned a verdict for Plaintiff, finding the facility terminated her in retaliation for whistleblowing and a willful and wanton disregard for the rights or safety of others. The jury also awarded punitive damages. The court of appeals (1) affirmed the court's finding that the public-policy exception to the at-will employment doctrine protected Plaintiff's employment from retaliatory termination, but (2) reversed the court's decision to submit the issue of punitive damages to the jury. The Supreme Court affirmed, holding (1) an employer's retaliatory discharge of Plaintiff violated public policy; and (2) the district court should not have submitted the punitive damages claim to the jury because at the time of Plaintiff's discharge, the Court did not recognize a public-policy exception to the at-will employment doctrine based upon a violation of administrative rules. View "Dorshkind v. Oak Park Place of Dubuque II, LLC" on Justia Law

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Plaintiffs, several nursing homes approved by the Iowa Department of Human Services (DHS) as Medicaid providers, submitted annual reports disclosing their income and expenses to DHS. DHS used the reports to calculate the Medicaid per diem reimbursement rates for the nursing homes. Some of the facilities' expenses were disallowed by DHS, and DHS reduced reimbursement rates accordingly. The facilities appealed the adjustments. The director of human services upheld the action. The district court affirmed. The court of appeals reversed, concluding that the DHS rules did not support its decision that the disputed costs were not allowable. The Supreme Court affirmed, holding that DHS's exclusion of the facilities' lab, x-ray, and prescription drug costs from the nursing homes' reports was based on an incorrect interpretation of its rules. View "Sunrise Ret. Cmty. v. Iowa Dep't of Human Servs." on Justia Law

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The Iowa Board of Nursing and Iowa Department of Public Health (collectively, Defendants) enacted rules allowing advanced registered nurse practitioners (ARNPs) to supervise radiologic technologists using fluoroscopy machines. Several physician associates brought this action against Defendants to invalidate the rules. Two nursing associations intervened to defend the rules. The district court invalidated the rules, concluding that Defendants exceeded their authority in promulgating the rules. The Supreme Court reversed, holding (1) the Board's application of law to fact was not irrational, illogical, or wholly unjustifiable; (2) the rules fell within the authority of the Board and Department; and (3) the other challenges to the rules failed. Remanded. View "Iowa Med. Soc'y v. Iowa Bd. of Nursing" on Justia Law

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Appellant pleaded guilty to first-degree harassment. While Appellant was incarcerated for the offense, the State sought to have him committed as a sexually violent predator (SVP) under Iowa Code 229A. A jury found Appellant was an SVP, and Appellant was ordered for commitment. The Supreme Court remanded the case. On retrial, the jury against concluded Appellant was an SVP, and Appellant was again ordered committed. The Supreme Court affirmed, holding (1) Appellant failed to meet his burden to show by a preponderance of the evidence that he was prejudiced by his counsel's advise to sign a speedy trial waiver; (2) Appellant was not prejudiced by his trial counsel's failure to adequately argue the trial should have been bifurcated to protect Appellant's due process rights; and (3) the prosecution did not misstate the evidence during trial. View "In re Detention of Blaise" on Justia Law

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After Defendant was twice arrested and convicted of sexual offenses, proceedings were commenced for Defendant's commitment as a sexually violent predator. After a jury trial, Defendant was committed to the Civil Commitment Unit for Sexual Offenders (CCUSO). In 2010, Defendant submitted a petition seeking a final hearing on whether he should be discharged from the CCUSO or placed in a transitional release program. Thereafter, the State submitted its notice of annual review for 2011 asserting there was no evidence of any change in Defendant's mental abnormality constituting a ground for his discharge. Defendant subsequently filed a petition requesting a final hearing on his 2011 annual review and his claims for either discharge or placement in the transitional release program. The district court concluded Defendant failed to demonstrate by a preponderance of the evidence that he was entitled to a final hearing on either discharge or placement in a transitional release program. The Supreme Court affirmed, holding that the district court did not err in its judgment. View "Taft v. Dist. Court" on Justia Law

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Respondent was incarcerated with an approaching release when the State filed a petition alleging Respondent was a sexually violent predator (SVP) under Iowa's civil commitment statute. After a jury trial, Respondent was found to be an SVP. The primary issue on appeal was whether the State properly waited until the conclusion of Respondent's overall prison term to bring an SVP proceeding, when Respondent received consecutive sentences for a sexual abuse offense and a burglary/arson offense, with the sentence for burglary/arson to be served after the sentence for the sexual abuse offense. The Supreme Court reversed, holding (1) a person receiving consecutive sentences, one of which is for a sexually violent offense, is "presently confined" within the meaning of the civil commitment statute, and thus, an SVP petition is timely filed if it is filed before the respondent's anticipated release from prison, as long as the current term of imprisonment includes a sentence for a sexually violent offense; (2) sufficient evidence supported the jury's verdict that Respondent was an SVP; but (3) it was error to admit expert testimony on the State's procedure for selecting persons against whom SVP proceedings are filed. View "In re Detention of Stenzel" on Justia Law

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After Appellant's emergency hospitalization, a district court concluded that B.B. was seriously mentally impaired. Appellant was subsequently involuntarily committed. During the pendency of the appeal, Appellant was released to outpatient treatment at the University of Nebraska Medical Center (UNMC). Because the court file indicated Appellant was no longer a patient at UNMC, the State filed a motion to discharge and terminate the proceedings. The district court granted the motion, terminated the proceedings, and discharged Appellant from court-ordered treatment and placement. At issue on appeal was whether Appellant's appeal was moot when Appellant had been released and the proceedings terminated. The Supreme Court affirmed the judgment of the district court, holding (1) this appeal was not moot, as a person adjudicated seriously mentally impaired and involuntarily committed suffers adverse collateral consequences; and (2) substantial evidence supported the conclusion that Appellant was seriously mentally impaired. View "In re B.B." on Justia Law

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In this putative class action, Plaintiffs were doctors of chiropractic who alleged they had been victimized by the discriminatory practices of Iowa's largest health insurer, Wellmark, Inc. The district court (1) granted Wellmark's motion to dismiss claims brought under Iowa's insurance regulatory statutes because no private cause of action was provided therein; (2) granted Wellmark's motion for summary judgment on Plaintiffs' antitrust claims based on the "state action" exemption found in Iowa Code 553.6(4); (3) granted summary judgment on claims alleging Wellmark breached its obligations under a judicially approved national class action settlement in Love v. Blue Cross Blue Shield Ass'n; and (4) granted summary judgment on several specific antitrust claims. The Supreme Court (1) reversed in part, holding that the district court erred in granting summary judgment on Plaintiffs' antitrust claims based on the state action exemption, as the record failed to establish the challenged conduct fell within the exemption; and (2) otherwise affirmed. Remanded. View "Mueller v. Wellmark, Inc." on Justia Law