Justia Health Law Opinion Summaries

Articles Posted in U.S. 10th Circuit Court of Appeals
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The plaintiffs in this case were David and Barbara Green, their three children, and the businesses they collectively owned and operated: Hobby Lobby Stores, Inc. and Mardel, Inc. As owners and operators of both Hobby Lobby and Mardel, the Greens organized their businesses with express religious principles in mind. As was particularly relevant to this case, one aspect of the Greens’ religious principles was a belief that human life begins when sperm fertilizes an egg. In addition, the Greens believed it was immoral for them to facilitate any act that caused the death of a human embryo. Plaintiffs brought an action to challenge portions of the Patient Protection and Affordable Care Act (ACA) whereby employment-based group health plans covered by the Employee Retirement Income Security Act (ERISA) were required provide certain types of health services for women that implicated contraceptive methods, sterilization procedures, and patient education and counseling (without cost-sharing by plan participants or beneficiaries) - all "abortifacients" that went against plaintiffs' religious beliefs. Plaintiffs filed suit to challenge the contraceptive-coverage requirement of the ACA under the Religious Freedom Restoration Act (RFRA), the Free Exercise Clause of the First Amendment, and the Administrative Procedure Act. Plaintiffs simultaneously moved for a preliminary injunction on the basis of their RFRA and Free Exercise claims. The district court denied that motion. Plaintiffs appealed the denial of the injunction. After review by the Tenth Circuit Court of Appeals, the Court held that Hobby Lobby and Mardel were entitled to bring claims under RFRA, established a likelihood of success that their rights under statute were substantially burdened by the contraceptive-coverage requirement, and established an irreparable harm. However, the case was remanded back to the district court for further proceedings on two remaining factors governing the grant or denial of a preliminary injunction. View "Hobby Lobby Stores, et al v. Sebelius, et al" on Justia Law

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George Cohlmia appealed a district court's decision to award attorney’s fees to St. John Medical Center pursuant to the Health Care Quality Improvement Act (HCQIA). This case arose from two surgeries Cohlmia performed: one patient died as a result of surgery, another was permanently disfigured. After the Hospital conducted an internal review, it concluded Cohlmia failed to follow proper medical protocols, and suspended the doctor’s staff privileges. The district court granted summary judgment in favor of the hospital on all of the doctor’s claims. The Hospital thereafter sought attorney’s fees under the HCQIA. Finding that the district court did not abuse it's discretion in awarding fees under the Act, the Tenth Circuit affirmed. View "Cohlmia, et al v. St. John Medical Center, et al" on Justia Law

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Full Life Hospice participates in the federal Medicare program. It sought reimbursement for hospice services provided to Medicare recipients from the Department of Health and Human Services (HHS). A fiscal intermediary, acting on behalf of HHS, later contested some of these reimbursements and demanded repayment of funds that it claimed were distributed in excess of a spending cap. Full Life unsuccessfully challenged HHS intermediary’s determination through an administrative appeal, which was denied as untimely. On appeal to the district court, the court found no basis to excuse Full Life's untimely challenge. Upon review, the Tenth Circuit agreed with the district court that it lacked subject matter jurisdiction because of Full Life's failure to file a timely administrative appeal. View "Full Life Hospice v. Sebelius" on Justia Law

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Decedent Charles Gray sought treatment for epilepsy at Defendant University of Colorado Hospital. In the course of his withdrawal from medication, hospital staff left Decedent unattended and he died after suffering a seizure. Plaintiffs, decedent’s estate and family members, filed a 42 U.S.C. 1983 suit alleging that the hospital (and affiliated doctors, nurses, and staff) deprived Decedent of life without due process of law in violation of the Fourteenth Amendment. The district court granted Defendants' motion to dismiss the complaint for failing to state a constitutional claim. Plaintiffs appealed. Applying the appropriate legal standards, the Tenth Circuit affirmed, but for reasons somewhat different than those of the district court: "The state actor’s affirmative act creating the danger or rendering the victim more vulnerable to it does not constitute a constitutional deprivation." View "Gray v. University of Colo. Hospital" on Justia Law

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Plaintiff appealed the administrative law judge's ("ALJ") denial of his application for supplemental security income alleging that he became disabled beginning in March 20, 2005 due to depression, post-traumatic stress disorder, and schizoaffective disorder. At issue was whether the factual findings were supported by substantial evidence and whether the correct legal standards were applied. The court held that the ALJ did not follow the law in evaluating all the medical evidence from a licensed clinical psychologist, a licensed professional counselor, and a physician who diagnosed plaintiff with schizoaffective disorder. The court also held that the ALJ failed to apply the correct legal standards in assessing plaintiff's credibility, and alternatively, the ALJ's adverse credibility determination was not supported by substantial evidence.