Justia Health Law Opinion Summaries

A group of retired firefighters from the City of Columbia claimed that the City had promised them free lifetime health insurance. This promise was allegedly made through verbal statements, newsletters, and retirement letters. The dispute arose when the City Council required all active and retired employees under 65 to contribute to their health insurance premiums, and later extended this requirement to Medicare supplemental coverage for retirees over 65. The firefighters argued that the City should be held to its promise under the doctrine of promissory estoppel.Initially, the Circuit Court granted summary judgment in favor of the City, but the Court of Appeals reversed this decision, allowing the promissory estoppel claim to proceed. After a nonjury trial, Judge Sprouse ruled in favor of the City, and the Court of Appeals affirmed this decision, stating that the firefighters had not proven an unambiguous promise or reasonable reliance on such a promise.The Supreme Court of South Carolina reviewed the case and affirmed the Court of Appeals' decision but modified the reasoning. The Supreme Court found that the firefighters did not prove the City made a clear promise of free lifetime health insurance. Additionally, the Court emphasized that the City Council, not individual employees, had the authority to make such promises. The Court also clarified that promissory estoppel claims need only be proven by the greater weight of the evidence, not by clear and convincing evidence, except in cases involving specific performance of land transfers. The Court concluded that the firefighters had no right to rely on statements made by City employees who lacked the authority to bind the City. View "Cruz v. City of Columbia" on Justia Law

In South Carolina, two hospitals, Walterboro Community Hospital and Trident Medical Center, appealed an Administrative Law Court (ALC) order which approved the certificate of need (CON) for the Medical University Hospital Authority (MUHA). MUHA had applied for a CON to construct a new general hospital in Berkeley County to address capacity issues at its existing hospital in Charleston. The appellant hospitals raised four issues against ALC's decision: 1) the ALC's dismissal of certain errors in the review by the South Carolina Department of Health and Environmental Control (DHEC), 2) a misinterpretation of the State Health Plan by the ALC, 3) the ALC's approval of MUHA's application conditional on the closure of a freestanding emergency department planned by MUHA, and 4) the appeal bond required by South Carolina law is unconstitutional.The Supreme Court of South Carolina affirmed the ALC's decision and held that despite errors in DHEC's review process and decision, the ALC's de novo review rendered these errors harmless. The court also agreed with ALC's interpretation of the State Health Plan and found no issue in the ALC's condition of approval. The court further held that the appeal bond requirement was not unconstitutional, as the appellant hospitals were statutory affected persons and there was a rational basis for different treatment for a party opposing an approved CON and a party appealing the denial of its own CON application. However, the court did instruct that the appeal bond be voided and returned to Trident Medical Center. View "Walterboro Comm Hospital v. SCDHEC" on Justia Law

In 2023, a majority of the South Carolina Supreme Court found unconstitutional the 2021 version of the Fetal Heartbeat and Protection from Abortion Act (the 2021 Act). In response to its decision, the South Carolina General Assembly (the legislature) revised the 2021 Act, especially in terms of its legislative findings and purposes, and passed a new version of the Fetal Heartbeat and Protection from Abortion Act (the 2023 Act). Immediately after the Governor signed the 2023 Act into law, Planned Parenthood South Atlantic and three other medical providers (collectively, Planned Parenthood) filed an action in the circuit court seeking a declaration that the new law was unconstitutional. Upon Planned Parenthood's motion, the circuit court enjoined enforcement of the 2023 Act pending resolution of the constitutional challenge. Numerous state officials (collectively, the State) promptly filed an emergency petition to the South Carolina Supreme Court for supersedeas or, alternatively, a request that it accept the matter in its original jurisdiction and expedite briefing. The Court denied the petition for supersedeas but granted the alternative request to accept the matter in its original jurisdiction and expedite resolution of the case. The Court vacated the preliminary injunction issued by the circuit court and declared the 2023 Act constitutional. View "Planned Parenthood South Atlantic, et al. v. State of South Carolina, et al." on Justia Law

The United States Court of Appeals for the Fourth Circuit certified a question of law to the South Carolina Supreme Court. In June 2005, Poly-Med, Inc. (Poly-Med) entered into a Sale of Materials and License Agreement with the predecessor in interest to Defendants Novus Scientific Pte. Ltd., Novus Scientific, Inc., and Novus Scientific AB (collectively, Novus). The Agreement required Poly-Med to develop a surgical mesh for Novus's exclusive use in hernia-repair products. The dispute between Poly-Med and Novus arose from two ongoing obligations in the parties' Agreement. As characterized by the Fourth Circuit, the alleged breach of the Agreement centered on the contractual provisions that contained these two obligations: the "hernia-only" provision and the "patent-application" provisions. The federal court asked whether, under a contract with continuing rights and obligations, did South Carolina law recognize the continuing breach theory in applying the statute of limitations to breach-of-contract claims, such that claims for separate breaches that occurred (or were only first discovered) within the statutory period are not time-barred, notwithstanding the prior occurrence and/or discovery of breaches as to which the statute of limitations has expired? The Supreme Court found South Carolina did not recognize the continuing breach theory. "Moreover, it may matter greatly 'if the breaches are of the same character or type as the previous breaches now barred.'" Nevertheless, in a contract action, the Court held it was the intent of the parties that controlled: "Whether separate breaches of the same character or type as time-barred breaches trigger a new, separate statute of limitations depends on the parties' contractual relationship—specifically, what the parties intended." View "Poly-Med, Inc. v. Novus Scientific Pte. Ltd., et al." on Justia Law

The United States District Court for the District of South Carolina certified a question of law to the South Carolina Supreme Court. Sullivan Management, LLC operated restaurants in South Carolina and filed suit to recover for business interruption losses during COVID-19 under a commercial property insurance policy issued by Fireman's Fund and Allianz Global Risks US Insurance Company (Fireman's). Specifically, the questions was whether the presence of COVID-19 in or near Sullivan's properties, and/or related governmental orders, which allegedly hinder or destroy the fitness, habitability or functionality of property, constituted "direct physical loss or damage" or did "direct physical loss or damage" require some permanent dispossession of the property or physical alteration to the property. The Supreme Court held that the presence of COVID-19 and the corresponding government orders prohibiting indoor dining did not fall within the policy’s trigger language of “direct physical loss or damage.” View "Sullivan Mgmt v. Fireman's Fund" on Justia Law

Before the South Carolina Supreme Court in this appeal was the trial court's dismissal of respondent Jeanne Beverly's claims pursuant to Rule 12(b)(6) of the South Carolina Rules of Civil Procedure. Beverly brought claims against Grand Strand Regional Medical Center, LLC. Blue Cross Blue Shield of South Carolina (BCBS) was a mutual insurance company that provided health insurance coverage through Member Benefits Contracts to its Members. Beverly was a BCBS Member. In 2005, Grand Strand and BCBS entered into a contract labeled "Institutional Agreement." The Institutional Agreement contained a clause entitled, "No Third Party Beneficiaries," that provided in part, "This Agreement is not intended to, and shall not be construed to, make any person or entity a third party beneficiary." Grand Strand and BCBS were the only parties to the Institutional Agreement. Grand Strand made two promises to BCBS in the Institutional Agreement that Beverly contended created rights she and other BCBS Members could enforce. Beverly was injured in an automobile accident on September 6, 2012. The same day, she received health care services at a Grand Strand emergency room for injuries she sustained in the accident. Beverly alleges she provided Grand Strand proof of her status as a BCBS Member. Some time later, Beverly received a bill directly from Grand Strand for $8,000. Beverly alleges the $8,000 bill does not reflect the discount Grand Strand promised in the Institutional Agreement. Beverly filed this action on behalf of herself and a class of similarly situated BCBS Members who were denied the right to have their bills processed and discounted according to Grand Strand's promises in the Institutional Agreement. The primary question before the Supreme Court was whether the "no beneficiary" clause in the Institutional Agreement overrode an otherwise manifestly clear purpose of the contracting parties to provide a direct benefit to non-contracting parties. "Mindful that we are reviewing a Rule 12(b)(6) dismissal order—not an order on the merits—we hold it does not." The Supreme Court affirmed the court of appeals' opinion reversing the 12(b)(6) dismissal. The case was remanded to circuit court for discovery and trial. View "Beverly v. Grand Strand Regional Medical Center, LLC" on Justia Law

The South Carolina Supreme Court granted petitioners' request for a declaration with respect to Provisos 1.108 and 1.103 of the 2021-2022 Appropriations Act1 were invalid. Proviso 1.108 (enacted June 22, 2021,) was directed to the South Carolina Department of Education for South Carolina's kindergarten through 12th grade (K-12) public schools, and banned face mask mandates at any of its education facilities. Proviso 1.103 permitted school districts to offer a virtual education program for up to five percent of its student population based on the most recent 135 day ADM [(average daily membership)]count without impacting any state funding. For every student participating in the virtual program above the five percent threshold, the school district would not receive 47.22% of the State per pupil funding provided to that district as reported in the latest Revenue and Fiscal Affairs revenue per pupil report pursuant to Proviso 1.3. Although the School District did not require its students to wear masks in its education facilities, it claimed Proviso 1.108 conflicted with local laws regarding mask requirements in schools and placed the School District in an untenable position. In addition, Petitioners claimed the School District reached the five percent cap for virtual enrollment and did not wish to risk losing state funds by exceeding the cap in Proviso 1.103. The School District asked for guidance on its options and obligations regarding face masks and virtual education. Petitioners contended: (1) Provisos 1.108 and 1.103 violate the one-subject rule of article III, section 17 of the South Carolina Constitution; (2) the plain language of Proviso 1.108 permitted the School District to implement and enforce mask mandates in its education facilities if the School District did so with funds not appropriated or authorized in the 2021-2022 Appropriations Act; (3) Provisos 1.108 and 1.103 improperly invade the authority of local school boards; and (4) Provisos 1.108 and 1.103 denied equal protection to students and violated their constitutional right to free public education. The Supreme Court held the provisos were constitutional, and rejected the remaining challenges to the validity of the provisos. View "Richland County School District 2 v. Lucas" on Justia Law

South Carolina Attorney General Alan Wilson sought a declaration by the South Carolina Supreme Court concerning the use of facemasks in the public schools of South Carolina during the coronavirus pandemic. The Court construed Proviso 117.190 of the 2021-2022 Appropriations Act relating to public institutions of higher learning, and determined from the language in that proviso that the University of South Carolina was not precluded from issuing a universal mask mandate that applied equally to vaccinated and unvaccinated students and faculty alike. This case involved a different proviso from the 2021-2022 Appropriations Act: Proviso 1.108, relating to public schools serving students grades kindergarten through 12 (K-12). Proviso 1.108 manifestly set forth the intent of the legislature to prohibit mask mandates funded by the 2021-2022 Appropriations Act in K-12 public schools. The Attorney General contended the City of Columbia passed ordinances in direct opposition to Proviso 1.108, mandating masks in all K-12 public schools in the City of Columbia. "While allowing school districts flexibility to encourage one policy or the other, the state legislature has elected to leave the ultimate decision to parents. Conversely, the City of Columbia has attempted to mandate masks for all school children by following guidance from the Centers for Disease Control, which has the effect of disallowing parents a say in the matter." The Supreme Court upheld Proviso 1.108 and declared void the challenged ordinances of the City of Columbia insofar as they purported to impose a mask mandate in K-12 public schools. View "Wilson v. City of Columbia" on Justia Law

Petitioner Charlotte-Mecklenburg Hospital Authority, d/b/a Carolinas Medical Center-Fort Mill sought a writ of certiorari to review the court of appeals' decision in Amisub of South Carolina, Inc. v. South Carolina Department of Health & Environmental Control, Op. No. 2017-UP-013 (S.C. Ct. App. filed Jan. 11, 2017). In 2005, four hospitals, Petitioner, Respondent Amisub, Presbyterian Healthcare System, and Hospital Partners of America, applied for a certificate of need (CON) to construct and operate an acute-care hospital in Fort Mill. In May 2006, the Department of Health and Environmental Control (DHEC) determined the acute-care hospital was necessary, and granted a CON to Amisub, but denied a CON to Petitioner and the others. DHEC's decision to award the CON to Amisub was based in part on its interpretation of the language of the South Carolina Health Plan that only existing health care providers in York County were eligible for additional hospital beds. Petitioner filed a contested case at the ALC, contending DHEC had erroneously interpreted the language of the Health Plan. Alternatively, Petitioner argued that if DHEC's interpretation was correct, the Health Plan violated the dormant Commerce Clause because it improperly restricted interstate commerce. The ALC found DHEC's interpretation of the Health Plan was not correct, reversed, and remanded to DHEC. The ALC's determination made it unnecessary for the ALC to reach the alternative dormant Commerce Clause claim. On remand, DHEC granted a CON to Petitioner, but denied a CON to the others. Amisub filed a second contested case at the ALC, which again reversed, this time ordering a CON be granted to Amisub and denied to Petitioner. The court of appeals affirmed, finding "the record does not show [Petitioner] presented to the ALC any argument that [Amisub]'s positions on adverse impact and outmigration, if adopted by the ALC, would violate the Dormant Commerce Clause. [Petitioner] waited until filing its Rule 59(e) motion to present this argument, which is too late." If Petitioner had reason to believe this issue was actually being litigated before the ALC in the second contested case, and yet remained silent, the South Carolina Supreme Court would have agreed with the court of appeals. However, the dormant Commerce Clause issues arising out of the language of the Health Plan were resolved in Petitioner's favor in the first contested case. Thus, Petitioner could not reasonably have foreseen the ALC would craft its order in a fashion to revive those issues. Therefore, Petitioner had no reason to raise the dormant Commerce Clause challenge in the second contested case until the ALC issued its order. “No party should be penalized for not addressing an issue as to which it had previously prevailed, and which it did not reasonably contemplate would yet be the basis of the court's ruling.” Accordingly, the Supreme Court reversed the court of appeals' finding that the dormant Commerce Clause issue was not preserved for appellate review, and remanded the case to the court of appeals for a ruling on the merits of the issue. View "Amisub v. SCDHEC" on Justia Law

In 2007, Linda Johnson enrolled her mother, Inez Roberts (Mrs. Roberts), in Heritage Healthcare of Estill (HHE) to receive nursing home care. Johnson held a general power of attorney for Mrs. Roberts, and as such, signed an arbitration agreement with HHE on her mother's behalf upon Mrs. Roberts's admission to HHE. Within six months of entering HHE, she developed severe pressure ulcers, resulting in the amputation of her leg and ultimately, her death in 2009. Prior to Mrs. Roberts's death, in August 2008, Johnson requested HHE allow her access to Mrs. Roberts's medical records, but HHE refused, citing privacy provisions in the Health Insurance Portability and Accountability Act (HIPAA). Johnson then filed an ex parte motion seeking to obtain a copy of Mrs. Roberts's medical records from HHE and to restrain HHE from changing, altering, or destroying the records. The circuit court granted a restraining order, and HHE filed a motion to dissolve the order, again citing HIPAA's privacy provisions. Subsequently, at Johnson's request, the circuit court appointed her Mrs. Roberts's guardian ad litem (GAL) in order to pacify HHE's HIPAA concerns. However, HHE still refused to produce the records. The court again ordered HHE to produce the records, and HHE appealed. During the pendency of the appeal, Mrs. Roberts died, and Johnson became her personal representative. HHE then produced the records, and the parties dismissed the appeal by consent. Several months after obtaining the records, in August 2010, Johnson filed a notice of intent (NOI) for a wrongful death and survival action against HHE. In October 2010, following an impasse at pre-suit mediation, Johnson filed her complaint. In November 2010, HHE filed its answer and asserted arbitration as one of several defenses, but did not move to compel arbitration at that time. Instead, HHE filed arbitration-related discovery requests on Johnson. Johnson asks this Court to review the court of appeals' decision to reverse the circuit court's finding that Heritage Healthcare of Estill (HHE) waived its right to arbitrate the claims between it and Johnson. Finding that HHE indeed waived its right to arbitrate the claims, the Supreme Court reversed the court of appeals. View "Johnson v. Heritage Healthcare" on Justia Law