Justia Health Law Opinion Summaries

Twelve Medicaid-participating hospitals (“Hospitals”) challenged the Department of Medicaid’s (“DOM’s”) recalculation of their Medicaid outpatient rates for fiscal year 2001. The chancery court affirmed the opinion of the DOM, finding that “DOM interpreted its own regulation – the State Plan, which is its contract with the federal government and which it is required to follow to receive federal funds to require Medicaid to calculate the cost to charge ratio by using Medicare Methodology, which at that time was using a blended rate.” The Mississippi Supreme Court found the plain language of Attachment 4.19-B of the State Plan provided a cost-to-charge-ratio formula for calculating outpatient rates. Laboratory and radiology charges were to be excluded from this formula, because they were reimbursed on a fee-for-service basis. DOM’s inclusion of radiology and laboratory services in the charges and substitution of costs with Medicare blended payment amounts was a clear violation of the State Plan. Therefore, the Court reversed the judgments of DOM and the chancery court. Consistent with its opinion, the Court remanded and ordered the Executive Director of DOM to recalculate the Hospitals’ cost-to-charge ratio using the Hospital’s submitted costs in their cost reports, excluding laboratory and radiology services, and reimbursing the Hospitals the appropriate amounts determined by using the State Plan. View "Crossgates River Oaks Hospital v. Mississippi Division of Medicaid" on Justia Law

Pursuant to Mississippi Code Section 27-35-119 (Rev. 2017), Natchez Hospital Company, LLC, (“Hospital”) filed a Complaint and Petition For Reduction of Assessment on Software. This ad valorem assessment was made by the Adams County Board of Supervisors (“Board”). Prior to appealing to the circuit court, the Hospital paid the ad valorem taxes as assessed. The Board filed a motion to dismiss for lack of jurisdiction, arguing that the Hospital had failed to post the necessary appeal bond required by Mississippi Code Section 11-51-77 (Rev. 2012), thus depriving the circuit court of jurisdiction. Following a hearing on the motion, the circuit court determined that the Hospital’s failure to post the bond under Section 11-51-77 deprived the court of jurisdiction to hear the appeal and granted the Board’s motion to dismiss. The Hospital appealed the circuit court’s decision to dismiss the case, asking only whether the bond requirement of Mississippi Code Section 11-51-77 was mandatory to confer jurisdiction on a circuit court to hear an appeal from a decision of a board of supervisors regarding an assessment of taxes. The Mississippi Supreme Court determined the Hospital paid the tax, but that was no excuse for not posting the bond to give the trial court jurisdiction to hear its complaint. Therefore, the Supreme Court affirmed dismissal of the Hospital’s case. View "Natchez Hospital Company, LLC v. Adams County Board of Supervisors" on Justia Law

In August 2014, Dianne and Reggie Harkins alleged the direct and proximate negligence of multiple healthcare providers located in Leake County and Hinds County resulted in, among other problems, the amputation of Dianne Harkins’s hands and feet. In January 2015, Madden Medical Clinic, PLLC (Madden Medical) and David Moody, M.D. (Dr. Moody) filed a motion to dismiss or, alternatively, for severance and transfer of venue to the Circuit Court of Leake County. Shortly thereafter, Baptist Medical Center-Leake, Inc. (BMC-Leake) and Mississippi Baptist Health Systems, Inc. (Baptist Health) filed a motion also to dismiss or transfer venue to the Circuit Court of Leake County. On February 26, 2016, the Circuit Court of the First Judicial District of Hinds County entered an order denying the motions of Dr. Moody, Madden Medical, BMC-Leake, and Baptist Health to dismiss or, in the alternative, to transfer venue. The parties appealed, collectively filing two interlocutory appeals, and both appeals were granted and consolidated. The Mississippi Supreme Court held that under the plain language of Mississippi Code Section 11-11-3(3), venue was proper for the properly joined defendants in Hinds County or Leake County, and the judgment of the trial court was affirmed. View "Mississippi Baptist Health Systems, Inc. v. Harkins" on Justia Law

Dr. Hosan Azomani seeks review of the Court of Appeals’ affirmance of his conviction and sentence for two counts of Medicaid fraud in violation of Mississippi Code Sections 43-13-213 and 43-13-215. Dr. Azomani practiced pediatric medicine under the name Children’s Medical Group of Greenville PLLC, in Greenville, Mississippi. In 2007, the Division of Medicaid conducted an audit of Dr. Azomani’s patient files, which revealed three coding errors. Though Dr. Azomani admitted to the errors, he claimed that he had not deliberately made the mistakes. The Mississippi Supreme Court granted certiorari to address venue and statute-of-limitations issues. Finding that venue was proper and that the claims were prosecuted within the statute of limitations, the Court affirmed the judgment of the Court of Appeals and affirmed the conviction and sentence of the trial court. View "Azomani v. Mississippi" on Justia Law

Citing the 2014 State Health Plan, Methodist Healthcare - Olive Branch Hospital (Methodist) applied for a certificate of need (CON) - seeking approval to perform percutaneous coronary intervention(s), at its Olive Branch hospital. But Baptist Memorial Hospital - DeSoto (Baptist) - a competing hospital from the same service area - contested Methodist’s application. The Mississippi State Department of Health (MSDH) held a hearing and ultimately approved Methodist’s application. Baptist appealed to the Chancery Court. And after review, the chancellor affirmed MSDH’s decision. Baptist appealed to the Supreme Court. The Supreme Court found substantial evidence that Methodist’s application substantially complied with the State Health Plan and was consistent with its requirements. So it affirmed. View "Baptist Memorial Hospital-Desoto, Inc. v. Mississippi Dept. of Health" on Justia Law

On her father’s behalf, Debra Tarvin signed a nursing home Admission Agreement which contained an arbitration provision. After her father Caldwell Tarvin died, she brought a wrongful-death suit against the nursing home, CLC of Jackson, LLC d/b/a Pleasant Hills Community Living Center (“Pleasant Hills”). Caldwell was admitted to Pleasant Hills in August 2007, and Debra signed an Admission Agreement as Caldwell’s “Responsible Party.” Janet Terrell and Annette Tarvin also signed the Agreement as “Family Members” but Caldwell himself did not sign the Agreement. Pleasant Hills moved to dismiss the proceedings and to compel arbitration. Debra responded and argued that Pleasant Hills had waived its right to compel arbitration by participating in the litigation. Debra also argued that Pleasant Hills had “completely ignore[d] the issue of whether or not Mr. Tarvin’s family members had the legal authority to bind him to an arbitration agreement[.]” Specifically, Debra argued that there was “no legal authority, such as a power of attorney or conservatorship” by which she could bind her father to the arbitration agreement, nor could she bind him under the Uniform Healthcare Decisions Act, because “the record is devoid of any evidence” that the physicians relied upon by Pleasant Hills were Caldwell’s primary physicians. The trial court granted Pleasant Hills' motion, and Debra appealed. The relevant statutes at play here were codified as the “Uniform Health-Care Decisions Act,” Mississippi Code Section 41-41-201 to 41-41-229 (the “Act”). The Supreme Court's review of this case found that Act required determination by a primary physician that an individual lacks capacity before a “surrogate” properly can make a healthcare decision for that individual. The record here did not support a finding that a certain "Dr. Thomas" was Caldwell’s primary physician. The Court therefore reversed the trial court’s order compelling arbitration and remanded the case for further proceedings. View "Tarvin v. CLC of Jackson, LLC d/b/a Pleasant Hills Community Living Center" on Justia Law