Justia Health Law Opinion Summaries

Petitioner Andrew Panaggio appealed a New Hampshire Compensation Appeals Board (Board) determination that respondent, CNA Insurance Company (the insurer), could not be ordered to reimburse him for his purchase of medical marijuana because such reimbursement would have constituted aiding and abetting his commission of a federal crime under the federal Controlled Substances Act (CSA). When Panaggio appealed the insurer’s denial to the New Hampshire Department of Labor, a hearing officer agreed with the insurer. Panaggio appealed the hearing officer’s decision to the Board, which unanimously found that his use of medical marijuana was reasonable and medically necessary. Nonetheless, the Board upheld the insurer’s refusal to reimburse Panaggio, concluding that “the carrier is not able to provide medical marijuana because such reimbursement is not legal under state or federal law.” The New Hampshire Supreme Court surmised the issue on appeal raised a question of federal preemption, "which is essentially a matter of statutory interpretation and construction." Although it was an issue of first impression for the New Hampshire Court, other courts considered whether the CSA preempted a state order requiring reimbursement of an employee’s purchase of medical marijuana. Panaggio reasoned that “[b]ecause New Hampshire law unambiguously requires the insurer to pay for the claimant’s medically related treatment,” an insurer that reimburses a claimant for the purchase of medical marijuana acts without the volition required by the federal aiding and abetting statute. The insurer asserted Panaggio’s argument leads to an absurd result, observing that “[c]onflict preemption applies because state law requires what federal law forbids.” The New Hampshire Supreme Court ultimately concluded the CSA did not make it illegal for an insurer to reimburse an employee for his or her purchase of medical marijuana. "[A] Board order to reimburse Panaggio does not interfere with the federal government’s ability to enforce the CSA. Regardless of whether the insurer is ordered to reimburse Panaggio for his medical marijuana purchase, the federal government is free to prosecute him for simple possession of marijuana under the CSA." Under these circumstances, the Court concluded the “high threshold” for preemption “is not met here.” The Board's decision was reversed and the matter remanded for further proceedings. View "Appeal of Andrew Panaggio" on Justia Law

The Court of Appeal issued a peremptory writ of mandate directing the trial court to set aside its order enjoining the County from enforcing its orders to the extent they prohibit outdoor dining due to the COVID-19 pandemic until after conducting an appropriate risk-benefit analysis. During the pendency of the petition, the County lifted its prohibition based on infection rates declining and ICU availability increasing. However, the court concluded that these cases are not moot because conditions may change and the County may re-impose its outdoor restaurant dining ban.The court held that courts should be extremely deferential to public health authorities, particularly during a pandemic, and particularly where, as here, the public health authorities have demonstrated a rational basis for their actions. In this case, the County's order banning outdoor dining is not a plain, palpable invasion of rights secured by the fundamental law and is rationally related to limiting the spread of COVID-19.Even assuming that Mark's, a restaurant, has a First Amendment right to freedom of assembly, or that Mark's has standing to bring a First Amendment challenge on behalf of its patrons or employees, the court held that the order does not violate Mark's purported First Amendment right to freedom of assembly or that of its patrons. The court explained that the County's order does not regulate assembly based on the expressive conduct of the assembly; it is undisputed that limiting the spread of COVID-19 is a legitimate and substantial government interest; and the order leaves open alternative channels for assembling. Accordingly, the court entered a new order denying the Restauranteurs' request for a preliminary injunction. View "County of Los Angeles Department of Health v. Superior Court of Los Angeles County" on Justia Law

Smith suffered an injury from a car accident, retained an attorney for a personal injury lawsuit, and authorized her attorney to obtain her healthcare information. The attorney requested Smith’s medical records from MHS, on three occasions. RecordQuest, not MHS, answered those requests and charged Smith’s attorney (who paid on her behalf) a $20.96 handling fee and an $8.26 certification fee each time.Smith brought a class action, alleging these charged fees contravened the permissible fee schedule set out in Wis. Stat. 146.83(3f)(b) for healthcare records requests and resulted in the unjust enrichment of RecordQuest. The district court dismissed both claims, reasoning that the statute imposes a duty upon only healthcare providers.” RecordQuest is not a healthcare provider but is the agent of MHS; “no principle of agency law holds that a principal’s liability is imputed to the agent when the agent performs the act that results in the principal’s liability.” Smith’s unjust enrichment claim failed because any unjust benefit that Smith allegedly conferred to RecordQuest belonged to MHS.The Wisconsin Court of Appeals subsequently expressly disagreed with the district court’s analysis of Smith’s statutory claim. The Seventh Circuit reversed the dismissal of the statutory claim but affirmed as to Smith’s unjust enrichment claim. Under section 146.83(3f)(b), Smith has a remedy at law for any “injustice” that allegedly resulted from excessive payments; the equitable remedy of unjust enrichment is derivative of and predicated upon the statutory claim. View "Smith v. RecordQuest LLC" on Justia Law

The Fifth Circuit withdrew its prior opinion and substituted the following opinion.The States filed suit against the United States, raising constitutional challenges to Section 9010 of the Affordable Care Act (ACA), as well as statutory and constitutional challenges to an HHS administrative rule (Certification Rule).As a preliminary matter, the Fifth Circuit affirmed the district court's ruling that the States had standing. The court 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 held that the Certification Rule and Section 9010 are constitutional and lawful. As a result, the court explained that there can be no equitable disgorgement, regardless of whether such a remedy would be otherwise appropriate. Accordingly, the court affirmed the district court's judgment on the Section 9010 claims and reversed the district court's judgment that the Certification Rule violated the nondelegation doctrine. Therefore, the court rendered judgment in favor of the United States. Because the court held that 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. United States" on Justia Law

Plaintiff-appellee Christina Smith was the mother of Joshua England. Her claims arose from the death of England from a ruptured appendix in May 2018, while England was housed at the Joseph Harp Correctional Center (JHCC), an Oklahoma Department of Corrections (ODOC) facility in Lexington, Oklahoma. England was a 21-year-old prisoner at JHCC who was a few months away from release when he submitted multiple sick call requests. At the fifth such request, England complained his stomach hurt and he was short of breath. Unable to bear the pain while waiting at the clinic, England died in his cell from a ruptured appendix with acute peritonitis. Defendants-Appellants Joe Allbaugh, the Director of the Department of Corrections at the time this claim arose, and Carl Bear, the Warden of Joseph Harp Correctional Center (collectively, Defendants) appealed the district court’s order denying their motion to dismiss Smith's subsequent lawsuit relating to England's death on grounds of qualified immunity. The Tenth Circuit reversed, finding Smith alleged only that JHCC medical staff failed to follow procedure, not that Defendants failed to enforce those policies. Furthermore, the Court determined Smith failed to plead sufficient factual allegations to support deliberate indifference on the part of these defendants. Likewise, Smith failed to sufficiently plead Defendants improperly hired, supervised, and retained certain medical staff employees. View "Smith v. Allbaugh" on Justia Law

When Medicare overpays hospitals, it offsets that mistake by reducing future payments. By 2013, Medicare was out $11 billion because of new diagnostic codes and bookkeeping that did not keep up. Congress required that the Secretary of Health and Human Services recoup that amount by the end of fiscal year 2017 by reducing the base rate (standardized amount) paid for inpatient care and directed the Secretary to adjust the base rate by 0.5% each year through 2023, 129 Stat. 87, 163 (2015). Subsequently, while reviewing the 2017 budget, the Secretary realized that a -3.2% adjustment would leave the agency short of its $11 billion goal and announced a -3.9% adjustment. Congress then told the Secretary to increase the base rate by 0.4588% (not 0.5%) in 2018, 130 Stat. 1033, 1320 (2016). In 2017, the Secretary adjusted the base rate -3.9%. The agency met its goal. In 2018, the Secretary adjusted the base rate -3.4412%.Medicare providers sued, arguing that the Secretary should have reversed that expedient at the end of 2017 rather than carry it over into 2018, costing the hospitals $840 million in lost payments. The D.C. Circuit affirmed the dismissal of the suit. While the hospitals felt a “significant financial impact” from the -0.7% adjustment, Section 7(b)(5) bars judicial review of adjustments made under the Act. View "Fresno Community Hospital and Medical Center v. Cochran" on Justia Law

The Supreme Court affirmed the circuit court's order extending K.E.K.'s involuntary commitment pursuant to Wis. Stat. 51.20(13)(g)3., holding that Wis. Stat. 51.20(1)(am), the statute upon which Waupaca County relied on to prove K.E.K.'s dangerous, is facially constitutional and that K.E.K.'s as-applied constitutional challenges failed.K.E.K. challenged the commitment extension on appeal, arguing that section 51.20(1)(am) was both facially unconstitutional and unconstitutional as applied because it does not require a sufficient showing of current dangerousness, as exhibited by recent acts of dangerousness. The court of appeals denied relief. The Supreme Court affirmed, holding that the statute is facially constitutional and that K.E.K.'s as-applied constitutional challenges, which the Court noted were disguised sufficiency of the evidence challenges, also failed. View "Waupaca County v. K.E.K." on Justia Law

Cutchin’s wife and daughter were killed in an automobile accident that occurred when another driver, Watson, age 72, struck their vehicle. Cutchin alleges that Watson’s driving ability was impaired by medications she had been prescribed, including an opioid. Cutchin filed a malpractice suit against Watson’s healthcare providers, charging them with negligence for an alleged failure to warn Watson that she should not be driving given the known motor and cognitive effects of those medications. After the providers and their malpractice insurer agreed to a settlement of $250,000, the maximum amount for which they can be held individually liable under the Indiana Medical Malpractice Act (MMA), Cutchin sought further relief from the Patient’s Compensation Fund, which acts as an excess insurer. The Fund argued that the MMA does not apply to Cutchin’s claim and that he is barred from seeking excess damages from the Fund. The district court agreed.The Seventh Circuit certified to the Indiana Supreme Court the questions: Whether Ithe MMA prohibits the Fund from contesting the Act’s applicability to a claim after the claimant concludes a court‐approved settlement with a qualified healthcare provider, and whether the MMA applies to claims brought against individuals (survivors) who did not receive medical care from the provider, but who are injured as a result of the provider’s negligence in providing medical treatment to someone else. View "Cutchin v. Robertson" on Justia Law

The Supreme Judicial Court vacated the judgment of the superior court denying A.S.'s petition for a writ of habeas corpus seeking release from his detention, holding that the superior court erred when it determined that the detention was lawful.A.S. was brought by law enforcement officers to the LincolnHealth Miles Hospital Campus and was held in the hospital's emergency department for thirty days. During that time, LincolnHealth did not seek or obtain judicial endorsement of its detention of A.S., as required by Me. Rev. Stat. 34-B, 3863. A.S. sought habeas corpus relief, arguing that LincolnHealth violated the statutory procedure for emergency involuntary hospitalization. The superior court denied the petition. The Supreme Court vacated the superior court's judgment, holding (1) A.S.'s detention was unauthorized because the hospital did not comply with section 3863; and (2) A.S.'s due process rights were violated when the superior court applied a standard of preponderance of the evidence, rather than clear and convincing evidence, to determine whether A.S. posed a likelihood of serious harm at the time of the habeas hearing. View "A.S. v. LincolnHealth" on Justia Law

Voters in the City of Enid presented a recall petition to City of Enid officials. The petition sought to recall plaintiff-appellant, City Commissioner Ben Ezzell for his support of a city wide mask mandate to combat the COVID epidemic. Ezzell objected to the recall petition, alleging that because the recall petition did not comply with the requirements of 34 O.S. 2011 section 3 and 34 O.S. Supp. 2015 section 6, which related to signature collection, the recall petition was insufficient. After a hearing, the trial court denied Ezzell's protest and determined that the petition was sufficient under the City Charter of Enid recall process. Ezzell appealed. The Oklahoma Supreme Court held there was no conflict between the City Charter recall process, and the additional state requirements of 34 O.S. 2011 sec. 3 and 34 O.S. Supp. 2015 sec. 6, the state statutes governed, but were not properly followed. The recall petition was therefore insufficient on its face pursuant to Clapsaddle v. Blevins, 66 P.3d 352, and its predecessors. View "Ezzell v. Lack" on Justia Law