Justia Health Law Opinion Summaries

In this case, inmates at the Louisiana State Penitentiary (LSP) filed a class action lawsuit in 2015 against the warden, the Louisiana Department of Public Safety and Corrections, and other officials. The plaintiffs alleged that the defendants were deliberately indifferent to their serious medical needs, violating the Eighth Amendment, the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA). The district court bifurcated the case into liability and remedy phases. After an eleven-day bench trial, the court found in favor of the plaintiffs on all claims. Subsequently, a ten-day trial on remedies concluded that the plaintiffs were entitled to permanent injunctive relief, but the court did not specify the relief in its judgment.The United States District Court for the Middle District of Louisiana entered a "Judgment" in favor of the plaintiffs and a "Remedial Order" outlining the appointment of special masters to develop remedial plans. The defendants appealed, arguing that the district court's judgment and remedial order were final and appealable under 28 U.S.C. § 1291 or, alternatively, under 28 U.S.C. § 1292(a)(1).The United States Court of Appeals for the Fifth Circuit reviewed the case and concluded that the district court had not entered a final decision appealable under 28 U.S.C. § 1291, nor had it entered an injunction appealable under 28 U.S.C. § 1292(a)(1). The appellate court determined that the district court's actions were not final because they contemplated further proceedings, including the appointment of special masters and the development of remedial plans. Consequently, the Fifth Circuit dismissed the appeal for lack of jurisdiction and vacated the stay of the remedial order. View "Parker v. Hooper" on Justia Law

A group of anesthesiology specialty medical practices sued the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to challenge the Merit-based Incentive Payment System (MIPS). MIPS evaluates eligible clinicians across several performance categories and adjusts their Medicare reimbursement rates accordingly. The plaintiffs received unfavorable MIPS scores and argued that the Total Per Capita Cost (TPCC) measure, one of MIPS’s performance metrics, was arbitrary and capricious as applied to them.The United States District Court for the Northern District of Texas concluded that the plaintiffs' suit was statutorily barred and granted summary judgment for the defendants. The district court determined that 42 U.S.C. §§ 1395w-4(q)(13)(B)(iii) and (p)(10)(C) preclude judicial review of the plaintiffs' claims. Additionally, the court found that even if the claims were justiciable, CMS did not exceed its statutory authority in establishing the TPCC measure and its attribution methodology, and that the TPCC measure, as applied to the plaintiffs, was not arbitrary or capricious.The United States Court of Appeals for the Fifth Circuit reviewed the case and affirmed the district court’s dismissal. The appellate court agreed that 42 U.S.C. § 1395w-4(q)(13)(B)(iii) bars judicial review of the plaintiffs' challenge because CMS’s establishment of an attribution methodology for the TPCC measure falls within the “identification of measures and activities.” The court also concluded that 42 U.S.C. § 1395w-4(p)(10)(C) bars judicial review of the plaintiffs' claims, as it precludes review of the evaluation of costs, including the establishment of appropriate measures of costs. The court found no merit in the plaintiffs' assertion that CMS exceeded its statutory authority. Thus, the appellate court affirmed the district court’s decision to dismiss the plaintiffs' claims for lack of jurisdiction. View "U.S. Anesthesia Partners of Texas v. Health and Human Services" on Justia Law

Seymour filed suit challenging DHHS's decision, founded on a manual that defined "primary roads" as numbered federal highways and defined "secondary roads" as non-primary roads, that it was not a critical access hospital. The district court granted summary judgment for DHHS. The court applied deference under Skidmore v. Swift & Co., and concluded that DHHS's approach was neither arbitrary nor unreasoned nor did it rely on irrelevant considerations in attempting to fulfill Congressional intent. In this case, the agency considered, among other things, more than a road's alphanumeric designation, and the agency's premise was that ordinarily, federal highways are likely to be bigger, better-maintained, and more well-traveled than state highways. DHHS's decision reflected the general conclusion that federal highways offer superior conditions than state highways. Accordingly, the court affirmed the judgment. View "Baylor County Hospital District v. Price" on Justia Law

In the underlying action, JCHCC sought to permanently enjoin the Parish from evicting it from two Parish-owned facilities in which JCHCC currently provides medical services to medically underserved populations. The district court granted JCHCC's motion for a preliminary injunction, enjoining the Parish from evicting JCHCC but allowing it to terminate the injunction by establishing that the medical needs of the population currently served by the relevant JCHCC facilities would be met if JCHCC were evicted. The court reversed, concluding that JCHCC has not established a substantial likelihood of success on the merits of the only claim that was properly before the court. In this case, JCHCC failed to establish a likelihood of success on the merits of its Medicaid violation claim where JCHCC does not point to any authority suggesting that every local government in every participating state must provide the relevant medical services, nor does it point to authority establishing that the Parish has any obligation under Louisiana state law to provide such services on behalf of the state. View "Jefferson Community Health Care Centers v. Jefferson Parish Government" on Justia Law

Delek petitions for review of OSHA citations for violations of its process safety management rules, which govern an employer’s responsibility to inspect, and to develop inspection and recording regimes for, machinery that handles large volumes of hazardous chemicals. Item 4 alleges a failure to resolve open findings and recommendations identified during process hazard analyses that occurred in 1994, 1998, 1999, 2004, and 2005—prior to Delek purchasing and taking possession of the refinery. Item 8 alleges an inadequate monitoring and inspection regime for certain equipment involved in process safety management. Item 12 alleges that Delek failed to determine and document a response to the findings of a 2005 compliance audit in a timely manner. Item 12 was also conducted before Delek took possession of the refinery. The court concluded that citations for Items 4 and 12 are barred by the six-month statute of limitations in 29 U.S.C. 658(c). Accordingly, the court vacated those items. The court also concluded that the regulations relevant to the citation for Item 8 are ambiguous and the Secretary's interpretation is reasonable. The court affirmed the citation for Item 8. View "Delek Refining, Ltd. v. OSHC" on Justia Law

West Texas LTC Partners, Inc., doing business as Cedar Manor Nursing & Rehabilitation Center ("Cedar Manor"), appealed a Departmental Appeals Board ("DAB") of the U.S. Department of Health and Human Services ("HHS") decision. In 2013, Cedar Manor was surveyed by the Texas Department of Aging and Disability Services ("DADS"). The surveyor found Cedar Manor out of compliance with three regulations after observing the care provided to two wheelchair-bound residents, Resident #1 and Resident #4. Early the next year, DADS found additional violations of several regulations. The surveys were conducted by a designated state agency on behalf of the Centers for Medicare & Medicaid Services ("CMS") of HHS. The findings were reviewed by CMS, and civil money penalties ("CMPs") or other remedies may be imposed by the Secretary of HHS if the facility was found noncompliant. For the two sets of violations, CMS recommended two CMPs: $6,050 per day for three days, and $350 per day for forty-two days, to run consecutively from the end of an "immediate hazard" penalty. Cedar Manor appealed the findings and CMPs and requested a hearing before an administrative law judge ("ALJ"). CMS moved for summary judgment on all of the violations after the briefing and evidence were submitted. The ALJ granted summary judgment and upheld the CMPs. On de novo review, the DAB affirmed. The Fifth Circuit found that the DAB decision was neither arbitrary and capricious nor unsupported by substantial evidence, it denied Cedar Manor's petition for review. View "West Texas LTC Partners, Inc. v. Dept. of Health & Hum. Svcs." on Justia Law

In response to secretly recorded videos released by the Center for Medical Progress depicting conversations with Planned Parenthood employees elsewhere, LDHH terminated PPGC Louisiana Medicaid provider agreements. PPGC and the Individual Plaintiffs filed suit against LDHH under 42 U.S.C. 1983, alleging violations of 42 U.S.C. 1396a(a)(23) and the First and Fourteenth Amendments of the U.S. Constitution. The Individual Plaintiffs, three women who are Medicaid beneficiaries and who receive medical care from one of PPGC’s Louisiana facilities, seek to continue receiving care from PPGC’s facilities. The Individual Plaintiffs contend that LDHH’s termination action will deprive them of access to the qualified and willing provider of their choice, PPGC, in violation of Medicaid’s free-choice-of-provider provision. The district court entered a preliminary injunction against LDHH’s termination of PPGC’s Medicaid provider agreements. The court held that the Individual Plaintiffs met their burden to show their entitlement to a preliminary injunction; the district court did not abuse its discretion in preliminarily enjoining LDHH’s termination of PPGC’s provider agreements; and thus the court affirmed the district court's preliminary injunction, remanding for further proceedings. View "Planned Parenthood v. Gee" on Justia Law

JTB Tools challenges the dismissal of its suit against defendants, alleging that the district court erred in granting OSHA’s Rule 12(b)(1) motion to dismiss for lack of subject-matter jurisdiction and in transferring the case to this court. The court affirmed the district court's transfer, holding that this court has exclusive jurisdiction to review OSHA’s actions pursuant to 29 U.S.C. 655(f). Because JTB Tools failed to adequately brief its merits arguments before this court, the court held that JTB Tools waived any potential right to relief and the court dismissed the case. View "JTB Tools & Oilfield v. United States" on Justia Law

Wal-Mart petitions for review of the decision of the Commission finding that the company failed to comply with 29 C.F.R. 1910.132(d)(1), which requires the company to perform a hazard assessment of its distribution center. The court concluded that the regulation, the preamble, and the non-mandatory appendix fail to resolve the ambiguity as to whether Wal-Mart may use its Searcy hazard assessment as the hazard assessment for the allegedly identical New Braunfels location. In such circumstances, the court gives substantial deference to an agency’s interpretation of its own regulation. While section 1910.132(d)(1) may not require an employer to conduct a full-fledged hazard assessment of all identical workplaces, it is reasonable to interpret section 1910.132(d)(1) to require an employer to confirm that workplaces are indeed identical before a hazard assessment for one workplace can qualify as the hazard assessment for another location. Therefore, the court agreed with the Commission’s conclusion that the Secretary’s interpretation of section 1910.132(d)(1) is reasonable. However, because Wal-Mart lacked adequate notice of that interpretation, the court vacated the citation and the related penalty. View "Wal-Mart Distrib. Center v. OSHC" on Justia Law

Chapter 1301 of the Texas Insurance Code requires healthcare insurers to make coverage determinations and pay claims made by preferred healthcare providers within a specified time or face penalties. HCSC filed suit seeking a declaratory judgment against Methodist, seeking a declaration that Chapter 1301 does not apply to HCSC as the administrator of particular health plans, and the Federal Employee Health Benefits Act of 1959 (FEHBA), 5 U.S.C. 8901, et seq., preempts application of the statute to its administration of claims under the Federal Employees Health Benefits Program (FEHBP). The district court granted summary judgment to HCSC. The court held that Chapter 1301 is not applicable to BCBSTX’s activities as administrator of the self-funded plans or state government plans, nor to those activities that it performs as administrator of claims under the BlueCard program. The court also held that FEHBA preempts Chapter 1301’s application to the claims processed by BCBSTX under FEHBP plans. Accordingly, the court affirmed the judgment. View "Health Care Serv. Corp. v. Methodist Hospitals" on Justia Law