Justia Health Law Opinion SummariesArticles Posted in Vermont Supreme Court
Howard Center v. AFSCME Local 1674, et al.
Employer Howard Center appealed a trial court order that confirmed an arbitration award in favor of grievant Daniel Peyser and AFSCME Local 1674. In May 2019, employer expressed concern over grievant’s billing practices, specifically, his submission of billing paperwork in May for services provided in April. Employer told grievant that it was considering disciplining him for “dishonesty and unethical action” concerning the backdated bills. Grievant brought two billing notes from patient records to show that other employees engaged in the same billing practices. Employer did not reprimand grievant for the billing practices. In August 2019, however, employer informed grievant that he breached employer’s confidentiality policy by sharing the billing notes with his union representative at the June meeting. Employer issued a written reprimand to grievant. The reprimand stated that sharing client records without redacting confidential information violated protocols and state and federal regulations, and that grievant knew or should have known of these standards. Employer also explained that it was required to report the breach to state and federal authorities and to those individuals whose records were disclosed. Grievant filed a grievance under the terms of his collective-bargaining agreement, arguing in part that employer lacked just cause to discipline him. In an October 2020 decision, the arbitrator sustained the grievance. Employer then filed an action in the civil division seeking to modify or vacate the arbitrator’s award, arguing in relevant part that the arbitrator manifestly disregarded the law in sustaining the grievance. Employer asked the Vermont Supreme Court to adopt “manifest disregard” of the law as a basis for setting aside the arbitration award and to conclude that the arbitrator violated that standard here. The Supreme Court did not decide whether to adopt the manifest-disregard standard because, assuming arguendo it applied, employer failed to show that its requirements were satisfied. The Court therefore affirmed. View "Howard Center v. AFSCME Local 1674, et al." on Justia Law
Human Rights Commission v. Vermont, et al.
Plaintiff Vermont Human Rights Commission, on behalf of plaintiff Latonia Congress, appealed a trial court’s decision granting summary judgment to defendant Centurion of Vermont LLC on the Commission’s claims of discrimination under the Vermont Public Accommodations Act (VPAA). Congress was incarcerated at a prison owned and operated by the Vermont Department of Corrections (DOC). The DOC contracted with Centurion to provide all medical services for inmates at the prison. Under the previous provider, Congress was seen by an audiologist, who determined that she had substantial bilateral hearing loss, and she was given hearing aids for both ears. In December 2016, Congress reported that the hearing aids were not working, and Centurion planned to send them “to Audiology for check of functioning.” Later in December 2016, a doctor examined Congress’s ears and did not find any indication of an obstruction or other problem that might be affecting her hearing. Congress delivered her hearing aids to the medical unit to be sent out for testing. They were returned to her without having been tested. The record established that no one knew what happened to the hearing aids during that time; they were apparently misplaced. Through 2017 and early 2018, Congress attempted numerous times to obtain functioning hearing aids. Because Congress was deemed “functional” for some period of time despite her reported difficulty in hearing conversations, she was not eligible for hearing aids under Centurion’s policies. Eventually, in March 2018, an audiologist concluded Congress had moderate to severe bilateral hearing loss, which was worse in one ear, and recommended hearing aids. She was provided with one hearing aid in April 2018, which improved her hearing in that ear. Congress was released from prison in October 2019. In March 2020, the Commission filed a complaint against Centurion, the DOC, and other state defendants, alleging, as relevant here, that they discriminated against Congress in violation of the VPAA by failing to provide her with functioning hearing aids and thereby denying her equal access to certain benefits and services offered at the prison. Finding no reversible error in the grant of summary judgment in favor of Centurion, the Vermont Supreme Court affirmed. View "Human Rights Commission v. Vermont, et al." on Justia Law
In re Blue Cross and Blue Shield 2022 Individual & Small Group Market Filing
Blue Cross Blue Shield of Vermont (Blue Cross) appealed the Green Mountain Care Board’s (GMCB) decision modifying its proposed health-insurance rates for 2022. The GMCB approved Blue Cross’s proposed rates with several exceptions, one of which was relevant here: its contribution to reserves (CTR). Blue Cross had sought a base CTR rate of 1.5%, but the GMCB ordered Blue Cross to lower it to 1.0%, thereby diminishing overall insurance rates by 0.5% and reducing health-insurance premiums. The GMCB found that a 1.5% base CTR was “excessive” because Blue Cross was expected to be above its target Risk Based Capital (RBC) range by the end of 2021, “individuals and small businesses are still struggling financially after a year-long economic slowdown,” and a 1.0% CTR would allow its “reserves to sit comfortably within the company’s RBC target range.” Blue Cross moved for reconsideration, arguing that the term “excessive” was strictly actuarial in nature, and that the GMCB misconstrued it by weighing non-actuarial evidence— testimony concerning affordability—as part of its examination of whether the proposed rate was excessive. On appeal to the Vermont Supreme Court, Blue Cross raised essentially the same issue. Because none of the actuarial experts who testified concluded that Blue Cross’s proposed CTR was excessive, Blue Cross argued, the GMCB could not properly conclude that it was. Blue Cross conceded that health-insurance rates for 2022 could not now be changed, but it urged the Supreme Court to rule on the merits, arguing that this matter was not moot because the CTR rate for this year will disadvantage Blue Cross in future rate-review proceedings. The Supreme Court determined Blue Cross did not demonstrate that this kind of case was capable of repetition yet evading review or subjected it to continuing negative collateral consequences. Therefore, Blue Cross failed to meet the exceptional thresholds necessary for the Court to reach the merits in a moot case. View "In re Blue Cross and Blue Shield 2022 Individual & Small Group Market Filing" on Justia Law
Kelly v. University of Vermont Medical Center
Plaintiff Sean Kelly appealed the grant of summary judgment to the University of Vermont Medical Center (UVMMC) on employment discrimination and breach-of-contract claims arising from UVMMC’s decision not to extend his one-year medical fellowship. UVMMC selected plaintiff for the 2017-18 fellowship. UVMMC was aware that plaintiff suffered from an adrenal deficiency that had delayed the completion of his residency. In the first five months of the fellowship, plaintiff missed nineteen full days and parts of nine more days for various reasons. By February 2018, after missing several more days and expressing that he felt “frustrated with [his] absences” and “overall inadequate as a fellow,” program personnel became concerned that plaintiff was falling behind in his training. In a March 30 meeting, the program director told plaintiff his performance had “deficiencies and these need[ed] to be addressed.” At some point during this period, the director also told plaintiff he “should plan on extending [his] fellowship due to [his] time out and some minor deficits through August.” Plaintiff emailed other program personnel expressing frustration at the prospect of staying through August to complete his training. On April 14, 2018, plaintiff suffered a stroke, and on April 19th he attempted suicide. He was hospitalized from April 14 through May 3 and was not cleared to return to work until June 1, 2018. In all, plaintiff missed approximately six more weeks of the fellowship. On or about May 31, the director called plaintiff and told him that while UVMMC had determined he needed six more months of training to finish the fellowship, it could not accommodate additional training for that length of time. UVMMC paid plaintiff his remaining salary. Plaintiff filed a grievance under the Graduate Medical Education rules; the grievance committee affirmed UVMMC's decision. Because the decision not to extend his fellowship was an academic decision, there was no employment action and consequently no adverse employment action. The Vermont Supreme Court did not find plaintiff's arguments on appeal persuasive, and affirmed the grant of summary judgment in UVMMC's favor. View "Kelly v. University of Vermont Medical Center" on Justia Law
In re ACTD LLC, d/b/a The Green Mountain Surgery Center
During the certificate of need (CON) application process, applicant ACTD, LLC (operator of the Green Mountain Surgery Center (GMSC), a for-profit multi-specialty ambulatory surgery center), indicated that it initially planned to offer surgical services in five identified specialties. After the CON was issued, applicant notified the Board that in addition to these five specialties, it planned to offer plastic surgery and ophthalmology procedures. The Board chose to review these changes and, after hearing, issued a decision clarifying that the original CON was limited in scope to the five specialties applicant had identified in its application, and that the proposed addition of plastic surgery and ophthalmology procedures was a nonmaterial change to the project. The Board concluded that applicant had demonstrated a need for greater access to plastic surgery and ophthalmology procedures currently performed in a hospital setting and approved the addition of these services. However, it rejected applicant’s proposal to offer ophthalmology procedures already available at another ambulatory surgery center nearby. The Board also extended applicant’s implementation reporting period for two additional years. Applicant argued on appeal of the Board's decision that the Board improperly restricted the scope of the CON and lacked the power to extend the reporting requirement. Finding that the Board acted within its authority, the Vermont Supreme Court affirmed its decision. View "In re ACTD LLC, d/b/a The Green Mountain Surgery Center" on Justia Law
Mullinnex et al . v. Menard et al.
Defendants Michael Touchette and Centurion Healthcare brought an interlocutory appeal of a trial court's certification of a class of plaintiffs in a Vermont Rule 75 action. The certified class was comprised of people in the custody of the Vermont Department of Corrections (DOC), each of whom suffered from opioid-use disorder, and alleged defendants’ medication-assisted treatment (MAT) program did not meet prevailing medical standards of care as required by Vermont law. Defendants, the former Commissioner of the DOC and its contract healthcare provider, argued the trial court erred both in finding that plaintiff Patrick Mullinnex exhausted his administrative remedies before filing suit, and in adopting the vicarious-exhaustion doctrine favored by several federal circuits in order to conclude that Mullinnex’s grievances satisfied the exhaustion requirement on behalf of the entire class. Defendants also contended the trial court’s decision to certify the class was made in error because plaintiffs did not meet Rule 23’s numerosity, commonality, typicality, and adequacy-of- representation requirements. After review, the Vermont Supreme Court reversed, concluding that - even if the vicarious-exhaustion doctrine was appropriately applied in Vermont - it could not apply in this case because, on the record before the trial court, no member of the putative class succeeded in exhausting his administrative remedies. Because plaintiffs’ failure to exhaust left the courts without subject-matter jurisdiction, the Supreme Court did not reach defendants’ challenges to the merits of the class-certification decision. View "Mullinnex et al . v. Menard et al." on Justia Law
Lawson v. Central Vermont Medical Center
Plaintiff Elizabeth Lawson alleged she incurred damages as the result of an emergency room nurse informing a police officer that she was intoxicated, had driven to the hospital, and was intending to drive home. The trial court granted defendant Central Vermont Medical Center (CVMC) summary judgment based on its determination that nothing in the record supported an inference that the nurse’s disclosure of the information was for any reason other than her good-faith concern for plaintiff’s and the public’s safety. In this opinion, the Vermont Supreme Court recognized a common-law private right of action for damages based on a medical provider’s unjustified disclosure to third persons of information obtained during treatment. Like the trial court, however, the Supreme Court concluded CVMC was entitled to judgment as a matter of law because, viewing the material facts most favorably to plaintiff and applying the relevant law adopted here, no reasonable factfinder could have determined the disclosure was for any purpose other than to mitigate the threat of imminent and serious harm to plaintiff and the public. Accordingly, the Supreme Court affirmed the trial court’s judgment. View "Lawson v. Central Vermont Medical Center" on Justia Law
Quinlan v. Five-Town Health Alliance, Inc., dba Mountain Health Center
In consolidated appeals, an executor of an estate sued the clinic and physician's assistant who treated the decedent for wrongful death. The trial court dismissed the case because plaintiff failed to file a certificate of merit, as was required by statute. The refiled case was dismissed as untimely. The executor appealed to the Vermont Supreme Court, which reviewed the trial court's dismissals and found that dismissal was proper in both cases. View "Quinlan v. Five-Town Health Alliance, Inc., dba Mountain Health Center" on Justia Law
In re J.H.
The State appealed the Human Services Board’s decision reversing a determination by the Economic Services Division of the Department for Children and Families (DCF) that J.H. could not be considered for a subsidized qualified healthcare plan on the Vermont Health Connect exchange because she had health insurance available to her through her husband’s employer. The appeal turned on whether, under controlling federal law, healthcare insurance had to be considered available to J.H. through her husband’s employer even though her husband elected not to enroll in his employer’s plan and she herself could not enroll in the plan unless he did. After review, the Vermont Supreme Court affirmed the Board’s ruling that J.H. could be considered for a subsidized healthcare plan through Vermont Health Connect, but the Court based its decision on a different rationale than that given by the Board. "The focus of the Affordable Care Act, however, is not to bolster the employer-based healthcare system. As the United States Supreme Court has stated, the principal purpose of the Act is 'to increase the number of Americans covered by health insurance and decrease the cost of health care.'” View "In re J.H." on Justia Law
In re I.G.
In involuntarily hospitalized patient diagnosed with schizophrenia appealed a trial court’s order allowing for his involuntary medication. Patient argued that the court erred by: (1) incorrectly applying the competency standard under 18 V.S.A. 7625; and (2) failing to address whether a previously prepared document reflecting his desire not to be given psychiatric medication was a “competently expressed written . . . preference regarding medication” under 18 V.S.A. 7627(b). After review, the Supreme Court concluded that the trial court’s findings supported its conclusion under section 7625, but agreed that the trial court did not squarely address patient’s argument under section 7627 in its findings. Accordingly, the Court reversed on that issue and remanded for the trial court to issue findings addressing the applicability of section 7627(b). View "In re I.G." on Justia Law