Justia Health Law Opinion Summaries

The issue presented for the New Mexico Supreme Court's review centered on whether the State’s public health orders (PHOs) could support a claim for just compensation under either Article II, Section 20 of the New Mexico Constitution or Section 12-10A-15 of the Public Health Emergency Response Act (PHERA) (2003, as amended through 2015). With respect to the constitutional question, the Court held that the PHOs could not support a claim for a regulatory taking requiring compensation. With respect to the statutory question, it Court held the PHOs’ restrictions on business operations regarding occupancy limits and closures could not support a claim for just compensation. Furthermore, claimants for just compensation under the PHERA had to exhaust the administrative remedies set forth in Section 12-10A-15(B), (C) before seeking judicial relief. View "New Mexico v. Wilson" on Justia Law

Kelly Bowman and her husband Vernon, brought a medical malpractice suit against St. John Hospital and Medical Center, Ascension Medical Group Michigan, and Tushar Parikh, M.D., alleging that Parikh erroneously advised Kelly Bowman that a growth in her breast was benign, on the basis of his interpretation of a 2013 mammogram. For the next two years, she felt the lump grow and sought follow-up care. In April 2015, she underwent a biopsy, which revealed “invasive ductal carcinoma with lobular features.” In May 2015, she was diagnosed with metastatic breast cancer and underwent a double mastectomy, which revealed that the cancer had spread to a lymph node. In August 2016, soon after learning that the cancer had spread to her bone marrow, she sought a second opinion from a specialist and learned that the 2013 mammogram might have been misread. Defendants moved for summary judgment, contending the Bowmans' complaint was untimely under the applicable statute of limitations. The trial court denied the motion, and defendants appealed. The Court of Appeals reversed in a split decision. During the pendency of the proceedings, Kelly Bowman died, and her estate was substituted as plaintiff. The question for the Michigan Supreme Court's opinion was on whether Kelly Bowman "should have discovered the existence of [her claim] over six months before initiating proceedings. The Court answered, "no:" the record did not reveal Kelly Bowman should have known before June 2016 that her delayed diagnosis might have been caused by a misreading of the 2013 mammogram. "the available facts didn’t allow her to infer that causal relationship, and the defendants have not shown that Ms. Bowman wasn’t diligent. The present record does not allow us to conclude, as a matter of law, that Ms. Bowman sued over six months after she discovered or should have discovered the existence of her claim. And so we reverse the Court of Appeals’ judgment and remand to the trial court for further proceedings." View "Estate of Kelly Bowman v. St. John Hospital & Med. Ctr." on Justia Law

The estate of a severely disabled woman sued her in-home care providers for negligence in causing her death. The superior court granted summary judgment in favor of the providers, ruling that the estate was required to support its negligence claim with expert testimony, and failed to do so. After review, the Alaska Supreme Court held that the estate was not required to present expert testimony to establish a breach of the duty of care because the estate’s theory of fault was one of ordinary negligence that did not turn on the exercise of professional skill or judgment. “The estate’s theory of causation, by contrast, is complex and must be supported by the opinion of a medical expert. But the treating physician’s deposition testimony is sufficient evidence of causation to survive summary judgment.” The Court therefore reversed the superior court’s decision and remanded for further proceedings. View "Culliton v. Hope Community Resources, Inc." on Justia Law

Bellin brought a putative class action under 42 U.S.C. 1983, alleging that managed long-term care plans (MLTCs) that contract with New York State violate Medicaid beneficiaries’ due process rights by denying them the right to appeal an MLTC’s initial determination of the personal care services hours the MLTC will provide the beneficiary if they choose to enroll with the MLTC. Bellin also alleged that beneficiaries are entitled to this appeal right, and to notice of the right, under federal statutory and constitutional law. Bellin brought her claims against ElderServe, an MLTC that she alleges denied her these rights, and Zucker, in his official capacity as Commissioner of the New York State Department of Health, for his alleged failure to enforce these asserted rights.The Second Circuit affirmed the dismissal of Bellin’s federal law claims on the grounds that the relevant federal statutes do not provide Medicaid beneficiaries a right to appeal initial personal care services hours determinations. The court vacated the dismissal of Bellin’s Fourteenth Amendment due process claims; Bellin plausibly alleged a constitutionally protected property interest in the determination of her personal care services hours. View "Bellin v. Zucker" on Justia Law

Connecticut Governor Ned Lamont and the state's Commissioner of the Department of Emergency Services and Public Protection James Rovella appeal from the district court's order granting a preliminary injunction ordering that the Governor repeal, in light of the COVID-19 pandemic, a provision to suspend collection of fingerprints in connection with applications for authorization to obtain firearms. The injunction also ordered that the Governor repeal that provision of the executive order and that the DESPP Commissioner resume fingerprinting services at that agency.The Second Circuit vacated the preliminary injunction and concluded that: (1) with respect to the individual plaintiffs, the preliminary injunction motion became moot in the district court; and (2) CCDL lacked organizational standing. Because the motion was moot and CCDL lacked standing, the district court had no jurisdiction to issue the preliminary injunction. View "Connecticut Citizens Defense League, Inc. v. Lamont" on Justia Law

Talevski, living with dementia, was a patient at Valparaiso Care, a state-run Indiana nursing facility. His wife filed suit under 42 U.S.C. 1983 for violations of the Federal Nursing Home Reform Act (FNHRA), 42 U.S.C. 1396r, which establishes the minimum standards of care to which nursing-home facilities must adhere in order to receive federal funds in the Medicaid program. Some of the requirements relate to residents’ rights, including two cited by Talevski, the right to be free from chemical restraints imposed for purposes of discipline or convenience rather than treatment and the right not to be transferred or discharged unless certain criteria are met.The district court dismissed the action, finding that FNHRA does not provide a private right of action that may be redressed under 42 U.S.C. 1983. The Seventh Circuit reversed. The section 1983 remedy broadly encompasses violations of federal statutory as well as constitutional law. The court noted the express rights-creating language in the statute and that FNHRA is not the type of comprehensive enforcement scheme, incompatible with individual enforcement. The right protected by the statute is not so vague and amorphous that its enforcement would strain judicial competence. View "Talevski v. Health and Hospital Corp. of Marion County" on Justia Law

The primary issue in consolidated appeals was the scope of an automobile insurance policy’s arbitration provision. Two insureds with identical Allstate Insurance Company medical payments and uninsured/underinsured motorist (UIM) insurance coverage settled with their respective at-fault drivers for applicable liability insurance policy limits and then made medical payments and UIM benefits claims to Allstate. Allstate and the insureds were unable to resolve the UIM claims and went to arbitration as the policy required. The arbitration panels initially answered specific questions submitted about the insureds’ accident-related damages. At the insureds’ requests but over Allstate’s objections, the panels later calculated what the panels believed Allstate ultimately owed the insureds under their medical payments and UIM coverages and issued final awards. Allstate filed superior court suits to confirm the initial damages calculations, reject the final awards as outside the arbitration panels’ authority, and have the court determine the total amounts payable to the insureds under their policies. The judge assigned to both suits affirmed the final arbitration awards; Allstate appealed both decisions. The Alaska Supreme Court determined the arbitration panels had no authority to determine anything beyond the insureds’ damages arising from their accidents and because Allstate withheld its consent for the panels to determine anything else, the Court reversed the superior court’s decisions and judgments. The Supreme Court also reversed some aspects of the superior court’s separate analysis and rulings on legal issues that the panels improperly decided. Given (1) the arbitration panels’ damages calculations and (2) the Supreme Court's clarification of legal issues presented, the cases were remanded for the superior court to determine the amount, if any, Allstate had to pay each insured under their medical payments and UIM coverages. View "Allstate Insurance Company v. Harbour" on Justia Law

Saunders worked as a bus attendant for the Washington, D.C., school system, helping students with special needs and those in wheelchairs on and off the bus. On January 7, 2014, she slipped and fell on ice at work, suffering a hip contusion and back pain. Saunders never returned to work but filed a disability claim with the Social Security Administration six months after her fall. She obtained multiple opinions from Dr. Williams, her generalist, and Dr. Liberman, her neurologist. Saunders received disability benefits from the Washington, D.C., workers’ compensation board.After Saunders’s federal disability claims were denied an ALJ held a hearing and concluded that she was not disabled. The ALJ gave “some” weight to certain medical opinions but “no weight” to others, including Dr. Lieberman’s opinion that Saunders was permanently disabled. The ALJ placed considerable weight on the vocational expert’s testimony and found that someone with Saunders’s functional capacity could perform her past work as generally performed in the national economy. The district court affirmed. The D.C. Circuit remanded. The ALJ erroneously failed to consider certain medical opinions, particularly those of Saunders’s treating physician. View "Saunders v. Kijakazi" on Justia Law

Indian Health Services (IHS) previously provided health care to the federally recognized Tribe through a clinic in McDermitt, Nevada, and an emergency medical services program. Federal law entitles members of other tribes also to receive care at the clinic. In 2016, the Tribe notified IHS of its intent to assume responsibility for the clinic and part of the EMS program. The Tribe requested about $603,000 annually to provide medical care at the clinic. IHS awarded only about $53,000. The parties disputed whether the Tribe was entitled to all the funds that IHS previously had spent on the clinic or whether the agency could withhold the portion of those funds to benefit members of another tribe. IHS allocates generally funding among health care programs according to the number of eligible users living in the tribe's assigned. IHS funded the clinic to benefit the Tribe and the nearby Winnemucca Tribe. IHS argued that it could not include Winnemucca’s “tribal share” of clinic funding without that tribe’s consent. The parties disputed the treatment of third-party income from Medicare and Medicaid, which the Tribe now collects directly. The Tribe assumed full control of the clinic, filed suit, and obtained summary judgment.The D.C. Circuit reversed. The Indian Self-Determination and Education Assistance Act, 25 U.S.C. 5321(a), did not permit withholding of the amount budgeted as benefitting members of the second tribe but did permit withholding an amount equal to the Medicare and Medicaid reimbursements. View "Fort McDermitt Paiute and Shoshone Tribe v. Becerra" on Justia Law

The Supreme Court affirmed in part and vacated in part the judgment of the circuit court rejecting Plaintiffs' claims challenging the refusal by the Department of Social Services (DSS) to provide MO HealthNet coverage, holding that the circuit court erred in declaring Mo. Const. art. IV, 36(c) constitutionally invalid.Plaintiffs, three Missourians eligible for MO HealthNet coverage under article IV, section 36(c), brought this action challenging the DSS's refusal to provide coverage on the grounds that the General Assembly failed to appropriate adequate funding. The circuit court rejected the claims, finding that the ballot initiative that enacted article IV, section 36(c) violated Mo. Const. art. III, 51, which prohibits initiatives from appropriating money without creating revenue to fund the initiative. The Supreme Court affirmed in part and vacated in part the circuit court's judgment, holding (1) article IV, section 36(c) does not appropriate money and does not remove the General Assembly's discretion in appropriating money to MO HealthNet; and (2) therefore, the circuit court erred in concluding that article IV, section 36(c) violates article III, section 51. View "Doyle v. Tidball" on Justia Law