Justia Health Law Opinion Summaries

The States filed suit raising constitutional challenges to Section 9010 of the Affordable Care Act (ACA) and statutory and constitutional challenges to the Certification Rule. The Fifth Circuit affirmed the district court's ruling that the States had standing to raise their Certification Rule claims; reversed the district court's ruling that the States' Administrative Procedure Act (APA) claims were not time-barred; and dismissed those claims for lack of jurisdiction.On the merits, the court affirmed the district court's judgment on the Section 9010 claims, holding that the Provider Fee is a constitutional tax that does not violate the Spending Clause and that Section 9010 satisfies both the requirements under the Tenth Amendment doctrine of intergovernmental tax immunity. In this case, the Provider Fee does not discriminate against states or those with whom they deal because it is imposed on any entity that provides health insurance (with certain exclusions). Furthermore, the legal incidence of the Provider Fee does not fall on the states because Congress expressly excluded states from paying the fee. However, the court reversed the district court's judgment that the Certification Rule violated the nondelegation doctrine, holding that HHS did not unlawfully delegate to a third party its authority to approve state managed-care organization (MCO) contracts. Accordingly, the court rendered judgment in favor of the United States. Because neither the Certification Rule nor Section 9010 are unlawful, the court vacated the district court's grant of equitable disgorgement to the States. View "Texas v. Rettig" on Justia Law

The Fifth Circuit reversed the Commission's decision affirming the application of OSHA's commercial diving safety regulations to the dives its staff members perform to feed animals housed at the Aquarium and to clean the facility's tanks. A majority of the Commission panel affirmed the ALJ's determination that feeding and cleaning dives did not fall within the "scientific diving" exemption to the commercial standard.The court held that the ALJ did not err in crediting the compliance officer's testimony about the Commercial Diving Operations (CDO) standard as lay opinion testimony; even if the compliance officer testified to some matters that fell outside the realm of lay opinion testimony, the admission of the testimony was harmless; and the Aquarium's witnesses were properly treated as lay witnesses. Under a plain reading of the entire definition of "scientific diving," as well as the regulation guidelines and regulatory history, the court held that the activities performed during the feeding and cleaning dives fall within the plain text of the exemption. In this case, the Aquarium has shown that feeding and cleaning dives are a necessary component of its scientific research. View "Houston Aquarium, Inc. v. Occupational Safety and Health Review Commission" on Justia Law

The Fifth Circuit denied a petition for review of the Commission's determination that Sanderson violated various regulations of the Department of Labor's Occupational Safety and Health Administration (OSHA).The court held that the ALJ's determination that the compressor cutouts and the emergency stops are subject to the mechanical integrity program was not an abuse of discretion or otherwise contrary to law; the ALJ's determination that Sanderson failed to rebut the presumption of exposure to a hazard was not an abuse of discretion or otherwise contrary to law; and the Secretary bore his burden with respect to all elements of a violation regarding Items 5a and 5b. View "Sanderson Farms, Inc. v. Occupational Safety and Health Review Commission" on Justia Law

In section 901 of the Family Smoking Prevention and Tobacco Control Act (TCA), Congress authorized the Secretary of Health and Human Services to determine which other products should be governed by the TCA's regulatory scheme. Plaintiffs filed suit against the FDA, its Commissioner, and the Secretary, asserting that Congress's delegation to the Secretary was unconstitutional.The Fifth Circuit affirmed the district court's dismissal of the complaint, holding that section 901's delegation to the Secretary does not violate the nondelegation doctrine. The court held that Congress undeniably delineated its general policy in the TCA; Congress plainly limited the authority that it delegated; and the relevant caselaw supports these conclusions. View "Big Time Vapes, Inc. v. FDA" on Justia Law

Plaintiffs, a Louisiana church and its pastor, filed suit seeking to enjoin stay-at-home orders restricting in-person church services to ten congregants.The Fifth Circuit held that the appeal of the denial of injunctive relief and related request for an injunction under Federal Rule of Appellate Procedure 8(a)(1) are moot because the challenged orders expired more than a month ago. In this case, plaintiffs failed to cite any authority applying the "capable of repetition" exception to support an injunction against an order that is no longer in effect. View "Spell v. Edwards" on Justia Law

Plaintiffs filed suit alleging that TDCJ's adoption and implementation of measures guided by changing CDC recommendations in regards to the COVID-19 pandemic do not go far enough. Plaintiffs filed a class action alleging violations of the Eighth Amendment's prohibition against cruel and unusual punishment, and the Americans with Disabilities Act, seeking a preliminary injunction.The Fifth Circuit granted TDCJ's motion to stay the district court's preliminary injunction, which regulates the cleaning intervals for common areas, the types of bleach-based disinfectants the prison must use, the alcohol content of hand sanitizer that inmates must receive, mask requirements for inmates, and inmates' access to tissues (amongst many other things). The court held that TDCJ is likely to prevail on the merits of its appeal because: (1) after accounting for the protective measures TDCJ has taken, plaintiffs have not shown a "substantial risk of serious harm" that amounts to "cruel and unusual punishment"; and (2) the district court committed legal error in its application of Farmer v. Brennan, by treating inadequate measures as dispositive of defendants' mental state. In this case, even assuming that there is a substantial risk of serious harm, plaintiffs lack evidence of defendants' subjective deliberate indifference to that harm. The court also held that TDCJ has shown that it will be irreparably injured absent a stay, and that the balance of the harms and the public interest favor a stay. Finally, the court held that plaintiffs have not exhausted their administrative remedies as required in the Prison Litigation Reform Act (PLRA), and the district court's injunction goes well beyond the limits of what the PLRA would allow even if plaintiffs had properly exhausted their claims. View "Valentine v. Collier" on Justia Law

On April 7, 2020, the Fifth Circuit issued a writ of mandamus vacating the district court's temporary restraining order (TRO) that exempted abortions from GA-09, an emergency measure temporarily postponing non-essential medical procedures during the COVID-19 pandemic. On April 9, 2020, the district court entered a second TRO exempting various categories of abortion from GA-09. At issue in this mandamus petition is the April 9 TRO.The court held that the district court disregarded the court's mandate in Abbott II and failed to apply the framework governing emergency exercises of state authority during a public health crisis, established over 100 years ago in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905). Furthermore, the district court second-guessed the basic mitigation strategy underlying GA-09 (the concept of "flattening the curve"), and also acted without knowing critical facts such as whether, during this pandemic, abortion providers do (or should) wear masks or other protective equipment when meeting with patients. The court concluded that these errors resulted in an overbroad TRO that exceeds the district court's jurisdiction, reaches patently erroneous results, and usurps the state's authority to craft emergency public health measures "during the escalating COVID-19 pandemic." Therefore, the court granted the writ in part and directed the district court to vacate parts of the April 9 TRO. View "In re: Greg Abbott" on Justia Law

In this case, the parties dispute the proper method for calculating the hospital specific limit for annual DSH payments. The Hospitals filed suit challenging the 2017 final rule clarifying that hospitals' "costs incurred" are net of payments from third parties, liked Medicare and private insurers. The Hospitals contend that the Secretary's definition of "costs incurred" conflicted with the Medicaid Act, 5 U.S.C. 706(2)(C).The Fifth Circuit reversed the district court's grant of summary judgment for the Hospitals, and joined three other circuits in holding that the 2017 rule was consistent with the Medicare Act. The court could not agree with the Hospitals that the ordinary meaning and dictionary definitions of "costs" and "payments" rendered the disputed language unambiguous; the court was unpersuaded by the Hospitals' argument that the statute draws a "clear line" between costs and payments; the court rejected the Hospitals' contention that Congress, by expressly excluding payments from Medicaid and the uninsured, meant to exclude only those payments and no others; the court rejected the Hospitals' argument that the express exclusion of third-party payments in a related Medicaid provision indicates that Congress chose not to deduct third-party payments in 42 U.S.C. 1396r-4(g)(1)(A); and the court saw no basis for the Hospitals' argument that the 2017 Rule conflicts with the statutory purpose of the hospital-specific limit. Accordingly, the court remanded for further proceedings. View "Baptist Memorial Hospital - Golden Triangle, Inc. v. Azar" on Justia Law

The Fifth Circuit granted a writ of mandamus directing vacatur of the district court's issuance of a temporary restraining order (TRO) against executive order GA-09 as applied to abortion procedures. In order to preserve critical medical resources during the escalating COVID-19 pandemic, the Governor of Texas issued GA-09, which postpones non-essential surgeries and procedures until 11:59 p.m. on April 21, 2020.The court held that the drastic and extraordinary remedy of mandamus was warranted in this case because the district court ignored the framework governing emergency public health measures, like GA-09, in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905); the district court wrongly declared GA-09 an "outright ban" on previability abortions and exempted all abortion procedures from its scope, rather than apply the Jacobson framework to decide whether GA-09 lacks a "real or substantial relation" to the public health crisis or whether it is "beyond all question, a plain, palpable invasion" of the right to abortion; the district court failed to apply the undue-burden analysis in Planned Parenthood v. Casey, 505 U.S. 833, 857 (1992), and thus failed to balance GA-09's temporary burdens on abortion against its benefits in thwarting a public health crisis; and the district court usurped the state's authority to craft emergency health measures, substituting instead its own view of the efficacy of applying GA-09 to abortion. Therefore, the court found that the requirements for a writ of mandamus are satisfied in light of the extraordinary nature of these errors, the escalating spread of COVID-19, and the state's critical interest in protecting the public health. View "In re: Gregg Abbott" on Justia Law

The Fifth Circuit affirmed the district court's grant of summary judgment to the Secretary in an action brought by Hendrick challenging Medicare payments it received for the 2015 federal fiscal year. The court held that the district court did not err by dismissing Hendrick's appeal, because the Board's determination that it did not have jurisdiction over Hendrick's appeal for failure to exhaust administrative remedies was correct. In this case, Hendrick received notice via the Federal Register but failed to request correction of its wage data by the published deadline in accordance with the established process under the statute. View "Hendrick Medical Center v. Azar" on Justia Law