Articles Posted in Oregon Supreme Court

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The issue presented for the Oregon Supreme Court’s review was whether an adult foster care provider claiming unjust enrichment may recover the reasonable value of its services from a defendant who, through fraud, obtained a lower rate from the provider for the services. Plaintiff owned two adult foster homes for the elderly. Plaintiff had contracted with the Oregon Department of Human Services to provide services in a home-like setting to patients who qualified for Medicaid. For those patients, the rates charged would be those set by the department. Isabel Pritchard resided and received care in one of plaintiff’s adult foster homes until her death in November 2008. Because Prichard had been approved to receive Medicaid benefits, plaintiff charged Prichard the rate for Medicaid-qualified patients: approximately $2,000 per month, with approximately $1,200 of that being paid by the department. Plaintiff’s Medicaid rates were substantially below the rates paid by plaintiff’s “private pay” patients. Prichard’s application for Medicaid benefits, as with her other affairs, was handled by her son, Richard Gardner. Gardner had for years been transferring Prichard’s assets, mostly to himself (or using those funds for his personal benefit). Gardner’s misconduct was discovered by another of Prichard’s children: defendant Karen Nichols-Shields, who was appointed the personal representative for Prichard’s estate. In 2009, defendant contacted the police and reported her brother for theft. Ultimately, Gardner pleaded guilty to three counts of criminal mistreatment in the first degree. Gardner’s sentence included an obligation to pay a compensatory fine to Prichard’s estate, to which he complied. After defendant, in her capacity as personal representative, denied plaintiff Larisa’s Home Care, LLC’s claim against Prichard’s estate, plaintiff filed this action, essentially asserting Prichard had been qualified for Medicaid through fraud and that Prichard should have been charged as a private pay patient. The Oregon Supreme Court concluded that, generally, a defendant who obtains discounted services as a result of fraud is unjustly enriched to the extent of the reasonable value of the services. The Court therefore reversed the contrary holding by the Court of Appeals. Because the fraud here occurred in the context of a person being certified as eligible for Medicaid benefits, however, the Court remanded for the Court of Appeals to consider whether certain provisions of Medicaid law may specifically prohibit plaintiff from recovering in this action. View "Larisa's Home Care, LLC v. Nichols-Shields" on Justia Law

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This case centered on a public records request made by defendant Oregonian Publishing Company, LLC (The Oregonian), a newspaper, to plaintiff Oregon Health and Sciences University (OHSU), a public health and research university that provided patient care at its hospital, conducted research, and educated health care professionals and scientists. The circuit court ordered OHSU to disclose the requested record, and OHSU appealed. The Court of Appeals reversed and remanded to the circuit court to examine the public records at issue and then determine whether state and federal exemptions permitted OHSU to withhold some of the requested information. On review, the issues narrowed to whether the requested record contained “protected health information” and student “education records” under federal and Oregon law and, if so, whether that information nonetheless had to be disclosed pursuant to ORS 192.420(1), a provision of the Oregon Public Records Law (OPRL). The Oregon Supreme Court concluded the requested record contained protected health information and that ORS 192.420(1) did not require the disclosure of that information. The Court declined to consider whether the part of the requested record consisting of tort claim notices filed by students contained “education records,” and, if so, whether those records were exempt from disclosure. The Court therefore reversed in part, and affirmed in part the decision of the Court of Appeals. View "OHSU v. Oregonian Publishing Co., LLC" on Justia Law

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The issue before the Supreme Court in this case concerned the scope of Clackamas County's contractual obligation to provide health insurance benefits to command officer retirees of the County Sheriff's Office. A contract between the county and command officers, including Plaintiff Neil James, required the county to use a particular fund to pay for a certain level of benefits to command officers after they retired. The contract added that the obligation to pay benefits was "contingent upon the availability of sufficient funding in said fund to pay for the same." After plaintiff retired, the cost of insurance premiums increased to the point where the fund was and would for the foreseeable future continue to be insufficient to pay for the benefits required. The county entered into a new contract with certain union employees to provide lesser benefits from a more stable fund, and plaintiff (a retired officer, not a union employee) also was provided those lesser benefits. Plaintiff brought an action against the county, asserting breach of contract. He maintained that the first contract required the county to pay him full health insurance benefits and argued that the contingency provision did not apply because of the creation of the new fund, which had sufficient money to pay for those benefits. The trial court entered judgment in favor of plaintiff, but the Court of Appeals reversed. Upon review, the Supreme Court concluded that the new fund was the product of a contract that was separate and independent from the earlier contract. Because the prior fund was insufficient to provide the agreed level of benefits, the county did not breach its contractual obligation to provide that level of benefits. Accordingly, the Court affirmed the appellate court's decision. View "James v. Clackamas County" on Justia Law

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An emergency room doctor telephoned defendant (an on-call neurosurgeon)to ask his advice about plaintiff, who had come into the emergency room for treatment. When plaintiff later sued defendant for malpractice, the jury returned a verdict in defendant's favor. The jury found that defendant was not acting as plaintiff's doctor and, as a result, owed her no duty. The Court of Appeals reversed, holding that the trial court should have directed a verdict in plaintiff's favor on that issue. The Supreme Court allowed defendant's petition for review to consider that issue. Because the Court concluded that the jury could have found that defendant was not acting as plaintiff's doctor, the Court upheld the trial court's ruling denying plaintiff's motion for a directed verdict. The Court also concluded, however, that the trial court erred in instructing the jury and, for that reason, agreed that the case be remanded for a new trial. View "Mead v. Legacy Health System" on Justia Law

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Plaintiff David Eads underwent surgery performed by a Defendant Dr. Timothy Borman, a physician whose office was in a building that Defendant Salem Hospital, a limited liability company (LLC), leased to medical providers. The surgeon performed the surgery negligently, causing Plaintiff permanent and disabling injuries. Plaintiff brought this malpractice action against the LLC landlord, as well as the surgeon and others involved in his medical treatment. Plaintiff pursued the action against the LLC on a theory of apparent agency. Specifically, Plaintiff's theory was that, through the signage on the building and other representations, the LLC created the appearance that the building housed a group medical entity of which Plaintiff's surgeon was an agent. The trial court granted summary judgment for the LLC, concluding that the evidence was legally insufficient to hold the LLC vicariously liable for the surgeon's negligence on an apparent agency theory. The Court of Appeals agreed, and affirmed. The Supreme Court granted Plaintiff's petition for review to resolve when a nonnegligent person or entity may be held vicariously liable on an apparent agency theory for physical injuries negligently inflicted by a medical professional. The Court concluded that, for such liability to arise, the injured party must have dealt with the negligent medical professional based on a reasonable belief, traceable to the putative principal's conduct or representations, that the medical professional was the principal's employee or was otherwise subject to the principal's right of control in providing the medical services that caused the injured party's injury. View "Eads v. Borman" on Justia Law

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The issue in this case was whether a healthcare provider could be held liable for damages when the provider's negligence permitted the theft of its patients' personal information, though the information was never used or viewed by the thief or any other person. Plaintiffs Laurie Paul and Russell Gibson (individually and on behalf of all similarly-situated individuals) claimed economic and noneconomic damages for financial injury and emotional distress that they allegedly suffered when, through Defendant Providence Health System-Oregon's alleged negligence, computer disks and tapes containing personal information from an estimated 365,000 patients (including Plaintiffs') were stolen from the car of one of Defendant’s employees. The trial court and Court of Appeals held that Plaintiffs had failed to state claims for negligence or for violation of the Unlawful Trade Practices Act (UTPA). Upon review, the Supreme Court concluded that, in the absence of allegations that the stolen information was used in any way or even was viewed by a third party, Plaintiffs did not suffer an injury that would provide a basis for a negligence claim or an action under the UTPA. View "Paul v. Providence Health System-Oregon" on Justia Law