Justia Health Law Opinion Summaries

A Mexican national, J.R., who worked seasonally in Sully County, South Dakota, required emergency medical treatment for appendicitis. He was taken to Avera St. Mary’s Hospital in Hughes County, where he received treatment and incurred medical bills totaling over $75,000. J.R. had no health insurance, few assets, and returned to Mexico without paying the bills. Avera sought reimbursement from Sully County under county poor-relief statutes.The Sully County Board of Commissioners denied Avera's application for reimbursement, citing J.R.'s status as a nonresident of Sully County. Avera appealed this decision to the circuit court, which remanded the case back to the Commission for a more detailed factual record. After a hearing, the Commission again denied Avera's claim, determining that J.R. was indigent by design and was not in distress in Sully County at the time the county was notified. Avera appealed this decision to the circuit court, which affirmed the Commission's decision.The Supreme Court of the State of South Dakota affirmed the lower court's decision. The court found that the county's obligation to support poor persons is statutory, not common law. The court interpreted the poor-relief statutes to require every county to support all poor and indigent persons who have established residency therein. However, the parties agreed that J.R. was not a resident of Sully County. The court found that the county had no statutory obligation to reimburse Avera for J.R.'s emergency medical services, as he was a nonresident indigent who had left Sully County before the Commission learned he was in distress. The court concluded that in these circumstances, where temporary relief had already been administered to the nonresident indigent by a third party in another county, Sully County had no statutory obligation to reimburse Avera for J.R.'s emergency medical services. View "Avera St. Mary’s Hospital V. Sully County" on Justia Law

In this case, a group of healthcare providers (Providers) sued the insurer Sanford Health Plan, Inc. (SHP) for excluding them from participating in some of its health benefit plans. The Providers argued that according to South Dakota’s “Any Willing Provider” law (SDCL 58-17J-2), they had the right to participate as panel providers in all of SHP's plans. The law stipulates that a health insurer cannot block patient choice by excluding a willing and qualified healthcare provider from its panel of providers if the provider is within the geographic coverage area of the health benefit plan. The circuit court determined that the law did not permit SHP to exclude a qualified and willing healthcare provider from participating in every health benefit plan it offered, granting summary judgment in favor of the Providers.The Supreme Court of the State of South Dakota affirmed the circuit court's decision. It interpreted the law as plan-specific, meaning an insurer may not exclude any willing and fully qualified provider from any of its plans or from any tier within a plan. It also clarified that an insurer may still exclude providers from plans if they do not meet the statutory requirements for participation as a panel provider. The court concluded that, according to the law, SHP could not exclude the Providers from participating in its TRUE Plan or Tier 1 of the PLUS Plan, thus affirming the circuit court's granting of summary judgment in favor of the Providers. View "Orthopedic Institute v. Sanford Health Plan, Inc." on Justia Law

The Supreme Court affirmed in part and reversed in part the judgment of the circuit court denying the motion for partial summary judgment brought by the Estate of Robert T. Lynch as to its action against Kevin Lynch and entering judgment as a matter of law for Kevin on his counterclaim for conversion, holding that remand was required.The Estate sued Kevin alleging claims for fiduciary fraud, conversion, breach of fiduciary duty, and elder exploitation. Kevin filed a counterclaim alleging conversion, among other claims. After the circuit court denied the Estate's motion for partial summary judgment on its claims against Kevin the court entered judgment as a matter of law for Kevin on his counterclaim. The Supreme Court (1) reversed as to the Estate's claims involving two payable-on-death CDs Kevin deposited in his individual account and directed that, on remand, the circuit court shall enter judgment as a matter of law for compensatory damages plus prejudgment interest on the Estate’s claims for breach of fiduciary duty and conversion; (2) ruled that the Estate's claim for punitive damage on the reversed portion of the judgment was an open question on remand; and (3) otherwise affirmed. View "Estate of Lynch v. Lynch" on Justia Law

The Supreme Court affirmed the judgment of the circuit court granting the petition filed by the administrator of the Human Services Center (HSC) to administer psychotropic medication to B.T. without his consent, holding that the circuit court did not err in granting the petition.Pursuant to an emergency commitment, B.T. was admitted to the HSC after reports that he was exhibiting delusional behavior connected to his fervent religious views. B.T. was later involuntarily committed. At issue was a separate proceeding in which the HSC's administrator sought an order to administer psychotropic medical to B.T. without his consent. After a hearing, the circuit court granted the petition, allowing the HSC to administer psychotropic medication to the victim for up to one year subject to conditions. The Supreme Court affirmed, holding that the circuit court correctly applied the law, and its factual determinations were based upon competent and unrequited evidence. View "Johnson v. B.T." on Justia Law

The Supreme Court affirmed the judgment of the circuit court determining that James Bruggeman was a vulnerable adult and finding by a preponderance of the evidence that Jennifer Ramos neglected and financially exploited Bruggeman while she was a caretaker and was entrusted with his property, holding that there was no error.Specifically, the Supreme Court held that the circuit court (1) did not abuse its discretion when it quashed the subpoena for Bruggeman to testify; (2) did not err in determining that Bruggeman was a vulnerable adult under S.D. Codified Laws 21-65-1(15); (3) did not err when it found that Bruggeman was the victim of financial exploitation; and (4) did not err when it ordered Ramos to pay Black Hills Advocate’s attorney fees. View "Bruggeman v. Ramos" on Justia Law

In this guardianship and conservatorship action, the Supreme Court affirmed the judgment of the circuit court granting the conservator's motion for approval of a settlement agreement reached in a separate civil action brought by the conservator against the protected person's son and daughter-in-law, holding that the circuit court did not err.Three of the protected person's other children objected to the conservator's motion for approval of the settlement agreement, requesting that they be allowed to present live testimony at the hearing on the motion. The circuit court denied the request and, after a hearing, granted the conservator's motion for approval of the settlement. The Supreme Court affirmed, holding that the circuit court did not err in denying an evidentiary hearing and in approving the settlement agreement. View "In re Guardianship & Conservatorship of Adam" on Justia Law

The Supreme Court affirmed the judgment of the circuit court entering judgment in favor of Yankton County on Sacred Heart Health Service Inc.'s (Hospital) declaratory judgment against the County, holding that circuit court did not err in holding S.D. Codified Laws chapter 28-13 is the proper mechanism for the Hospital to obtain reimbursement from the County for medical costs associated with the twenty-three patients in the involuntary commitment process.The Hospital brought a declaratory judgment action against the County seeking a declaration as to the County's liability and reimbursement for charges for the medical care and treatment of patients subject to an emergency hold under S.D. Codified Laws chapter 27A-10. The circuit court first entered a memorandum decision in favor of the Hospital, but after granting the County's motion to reconsider issued a second memorandum decision and corresponding judgment in favor of the County. The Supreme Court affirmed, holding (1) the circuit court did not err in granting the County's motion for summary judgment; (2) the Hospital did not have a claim in quantum merit for reimbursement from the County; and (3) the circuit court did not err in granting the County's motion to reconsider. View "Sacred Heart Health Services v. Yankton County" on Justia Law

The Supreme Court affirmed the judgment of the circuit court in favor of Children's Care Hospital and School (CCHS) as to Benjamin Graff's complaint alleging that CCHS was negligent and inflicted emotional distress by using physical restraints on him when he received services at CCHS, holding that the circuit court did not err in excluding various Department of Health surveys and by taxing partial disbursements against Graff's parents.Graff, who was in the moderately to severely impaired range of intellectual ability, was receiving services through CCHS when, as a teenager, he began acting out aggressively. CCHS employees used physical restraints on him. Through his parents acting as guardians ad litem, Graff commenced this action alleging, among other things, that CCHS was negligent in its use of physical restraints on him. A jury returned a verdict in favor of CCHS on all of Graff's claims. The circuit court taxed partial disbursements against Graff's parents. The Supreme Court affirmed, holding (1) the circuit court's exclusion of the Department of Health surveys did not prejudice Graff; and (2) the circuit court did not abuse its discretion when it apportioned disbursements against Graff's parents. View "Graff v. Children’s Care Hospital & School" on Justia Law

At issue was whether a guardian’s attorney fees should be paid from a protected person’s estate when the fees were incurred in responding to pleadings to remove the guardian and to move the protected person to an assisted living facility.Beverly Sears, the guardian in this case, moved for her attorney fees incurred in a dispute seeking to remove her as guardian and to move the protected person to a facility. The parties settled, with Sears agreeing to step down as guardian but the parties deciding that the protected person would not be moved to a facility. Sears moved for her attorney fees paid from the estate. The circuit court denied the motion. The Supreme Court reversed, holding that without a resolution of factual matters relating to the necessity of the services in administering the guardianship or the reasonableness of the fee amount, the court was unable to meaningfully review the circuit court’s decision. View "In re Conservatorship of Bachand" on Justia Law

Three individuals (the Conservators) were appointed guardians and conservators of Mary Novotny. The Conservators established the Mary D. Novotny Trust. Catherine Novotny was a beneficiary of the Trust, and the conservators were the trustees. When a dispute over the Trust arose between the trustees and Catherine, the circuit court granted reimbursement of expenses to the trustees. The circuit court granted summary judgment in favor of the Conservators and awarded them reimbursement and future expenses. Catherine appealed. The Supreme Court remanded, holding that there was no evidence in the record that supported the basis for reimbursement under S.D. Codified Laws 55-3-13, and therefore, the circuit court erred in granting the Conservators’ motions for expenses. View "In re Guardianship of Novotny" on Justia Law