Justia Health Law Opinion Summaries

Providers filed suit under 42 U.S.C. 1983 and the Medicaid Act, alleging that the Department violated constitutional and statutory law in retroactively recalculating their Medicaid reimbursement rates for the three-month period of January through March 2016.The Seventh Circuit reversed the district court's dismissal of the Providers' procedural due process claim, concluding that, at this early stage in the litigation, the allegations are sufficient to allege a violation of procedural due process. First, the court explained that the Providers retain a legitimate entitlement to a rate determined according to that formula, and any action to alter the rate must be conducted with due process. In this case, according to the amended complaint, the auditors failed to provide any notice of the alleged deficiencies prior to the final decision, and the Providers had no opportunity to submit additional documentation or other evidence following that decision. The court stated that the burden on the Department in providing such notice is no impediment, given that the procedures are already in the Code. The court explained that the Department need only follow those procedures rather than routinely bypass them. Therefore, in the absence of that basic and fundamental protection against unfair or mistaken findings, the court concluded that the Providers have sufficiently alleged a violation of due process. Accordingly, the court remanded for further proceedings. View "Rock River Health Care, LLC v. Eagleson" on Justia Law

The First Circuit dismissed this appeal from the district court's denial of Plaintiff's request for injunctive relief, holding that Plaintiff's claims were moot.During the initial stages of COVID-19 vaccine distribution, the State of New Hampshire implemented a plan to allocate its supply. The overall plan earmarked up to ten percent of vaccines to an "equity plan" to reach certain vulnerable individuals. Before he obtained a vaccine appointment, Plaintiff sued to challenge the equity plan, arguing that the plan illegally discriminated on the basis of race. The district court denied Plaintiff's request for a preliminary injunction, and Plaintiff appealed. The First Circuit dismissed the appeal, holding that where Plaintiff no longer had any stake in how New Hampshire allocates its abundant supply of vaccines, his request for a preliminary injunction was moot. View "Pietrangelo v. Sununu" on Justia Law

Plaintiff, a severely disabled child who suffered catastrophic injuries during her birth in 2015, filed suit against various medical providers for professional negligence. In 2019, the actions were settled for $3 million. DHCS, through its director, then asserted a lien on plaintiff's settlement to recover what DHCS paid for plaintiff's medical care through the state's Medi-Cal program. The trial court denied the lien, concluding that it was prohibited by the "anti-lien" provision of the federal Medicaid Act.The Court of Appeal concluded that the trial court erred in denying DHCS's lien. The court concluded that, while the anti-lien provision of the Medicaid Act generally prohibits liens against the property of Medicaid beneficiaries, other provisions of the Act carve out exceptions for settlements or judgments recovered from third-party tortfeasors, to the extent such settlements or judgments are attributable to payments made by the state for the beneficiaries' medical care. Accordingly, the court reversed and remanded for the trial court to determine what portion of the settlement properly is subject to DHCS's lien. View "L.Q. v. California Hospital Medical Center" on Justia Law

The Eighth Circuit affirmed the district court's grant of summary judgment in favor of HHS and CMS in an action brought by Northport, alleging that a regulation promulgated by CMS through notice and comment rulemaking is unlawful and should be set aside for violating the Administrative Procedure Act (APA), the Federal Arbitration Act (FAA), and the Regulatory Flexibility Act (RFA). The revised HHS regulations (Revised Rule) prohibits long-term care facilities from conditioning the admission of Medicare and Medicaid residents on their agreement to pre-dispute, binding arbitration and gives the residents the right to rescind the binding arbitration agreements, as well as certain other rights.The court concluded that the Revised Rule does not, in words or effect, render arbitration agreements entered into in violation thereof invalid or unenforceable, and thus it does not conflict with the FAA. Furthermore, the Revised Rule represents a reasonable accommodation of manifestly competing interests and is entitled to deference, and thus the district court properly concluded that it is not ultra vires. The court also concluded that the Revised Rule reflects CMS's reasoned judgment in light of competing considerations, and is not arbitrary or capricious. Finally, although CMS failed to provide a factual basis in support of its section 605(b) certification in the Revised Rule, the court concluded that failing to do so was harmless error. View "Northport Health Services of Arkansas, LLC v. U.S. Department of Health and Human Services" on Justia Law

Dr. Zenon Bednarski and his practice, Auburn Urgent Care, Inc. ("AUC"), appealed a circuit court judgment awarding Cortney Johnson ("Cortney"), as the administrator of the estate of Hope Johnson ("Hope"), deceased, $6.5 million. In October 2014, Hope and her mother visited Dr. Kerri Hensarling for evaluation and the prescription of a birth-control method. Hope's mother informed Dr. Hensarling that she had personally experienced multiple blood clots, and Dr. Hensarling ordered tests to determine if Hope was also at risk of experiencing blood clots. The test results revealed the presence of factor V Leiden, which contributes to the possibility of blood clotting. However, Dr. Hensarling failed to accurately determine the results of the test, and Hope and her mother were informed that the test results were negative for blood-clotting factors. Dr. Hensarling prescribed hormonal birth-control pills for Hope, the taking of which in combination with the presence of factor V Leiden would increase her risk of experiencing blood clots. Hope began taking the birth-control pills as prescribed, without knowledge of her increased risk for blood clots. In December 2014, Hope visited the AUC clinic, complaining of shortness of breath, chest pains, coughing, a headache, and a sore throat. Dr. Bednarski diagnosed Hope with bronchitis and prescribed an antibiotic medication. Hope returned to the AUC clinic a few days later, complaining of a much worsened condition, with sharp chest pains and extreme shortness of breath. A blood test was conducted, and Hope was diagnosed with leukocytosis and dyspnea and was prescribed an inhaler. The next morning, Hope died of a pulmonary blood clot. In May 2016, Hope's father, Cortney, as the administrator of her estate, filed suit, naming as defendants Dr. Hensarling and her practice, and Dr. Bendarski and AUC. Cortney settled with Dr. Hensarling; the Bednarski defendants unsuccessfully moved for a judgment as a matter of law at the close of Cortney's case-in-chief. The jury returned a general verdict in favor of Cortney against the Bednarski defendants. Finding that the Bednarski defendants failed to demonstrate they were entitled to a judgment as a matter of law, the Alabama Supreme Court affirmed the trial court. View "Bednarski v. Johnson" on Justia Law

The South Carolina Supreme Court granted petitioners' request for a declaration with respect to Provisos 1.108 and 1.103 of the 2021-2022 Appropriations Act1 were invalid. Proviso 1.108 (enacted June 22, 2021,) was directed to the South Carolina Department of Education for South Carolina's kindergarten through 12th grade (K-12) public schools, and banned face mask mandates at any of its education facilities. Proviso 1.103 permitted school districts to offer a virtual education program for up to five percent of its student population based on the most recent 135 day ADM [(average daily membership)]count without impacting any state funding. For every student participating in the virtual program above the five percent threshold, the school district would not receive 47.22% of the State per pupil funding provided to that district as reported in the latest Revenue and Fiscal Affairs revenue per pupil report pursuant to Proviso 1.3. Although the School District did not require its students to wear masks in its education facilities, it claimed Proviso 1.108 conflicted with local laws regarding mask requirements in schools and placed the School District in an untenable position. In addition, Petitioners claimed the School District reached the five percent cap for virtual enrollment and did not wish to risk losing state funds by exceeding the cap in Proviso 1.103. The School District asked for guidance on its options and obligations regarding face masks and virtual education. Petitioners contended: (1) Provisos 1.108 and 1.103 violate the one-subject rule of article III, section 17 of the South Carolina Constitution; (2) the plain language of Proviso 1.108 permitted the School District to implement and enforce mask mandates in its education facilities if the School District did so with funds not appropriated or authorized in the 2021-2022 Appropriations Act; (3) Provisos 1.108 and 1.103 improperly invade the authority of local school boards; and (4) Provisos 1.108 and 1.103 denied equal protection to students and violated their constitutional right to free public education. The Supreme Court held the provisos were constitutional, and rejected the remaining challenges to the validity of the provisos. View "Richland County School District 2 v. Lucas" on Justia Law

The Supreme Court held that Conn. Gen. Stat. 28-9 provided authority for Governor Ned Lamont to issue executive orders during the civil preparedness emergency he declared pursuant to the statute in response to the COVID-19 pandemic and that the statute passes constitutional muster.In response to the pandemic, Governor Lamont issued certain executive orders that limited various commercial activities at the State's bars and restaurants. At issue in this case was whether the COVID-19 pandemic constituted a "serious disaster" pursuant to section 28-9 and whether that statute conferred authority on the governor to issue the challenged executive orders. The Supreme Court held (1) Governor Lamont did not exceed his statutory authority when he issued the challenged orders; and (2) section 28-9 is not an unconstitutional delegation of the General Assembly's legislative powers to the governor. View "Casey v. Lamont" on Justia Law

The Court of Chancery denied a request for an injunction to compel a healthcare provider to treat a hospitalized COVID-19 patient with ivermectin, holding that Plaintiff failed to show she was entitled to the relief she sought and failed to identify any established right that would entitle her to such relief.When a COVID-19 patient was admitted to the hospital for the virus, the patient requested to be treated with ivermectin. The request was denied. Plaintiff, the patient's wife, obtained a prescription from a doctor, but the hospital refused to administer the ivermectin prescription. Plaintiff filed a verified complaint for injunctive and declaratory relief requiring the hospital to administer the prescribed ivermectin. The Court of Chancery held that patients do not have a right to a particular treatment, and medical providers have a duty to treat in accordance with their standard of care. Because ivermectin was not part of the standard of care for the COVID-19 virus, Plaintiff was not entitled to relief. View "DeMarco v. Christiana Care Health Services, Inc." on Justia Law

In this guardianship and conservatorship action, the Supreme Court affirmed the judgment of the circuit court granting the conservator's motion for approval of a settlement agreement reached in a separate civil action brought by the conservator against the protected person's son and daughter-in-law, holding that the circuit court did not err.Three of the protected person's other children objected to the conservator's motion for approval of the settlement agreement, requesting that they be allowed to present live testimony at the hearing on the motion. The circuit court denied the request and, after a hearing, granted the conservator's motion for approval of the settlement. The Supreme Court affirmed, holding that the circuit court did not err in denying an evidentiary hearing and in approving the settlement agreement. View "In re Guardianship & Conservatorship of Adam" on Justia Law

The Supreme Court reversed the order of the district court committing N.A. to Montana State Hospital (MSH) for a period of up to ninety days, holding that the district court committed reversible error when it allowed testimony by video conferencing at the commitment hearing over N.A.'s objection.The State filed a petition for N.A.'s involuntary commitment alleging that N.A. presented an imminent risk of harm to herself based upon her statements of suicidality. After an evidentiary hearing, the district court found that N.A. suffered from a mental disorder and required commitment and ordered that N.A. be involuntarily placed at MSH in Warm Springs for a period of up to ninety days. The Supreme Court reversed, holding that the district court committed reversible error when it allowed testimony by video conferencing over N.A.'s objection. View "In re N.A." on Justia Law