Justia Health Law Opinion Summaries

A group of skilled nursing facilities in New York and Rhode Island challenged a rule promulgated by the U.S. Department of Health and Human Services (HHS). The rule allowed certain inspections of these facilities without the presence of a registered nurse, which the plaintiffs argued contradicted the Medicaid Act's requirement for a registered nurse to be part of the survey teams. The dispute arose after an incident at Avon Nursing and Rehabilitation, where a resident was injured, leading to an inspection by a team that did not include a registered nurse. The plaintiffs contended that the rule violated the statutory requirement.The United States District Court for the Southern District of New York granted summary judgment in favor of the government. The court concluded that the Medicaid Act's registered nurse requirement applied only to surveys conducted under 42 U.S.C. § 1396r(g)(2) and not to activities under 42 U.S.C. § 1396r(g)(4), which were the subject of the challenged rule. The court also determined that even if the statute were ambiguous, the agency's interpretation was reasonable and entitled to deference under Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc.The United States Court of Appeals for the Second Circuit reviewed the case and affirmed the district court's judgment. The appellate court held that the registered nurse requirement did not extend to complaint investigations and other enforcement activities under 42 U.S.C. § 1396r(g)(4). The court reasoned that the term "survey" in the statute referred specifically to annual standard surveys, extended surveys, and validation surveys, and not to the investigatory activities described in § 1396r(g)(4). Consequently, the rule allowing inspections without a registered nurse did not contradict the Medicaid Act. View "Avon Nursing & Rehabilitation v. Becerra" on Justia Law

Samuel Boima, a native of Sierra Leone, was charged with assaulting federal officers at the Buffalo Federal Detention Facility while awaiting deportation. The incident involved Boima spitting a mixture of saliva and blood on the officers. Following his arrest, Boima exhibited uncooperative and erratic behavior, leading to a court-ordered psychological evaluation. Dr. Kari Schlessinger diagnosed Boima with a psychotic disorder, concluding he was incompetent to stand trial. Boima was subsequently committed to the Federal Medical Center in Butner, North Carolina, for further evaluation.The United States District Court for the Western District of New York found Boima incompetent to stand trial and ordered his hospitalization. Dr. Kristina P. Lloyd and Dr. Charles Cloutier at FMC Butner diagnosed Boima with schizophrenia and recommended antipsychotic medication to restore his competency. The government moved for a Sell hearing to authorize involuntary medication. The district court granted the motion but did not address whether the government had an important interest in prosecuting Boima, a necessary finding under Sell v. United States.The United States Court of Appeals for the Second Circuit reviewed the case. The court vacated the district court's order authorizing forced medication, noting the lower court's failure to consider whether important governmental interests were at stake, as required by Sell. The appellate court remanded the case for further proceedings to determine if the government’s interest in prosecuting Boima justified involuntary medication, considering factors such as the seriousness of the crime, potential civil commitment, and the time Boima had already spent in custody. View "United States v. Boima" on Justia Law

Bruce Kelley and his spouse, Nancy Kelley, filed a medical malpractice lawsuit in Vermont state court after Bruce Kelley was paralyzed from the waist down while residing at Franklin County Rehabilitation Center (FCRC). They alleged that Dr. Teig Marco, employed by Richford Health Center, Inc. (RHC), negligently treated Kelley, leading to his paralysis. RHC is a federally funded community health center deemed a member of the Public Health Service under the Federally Supported Health Centers Assistance Act (FSHCAA).The United States intervened and removed the case to federal district court, asserting that RHC and Dr. Marco were covered under the Federal Tort Claims Act (FTCA) due to their deemed status. The United States District Court for the District of Vermont held an evidentiary hearing and determined that the FSHCAA did not apply to Dr. Marco’s treatment of Kelley because Kelley was not a patient of RHC, and the treatment did not fall under the specified statutory criteria for nonpatients. Consequently, the District Court remanded the case to state court for lack of subject matter jurisdiction.The United States Court of Appeals for the Second Circuit reviewed the case and affirmed the District Court's decision. The appellate court agreed that Kelley was not a patient of RHC and that Dr. Marco’s treatment did not meet the criteria for FTCA coverage for nonpatients under the FSHCAA. The court concluded that the treatment did not qualify as after-hours coverage or emergency treatment and that RHC had not sought a particularized determination of coverage from the Department of Health and Human Services. Therefore, the remand to state court was appropriate, and the District Court's order was affirmed. View "Kelley v. Richford Health Center, Inc." on Justia Law

Enock Mensah, a social worker, was convicted of theft of public funds and health care fraud for billing publicly funded agencies for over 1,600 treatment sessions that never occurred. The United States District Court for the Eastern District of New York sentenced him to forty-two months of imprisonment, followed by one year of supervised release, and ordered him to pay $177,345 in restitution.Mensah appealed, arguing that the district court erred in three ways: (1) failing to excuse or further examine a juror who knew a government witness, (2) denying his post-trial motion for a new trial based on a prosecutor's comment that suggested Mensah had the ability to testify, and (3) applying a ten-level enhancement based on the loss amount in calculating the United States Sentencing Guidelines advisory range.The United States Court of Appeals for the Second Circuit reviewed the case. The court found that the district court did not abuse its discretion by allowing the juror to remain, as the connection was too attenuated to presume bias. The voir dire was deemed adequate in screening for actual bias. Regarding the prosecutor's comment, the court held that any potential prejudice was moot since Mensah chose to testify, and there was no evidence that the comment compelled him to do so. Finally, the court found no clear error in the district court's calculation of the loss amount, which was based on substantial evidence, including video surveillance, license-plate reading technology, and cellphone records.The Second Circuit affirmed the district court's judgment, upholding Mensah's conviction and sentence. View "United States v. Mensah" on Justia Law

Nicole Costin, individually and on behalf of her minor son, filed a lawsuit against Glens Falls Hospital and several of its staff members. Costin alleged that the hospital discriminated against her due to her substance-abuse disorder, violating the Americans with Disabilities Act and the Rehabilitation Act. She also raised state-law claims. Costin's allegations included the hospital conducting drug tests without informed consent, reporting her to the New York State Child Abuse and Maltreatment Register based on a false positive drug test, withholding pain relief, accelerating her labor without consent, and refusing to correct their actions.The United States District Court for the Northern District of New York dismissed Costin’s action, concluding that she failed to plausibly allege that she was discriminated against due to her disability. The district court also declined to exercise supplemental jurisdiction over her state-law claims.The United States Court of Appeals for the Second Circuit affirmed in part, vacated in part, and remanded the case for further proceedings. The court agreed with the lower court's dismissal of Costin’s claims related to the denial of an epidural, acceleration of labor, and treatment of her newborn. However, the court disagreed with the dismissal of Costin’s claims related to the hospital's instigation of a Child Protective Services investigation and its administration of a drug test. The court found that Costin had plausibly alleged that these actions were based on discriminatory policies, not medical decisions. The court also vacated the lower court's decision to decline supplemental jurisdiction over Costin’s state-law claims. View "Costin v. Glens Falls Hospital" on Justia Law

Carlos Esteras and Raphael Frias were convicted of fentanyl trafficking charges and appealed their sentences, arguing that the district court erred in calculating their respective Guidelines ranges. Esteras contended that the district court wrongly calculated his base offense level by applying a two-level increase for maintaining a premises for narcotics trafficking and declining to apply a two-level reduction for being a minor participant in the trafficking scheme. He also argued that the district court wrongly applied a two-point increase to his criminal history score after finding that he was on parole at the time of the offense. Frias argued that the district court erred in applying the two-level premises enhancement and a four-level increase for being an organizer or leader of the scheme, and failed to adequately consider his mitigating evidence in declining to vary downwards.The United States District Court for the Northern District of New York had sentenced Esteras to 84 months' imprisonment and Frias to 135 months' imprisonment. The court had applied several sentencing enhancements, including a two-level enhancement for maintaining a premises for narcotics trafficking and a four-level enhancement for being an organizer or leader of the scheme.The United States Court of Appeals for the Second Circuit affirmed each of the district court’s sentencing decisions except its application of the organizer or leader enhancement to Frias. The court affirmed Esteras’s sentence and vacated and remanded Frias’s sentence for further proceedings consistent with its opinion. The court found that Esteras's home qualified for the stash-house enhancement and that he was not a minor participant in the conspiracy. The court also found that Esteras was on parole when he committed his offenses, warranting a two-point increase to his criminal history score. However, the court found that Frias did not qualify as an organizer or leader under the Guidelines, warranting a remand for further proceedings. View "United States v. Frias" on Justia Law

The United States Court of Appeals for the Second Circuit heard a case initiated by Adam Hart, who filed a qui tam action under the False Claims Act (FCA) against pharmaceutical distributor McKesson. Hart alleged that McKesson provided business management tools to its customers for free in exchange for commitments to purchase drugs, which he claimed violated the federal anti-kickback statute (AKS) and several analogous state laws. The district court dismissed Hart's FCA claim, determining he failed to allege McKesson acted "willfully" as required by the AKS.On appeal, the Second Circuit held that to act "willfully" under the AKS, a defendant must knowingly act in a way that is unlawful. The court found that Hart failed to provide sufficient facts to meet this standard. However, the court disagreed with the district court's assertion that Hart's state claims were premised solely on a violation of the federal AKS. Consequently, the Second Circuit affirmed the dismissal of Hart’s federal FCA claim, vacated the dismissal of the remaining state claims, and remanded for further proceedings. View "United States, ex rel. Hart v. McKesson Corp." on Justia Law

The plaintiff, Dr. Misty Blanchette Porter, had been a staff physician at Dartmouth-Hitchcock Medical Center (DHMC) since 1996. She specialized in reproductive medicine and was highly regarded in her field. In November 2015, Dr. Porter developed a medical condition that required her to take a medical leave of absence and subsequently work reduced hours. In 2017, DHMC decided to close the Reproductive Endocrinology and Infertility Division (REI) where Dr. Porter worked and terminate her employment. Dr. Porter claimed that her termination was due to her disability and her whistleblowing activity, in violation of the Americans with Disabilities Act (ADA), the Rehabilitation Act, and the laws of Vermont and New Hampshire.The United States Court of Appeals for the Second Circuit found that the district court erred in granting summary judgment to DHMC. The court found that there was direct evidence that the decision to terminate Dr. Porter's employment was based, in whole or in part, on her disability. The court also found that a jury could reasonably infer that Dr. Edward Merrens, the chief decision-maker in the termination, was aware of Dr. Porter's whistleblowing activity. The case was affirmed in part, vacated and remanded in part. View "Porter v. Dartmouth-Hitchcock Medical Center" on Justia Law

In this case, a group of patients initiated a class action lawsuit against various hospitals and vendors who provide medical record production services to the hospitals. The plaintiffs alleged that the hospitals and vendors were involved in an illegal kickback scheme, where the vendors charged patients excessive prices for their medical records and used the profits to offer free and discounted pages to the hospitals for other types of medical records. The plaintiffs alleged violations of New York Public Health Law (PHL) § 18(2)(e) (which restricts the price that can be charged for medical records), New York General Business Law (GBL) § 349 (which prohibits deceptive business practices), and unjust enrichment. However, the New York Court of Appeals had previously ruled in Ortiz v. Ciox Health LLC that PHL § 18(2)(e) does not provide a private right of action.The United States Court of Appeals for the Second Circuit affirmed the district court's dismissal of all the plaintiffs' claims. It found that the patients' GBL § 349 and unjust enrichment claims were essentially repackaging their PHL § 18(2)(e) claims, and therefore not cognizable as they attempted to circumvent the Ortiz ruling. The court also held that the plaintiffs failed to allege any actionable wrongs independent of the requirements of PHL § 18(2)(e). The court concluded that the plaintiffs failed to state a claim, and as such, the district court did not err in granting the defendants' motions for judgment on the pleadings, in denying the plaintiffs' cross-motion for summary judgment as moot, and in denying the plaintiffs' leave to file a second amended complaint. View "McCracken v. Verisma Systems, Inc." on Justia Law

The United States Court of Appeals for the Second Circuit upheld the life imprisonment sentence of Azibo Aquart, who was found guilty of multiple federal homicide and drug trafficking crimes. The court had previously affirmed his conviction but vacated his death sentence, remanding the case for a new penalty proceeding. On remand, the government decided not to pursue the death penalty, and Aquart was resentenced to life imprisonment. Aquart appealed, arguing that the district court erred in refusing to address new challenges to his conviction and in sentencing him for both drug-related murder and drug conspiracy, which he argued constituted double jeopardy. The Appeals Court rejected both arguments, ruling that the district court correctly applied the mandate rule and that Aquart's double jeopardy argument was without merit. View "United States v. Aquart" on Justia Law